HomeMy WebLinkAboutBLD2024-00570 - BLD CD Environmental Health Review - 5/7/2024 q'� A�,,��1I,,II //��yy���7,�I
MASON COUNTY Permit Nm'51,1)5?2a4-00✓Y(d
COMMUNITYDEVELOPMENT RECEIVED
Permit Assistance Center,Building,Planning MAY 0 7 2024 z
BUILDING PERMIT APPLICATION 615 W. Alder Stoat
PROPERTY OWNER INFORMATION: C0NTRACr0RND 0RMAT10N: m
NAME: l 91 AMC NAME: Le -r �} .¢SerIS n z
MAILD46 ADDRESS Vo MARDIGADDRESS: `Pa__$gy I'J')SS K
CITY: STATaU 21P:9EFa MY: sje&.'c fs ATey�w ZIP: S M
PHONE#I: Vn6- 341/- 75Ow'7 PRONE: >CELL: z
PHONE#2: EMAIL: QK4' Bpi f
EMAIL: \.; IM REG N(PZM,Et R7 EXP.g/1/�f D
PRRMARY CONTACT- OWNER CONTBACTOR&-� O El r
NAME EMA L
M UNGADDRESS o aT CITY STATE ZIP 4
PHONE YG6�341-7eO CELL 9 ��
PARCEL INFORMATION: O
PARCELNUMBER(12M,it Nlmroer) .3 XI23- 75- 9m01\ ZONING 5 n�
LEGAL DESCRIl'110N(Abbmiatd) - e S //OVIIMD CT 3 �r
STrEADDRESS Jib _ CRY r o
DIRECTIONS TO SITE ADDRESS a,? 041
AOr
R3 TREPROIEC'EWYIHHi M0 OFSLOPE(S)GRRATRRTHANI4%: YE50 NO SNOWLOAD: t
LSPROPRETYWYLHLN200 FT OP THEFOLLOWHSG: /Cl WETLiNDF
SALTWATER❑ LAKE❑ RIV-F,R//cREEE❑ POND❑ WE'LIAND❑ SEASONAL RUNOFF[] STREAM❑
TYPE OF WORK: NEW p ADDCNON❑ ALTERATION❑ REPAHI❑ OTIIiE`RR n
USEOFSTRUCrtIRE(1 '01—`.ag..r BlaB ) hS—^v` e=. k CIR, �I
IS USE: PRCMkRY Er SEASONAL❑ -/NUMBEROFBEDROOMS -,2_NUFIDER OF BATHROOMSy_
AEATID STRUC[[EUi? YES(wuaBUB)M- YHsr �4W&1❑ NO[]
DESCRIBE WORK
SOUARE FOOTAGE:(p.oao..e/
ISTFLOOR q.R 2NDFLOOR I.A. 3RDFLOOR R.R. HAEELR+Ni_aq.R
DECK-21LR..R COVERED DECIC aq.R STORAGE ag.R OTBER sq.R
GARAGE K.ft. A. !❑ D.WJW❑ CARPORT n ft. Af [I Dew:
MANUFACTURED HOME INFORMATION: 4 COPIES OF THE FLOORPLAN REQUIRED'
( I/V/9p
MAKE MODEL YEAR Z02 LENGTH_
WIDTkt BEDROOMS�� BATHS�__SF.RIAI.NUMBER
ENVHLONMENTAL HEALTH:
SEWAGMEWER SOURCE: SEPTI.,C/ SEWER❑ / NEW[J EXLSTNG❑
PLUMBINGIN STRUCTDREP YESI� NO[I lfY elbrA�k WF Adegwcp F.
PERII.O3TERIF011NDATIOND PROPOSEDT YES NOM-/ EKISTMG SO,FT.
EXISTIN�HIDROOMS PROPOSED BEDROOMS3_ TOTALBIDROOMS�
OWXFlt afuoyleAjs Mye �ibmyale Yem�n.my leaf MashgxvkoBV TF®aNM�vMb.mwYlMlbbY
y —ibltn. n"mMallan tln wxWNI WMSE%I4BtlWInl mtltlMbreawnpaI IOMEw I..T.—.11We
Mlaln�lennlu'nn M1am ell Me remaary pNn,intlufn9 airy ena'nem h.IEd w paNrs.l lnlereal regeNin9 Uss 4mlecl TM wmarof IBgN
.m zMnurelal�lew ew�acem�aue Tt�s oamuvaepieetim becwnes null&void rtxvrt o:eamwn:ea coneeucuonb wome mcea wS l�ieo
any«r rammmon�a ee.emm mr a paloe a+w eeya.
PROOF OF CONTINUATION OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS
PERMIT MPLI�TIO Oyl F 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON
(�/,.'aT AP CitTl//% ryp COM W CODE USE THE
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SigmWre a OWNER IMuM he SM Wby do OWNER) Del.
DEPARTMENTAL REVD:W APPROVED DATE DEN® DAM TAGS/NOTRSICOMMONS
BURDA`G DEPARTNIEN'1'
PLANNINGDEPARTMENT
FIRE MARSHAL
PUBLIC HEALTH
R1 STANDARD VERTICAL SIDING �
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PLN Appro -3N
05/10/2024
MasoO�iklHN COgI111Dg1lyIIevef0�i11T' Zp51
Gavin Scouter, 1
All Changes Subject to Approval l0 ^ fiOt
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�e�erv� 70'
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_ EH Setbacks
IL N W ...— A) Drainfield/Reserve requires 10'selbackfrom foonng4oundatlorjs
B.)Septic tank(s)requires 5'setback from all fooling/foundations
2 N 0 0 i C.)No foundation/Perim aw foundation/Perimeter Drains within 3M,dngmdient of
GG 1 Q Dralnfield/Reserve was
G m N b N 1 0.)No Cut Sank(s)(greater than 5g and over 45 degrees)within
2 p m — Q Soft,down gradierd of Drainfield/Reserve area
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EH APPROVED j -Z
Rhonda Thompson 06/06/2024PJ
' 32�23-75- g00a�
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