HomeMy WebLinkAboutBLD2024-00930 - BLD CD Environmental Health Review - 8/2/2024 MASON COUNTY ,,II/� 11 lF Permit NO:
COMMUNITY DEVELOPMENT
PennRAssisfa.Cemer,,Bulatry,Plamine JU 1 2024 rn
BUILDING PERMIT APPLICATION 615 . Alder et
PROPNAMEERTY OWNER INFORMATION: N CONTRACTOR INFORMATIO q(��e all
o1 'V
MAILAIG ADDRESS %Y 1 MAH, ;0 ADDRESS: Z/ O
Cn1': srATE:I 214li C STATE: 2IP: z
PHONE 1: PHONE: CELL
PHONE#2: EMAIL: rn
EMAIL: t L&I REGp EXP._/ /_ z
PIUMARY CONTACT: OWNED CONTRACTOR❑ OTHER❑ l�
NAMEWAl d0jill t6N. EMAIL Y
MAILINGADgS1)SJin� A� —Cln ATEall_2IP r
PHONE CELL
PARCEL INFORMATION: �1 C
PARCELNUMBER(12agitNumber) =;30S060153 Z ,l PS_<
LEGALDESCRIPTION(Abbrawated) PREDISTR[CI nOQ�'{7 /Y1i)
SMADDRESS IJA�T2 q 1 p-W. an Ta.hu Y0.
D@ECTIONS TO STTE ADDRESS ��(
13T�PRO.IELTWITHIN3N0 OFSLOPE(S)OREATERTHANIY/A: YEypl NOO SNOWICAD:—Pef
ISPROPERntNTHIN2UUFTOFTUMFOLLOWDNG: lc aevva ty):
SALTWATER❑ LAKEU RIVER/C 11 FORD(I WETLAND[I SEASONAL RUNOFF O STREAM❑
TYPE OF WORK: NEW❑ ADDITION ALT/EER�ATION�1�_ REPAIR❑ OTHER FI QF�9P. T--,l
USE OF STRUCTURE(anwonvc ,Rt cVo-.. Blat,p) IeLC l q�.
MUSE. PRQ.iMY❑ SEASONAL IZY/ NUM S NUMBER OF BEDROOM NUFIDEROFBATHROOMS
HEATED STRUCTURE? YES Moll lL YES�/+J fjNet❑— , 'NOJ[�1 A
DESCRIBEWORA ('xF� ;Ado l�-Inf�
SOUARE FOOTAGE:6s+rerbl
ISTFIOCl sl 2DFLOORBT sl 3RDFLOOR_,& BMEMEW B.
DECK R.R COVEREDDEC)l STORAGE s,E p OTHER ft
GARAGE_p.ft AtmcAedO IMaBN❑ CARPORT p.ft AaaA�O tac_De AM(]
MANUFACTURED HOME INFORMATION: A4 COPIES OF THE FLOOR PLAN REQUIRED-
MAIM MODEL YEAR LENGTH
WIDTH BEDR00l BATHS SERL4LNIIAHER
ENVIRONMENTAL HEALTH:
SEWAGE/SEWERSOURCE: SEPTIC SEWER❑ / NEW❑ EXISITl
PLU Dvl INSTRUCTURE? YESg NOD Ifyaa,attaA cpnay?aed WetvAdequory Farm
PEJUM[ETER/POUNDATION DRAINS PROPOSED? YES❑ NOO EXISTING SQ.FT.
EXISTING BEDROOMS S PROPOSEDBEDRO011 TOTALBEDROOl
OWNER ecdwbEpea tlW euhnison ot'v¢wale'mMretlm mvy muttO a abp'roM oNerarynnitnvssWn.Atl�lvsxbtlpememolsutll Y Oy
cana rtMYw,laefoam all1r emlM payounal fvudingany
Bm Nellem al or as otlbpemMandb WRexnM a Thoo—N.IMw
mmM 1w,momse alltlwnein sm onpm ,dlanp anyWaemam Womor parti fm'mm rryaming Nlep a Theovmerm legal
mpre9emalive,rtp25e�M1s foot Me InbrmeYoapmWea la ewnle ena granb emvtryem al Maem County evess bor a1ova descnaea wit i
am stnawm(sl ra re-+la+r.m mavacmn.mh varmluavvlveor I�nnme:null avow nwwR araNmn:ea cmmwrnmm Y nni w�nma�ea wl:nm Im
_ an orrcwnwaaon»ot�leewpemam raapmoemtao Bays.
PROOF OF CONTINUATION OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. RNACTMn OF THIS
PERMIT APPLICATION OF 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON
COUNTY CODE 14.08.42)
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SIBnaW of re OMMER(Noel he alanad by Mrs OWNER) Data
DEPARTMENTAL REVIEW I APPROVED I DATE DENIED DATE I TACSMOTEVCONDTI'IONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT
PILE MARSHAL
PUBLIC HEALTH a
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