HomeMy WebLinkAboutMEP Application - 8/16/1999 PERMIT NO.: / (�
DATE RECEIVED: U iL I 1
MASON COUNTY
DEPARTMENT OF COMMUNITY DEVELOPMENT
INTERIM RESOURCE ORDINANCE (Chapter 17.01 MCC)
411 N. 5TH Street/P.O. Box 578,Shelton,Wa 98584
ENVIRONMENTAL P MIT APPLICATION
MASON ENVIRONMENTAL PERMIT CONDITIONAL USE ❑ VARIANCE ❑
The purpose of the Interim Resource Ordinance is to protect Mason County's natural resource lands and critical areas and
is under the authority of Chapters 36.32, 36.70A, 39.34, 58.17, 76.09, 84.33, 84.34 and 90.58 RCW.
PLEASE PRINT FEE:$110.00
1. Owner: AM C--1 ` W UoDr a)2P Owner Mailing Address: Q. 0 c x
Site Address: 3cTWEF' 4 tiu,'`i#3 I City: 6uLr- Ft 0 State: U f Zip:4 - `—?
City: q uPL State: Zip: `2 Lien/Title Holder: K, T s.,N I- 3 A t tc
Phone: 7 � 5 . Fire District#2_ Address:
City: 3el-v�,4 I c State: U0q Zip:
2. Parcel Number: 1 23 Z� _ L43 _ 6012-6 Legal description: Tk Z G F 5o - S c
TY� I U S i.cJ S c
Parcel Size:r-4FA011' 123 20' `f - ON66
3. Directions to Site: FF
I E ulH S r �al - ►'N U 1. i J
I T
4. State what sections required a permit:
Long-Term Commercial Forest, Chapter 17.10.060; Inholding Lands, Chapter 17.01.062;
Mineral Resource Lands , Chapter 17.01.066; Wetlands, 17.01.070; Critical Aquifer Recharge,
Chapter 17.01.080; _Aquatic Management Areas, Chapter 17.01.110; Frequently Flooded Areas,
Chapter 17.01.090; Landslide Hazard Areas, 17.01.100; Seismic Hazard Areas, Chapter 17.01.102;
Erosion Hazard Areas, 17.01.104.
5. Idybfy current use of property with existing improvements: ,
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CVZ�`1C F P7v P2�y10VS�`i lL1ri 1N~r0 A )2" CVLVj-67 Tr-IAT wEN1
l Tl-) r G -i F Lb
A ZH L,/ (AT(t) 1215I U JIt- L —Zap 't= HiLO P/IYZK),ul u�T.
6. Identify and describe the proposed project, including the type of materials to be used, construction methods,
principal dimensions, and other pertinent information (Attach additional sheets if needed):
01L, UU 1 A TIE J Cfl-YC " StN &f r NU 1 -1> > L-1rr
,Z`I '' .$l.:flUz `DM00"y0 F S' ( ULI/E-JQ-y11'(6 WI-rH T'1?t
CAICti 6ASirt T C.Ot2..NtYz U� E*k,2,T)1-(& C-kt=t AW-Kit46 Ly1
RN1� �7 Ic�ti►� `► n y1S�1KLi ��i " C0LV0Z7Q) CQEl`K
7. Any water on or adjacent to property: Saltwater Lake River Pond Wetland
Seasonal Runoff ` Other
8. Will there be an alteration of a wetland and/or wetland vegetation area? Yes NoX I
9. If septic is located on project site, include records.
Connect to septic? Community Septic? Public Water Supply? Well?
10. Type of Job: New Add Alt Repair. Demolition Other
This permit is granted pursuant to the Interim Resource Ordinance (Chapter 17.01 MCC) and nothing in this permit shall
excuse the applicant from compliance with any other federal, state, or local statutes, ordinances, or regulations applicable
to this project, but not inconsistent with the Interim Resource Ordinance. The permit may be rescinded pursuant to the
event the permittee fails to comply with the conditions of this ordinance.
Show the following on the site plan
Lot Dimensions Flood Zones
Existing Structures Fences
Stucture Setbacks Driveways
Water Lines Shorelines
Drainage Plans Topography
Septic System Wells Indicate Directional by (N,S,E,W,etc.)
Proposed Improvements Easements in relafion to plot plan
Name of Flanking Street
APPLICANT TO DRAW SITE PLAN BELOW
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I Icut Vim;
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APPLICANT TO DRAW TOPOGRAPH BELOW:
DEPARTMENTAL REVIEW
FOR OFFICE USE ONLY
C71111VI NTS
Planning:
Environmental Health:
Building Plan Review:
Occupancy Gro Ap:
Fire Marshal:
Other:
Conditions: FEES
TOTAL FEES:
Accepted by: Its,