HomeMy WebLinkAboutBLD2024-00300 - BLD CD Environmental Health Review - 4/5/2024 MASON COUNTY
COMMUNITY DEVELOPMENT <r2
F mRu BuildinE.PIxNNin MAR — 6 2024 G
BUILDING PERMIT APPUCATiCU 5 W. Alder Street y �O
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION: 2�
NAME: //AILL }L'-5 HXsL NAME: —&�w .A
MAILING ADDRESS:j2fRO_.7Fj Ond 20 MAILING ADDRESS: \�
CITY: AGTDPI STATE:C_LP:9 f/D CITY: STATE: ZIP: J'
PHONE#I:112bil8(0-0719 PHONE: CELL:
PHONE#i: 9 EMAIL
EMAII.: (/ESL(:d-04(aA L&I REG#—
PRMARY NTACF: OWNER21' CONIRACToat] OTH®l❑
NAME L�M�Y'S(.a Aor.CDM
SF L EMAE
MABANGADDREM'93P CRY kLTv STATE ZIP QT.CJo Y
PHONE P- C®.L q. P(O —r!>4 ,p
50
PARCEL INFORMATION:
PANCELNII.IBER(12MONumber) 22-2-23'50-01022- ZONINO m
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LEGAL DESCRIRTION(Abbrevieled) FIRH DISI'RICI O O�
- SITE ADDRESS 'T SY /= jr W-S EA/0 UQSPV CITY 8 w ✓-
DIRECTIONS TO SITE ADDRESS
IS TBBPROIECE�3OOn OFSLOPE(S)GREATERTHANId%: YESQ NOg S1NOWLOADL—Pd
ISPROPERTYI LAKE OB FTOET�FGLLOWBVG: lch WEILA D[
SALTWAl1Rl❑ LAKE®` RIVER/CRHBR❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑
TYPE OF WORK: NEW M ADDTDON p ALTERATION 0 REPAIR p OTHER ❑
USE OF SIRU=RE(go.ahaeo,�r<w¢w.ml Borg.pc) �jf<rnc.G,F
BUSE: PROd RY® SEASONAL❑ NUMBEAOFBEDROOMS_NUMBEROFBATHROOMS 1-
HEATEDSTRUCTURET YES(wwda u® YES(Poover WO NOD
DESCRIBEWORKLO 5 z.u-;r A-CW 5Tea5� c� 6a+e2:N-6MC
SQUARE FOOTAGE:aw¢,aw+d
ISYELO RR&7-3 q.ft DD)FLOOR 726 eq.@ 3RD FLOOA A'� q.ft HAS@.ffitf 6� rq.ft
DBCK -Or q.8 COVERED DECK 42R q,@ S[ORAGE .B� q.@ OTHER-9-1q.@
cARAGE�K.@%nm:ned D Dft-�[3 CARPORT_jL _q.@%rcud [] DaRa+edf]
MANUFACTURED HOME INFORMATION: VCOPIESOF TEE FLOOR PLAN REQUIRED-
MARE A1Ik MODEL YEAR LENGTH
WMgT BEDROOMS BATHS SERLU.NMBEP.
ENV E RONMEN'FAL HEALTH:
MWAGESEWERSOD CE: SEPncf ssweR❑ I NEWS EXISTING❑
PL WGINSTRDCNIRE, YES® NO jY,,aa aNach coodekd Wate,Adegee,Forw
PERIMFTE.N/POUNDATIONDRA BPROPOSEDT YES❑ NO[] MWMGSQ.FT.
EXISTWGBEDRMNB PROPOSEDBEDROOMS L TOTAL BEDROOMS Z
OWNER mk-mled,s em submYSbn n51R4o a 9c9vgk o�brapemi[mWaMn.A�Owlel2emw<Ot<IItl1Y4y
EipneWre below.l0erbre Mel BT be ama,BM I NMa Eetlan Mel do Me,wM1 m paWM.l b ee
oMalna]pem65ionhan eY Oie rcws¢ary poNm.induEbp eeY ememem M1dEv a p Nin dlnlwW m]erElrp MY go)act lbe a'.mxwbyl
�re5enlaEre,npe¢wY tlN Me InlamaYn wwgtl i5 eccurW aiE 9m andeY¢ec d Muon Cw^M eax¢¢bCc eNns EnmG!PW¢AY
gab veMelmrelewem M¢Pecl<m.ml5 pemin2Pglmbon became nulBwla xww¢a,euMor®tl on.5wmonNw�mecea wenm lNl
aeys w PwreMxAawwM i¢¢ewem.e b,e Pew d lea w,.
PROOF OF CONTINUATION OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTRATY OF THIS
PERMR APPLICATION OF 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MABON
_ COUNTY WOE U.N.0)
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DEPARTMENTAL REVIEW APPROVED DATE DEND:D DATE TAGSMTFSiOONDTDONS
BUI.DNODEPARTMENL
PLANNING DEPARTMENT
FIRE MARSHAL
PUBLIC HEALTH
EH APPROVED NOT AN APPROVED SEPTIC DESIGN
Must use SWG 2021-00355 lot septic installaton
EH setbacks
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