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HomeMy WebLinkAboutBLD2017-01204 DDR2017-00150 Replace MFG Home - BLD Application - 11/15/2017 oN °pU MASON COUNTY COMMUNITY SERVICES A -ems° PERMIT ASSISTANCE CENTER: Permit No: ':,•BUILDING•PLANNING•PUBLIC HEALTH•FIRE MARSHAL 615 W.Alder Street,Shelton,WA 98584 RECEIVED Phone Shelton:(360)427-9670 ext. 352•Fax:(360)427-7798 Phone Belfair.,(360)275-4467•Phone Elma:(360)482-5269 NOV 15 2Q17 1854 BUILDING BUILDING PERMIT APPLICATION 615 W. Alder Street PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION: NAME: I NAME: I Vt P> a ryV6 MAILING ADDRESS: Z j?) E 5 i- p-r-,3 MAII�G ADDRESS: 'J 30ta " U CITY:_3�,i }-Call, STA ZIP: CI&S CITY:Kj STATE: U ZIP: 7� PHONE#1:601 ( }{tb) 40 (e qij 555'I cS PHONE: ,Z5 - CELL: PHONE#2:C�1 I (h eaS) ��.�,gg 5 j EMAIL : - �`!,} X oR MMM f't0 — �7(QO �'7S•��i L&I REG# EXP. PRIMARY CONTACT: / OWNER ❑ CONTRACTOR❑ OTHER❑ NAME EMAIL MAILING ADDRESS CITY STATE ZIP PHONE CELL PARCEL INFORMATION: PARCEL NUMBER(12 Digit Number) — ZONING 'Jr' LEGAL DESCRIPTION(Abbreviated) t✓ DIV#7A in FIRE DISTRICT oZ SITE ADDRESS LoO nC' CITYj DIRECTIONS TO SITE ADDRESS IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES[] NO ❑ IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Check all that apply): SALTWATER❑ LAKE ❑ RIVER/CREEK ❑ POND ❑ WETLAND ❑ SEASONAL RUNOFF ❑ STREAM ❑ TYPE OF WORK: NEW)( ADDITION ❑ ALTERATION E] REPAIR❑ OTHER ❑ USE OF STRUCTURE(Residence,Garage,Commercial Bldg,Etc. n loo -,e�4 ep p n IS USE: PRIMARY ❑ SEASONAL ❑ NUMBER OF BEDROOMS 3 NUMBER OF BATHROOMS Q• tJ HEATED STRUCTURE? YES (Whole Bldg) ❑ YES (Part[s]of Bldg) ❑ NO ❑ DESCRIBE WORK SOUARE FOOTAGE: (propose+existing) I ST FLOOR e)&-4 sq.ft. 2ND FLOOR sq. ft. 3RD FLOOR sq. ft. BASEMENT sq. ft. DECK sq. ft. COVERED DECK 1 G8 sq, ft. STORAGE sq.ft. OTHER sq. ft. GARAGE5ZEj sq.ft. Attached Detached❑ CARPORT sq. ft. Attached❑ Detached❑ MANUFACTURED HOME FORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED* MAK i MODEL EAR LENGTH DTH BEDROOMS BATHS SERIAL NUMBER ENVIRONMENTAL HEALTH: ► SEWAGE/SEWER SOURCE: SEPTIC SEWER❑ / T NEW ❑ EXISTING, PLUMBING IN STRUCTURE? YESX NO ❑ Ifyes, attach completed Water Adequacy Form KOUNDAT EXISTING BETS OKS ION IAA S�P�RO S POSED BEDROOMS NO TOTAL BEDROOMS SQ.FT. K b ROOMS OWNER acknowledges that submission of inaccurate information may result in a stop work order or permit revocation.Acknowledgement of such is by signature below. I declare that I am the owner and I further declare that I am entitled to receive this permit and to do the work as proposed. I have obtained permission from all the necessary parties, including any easement holder or parties of interest regarding this project. The owner or legal representative,represents that the information provided is accurate and grants employees of Mason County access to the above described property and structure(s)for review and inspection. This permit/application becomes null&void if work or authorized construction is not commenced within 180 days or if construction work is suspended for a period of 180 days. PROOF OF CONTINUATION OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS PET I , APPLICATION OF 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED. (MASON COUNTY CODE 14.08.42) r r X / 6�21 ! J // 7 Signature 6f N R qffust bVdihninea b the OWNER) Date DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS BUILDING DEPARTMENT PLANNING DEPARTMENT FIRE MARSHAL PUBLIC HEALTH MASON COUNTY DECEIVED COMMUNITY SERVICES R R e"' Building,Planning,Environmental Health,Community Health 11 1 L D I t�1 NOV 15 2017 0 bil Physical and Mailing Address: 615 W Alder St.,Bldg 8,Shelton, WA 98584 V 615 W. Alder Street Shelton Phone: (360)427-9670 ext 352 S• Fax (360)427-7798 PLUMBING & MECHANICAL PERMIT APPLICATION Permit#: f31d3D0, 01X)4__ _ OWNER INFORMATION: CONTRACTOR NFORMATION: NAME: UY1Ct �� . I(yt�l�— NAME: D MAILING ADDRESS: MAILING ADDRES CITY: STATE: ZIP: CITY: STATE: ZIP: 1st PHONE: PHONE: CELL: 2nd PHONE: EMAIL: EMAIL: L&I REG# EXP. PARCEL INFORMATION:PARCEL NUMBER (12 Digit Number): I pp3 3o-.A5n 0060.3 Zoning: 'PR 5 LEGAL DESCRIPTION (Abbrevia ec/): SITE ADDRESS: Vti CITY: DIRECTIONS TO SITE ADDRESS: TYPE OF JOB/WORK: NEW ADD ALT REPAIR OTHER USE OF BUILDING PLUMBING FIXTURES MECHANICAL UNITS [uKlectric in-wall heaters(no lee) Type of Fixture No. of Fixtures Fuel Type Fees Type of Unit No. of Units Fuel Type Fees Toilet(s) Furnace [E/G/LPG] Bathroom Sink(s) Heat Pump [ /G/LPG] Bath Tub(s) 4,[V(J)VA a Ductless H.P. dW-,/LPG] Shower(s) Spot Vent Fan Water Heater(s) I [E/G/LPG] Propane Tank — gal.] Clothes Washer(s) [E/G/LPG] Gas Outlet(s) Kitchen Sink(s) Heat Stove [E/G/LPG/W] Dishwasher(s) �— Kitchen Exhaust Hood Hose bib(s) Z Dryer Vent Other Solar Panel Other Other Plumbing Subtotal Mechanical Subtotal Plumbing Base Fee Mechanical Base Fee Final Inspection Fee Final Inspection Fee TOTAL PLUMBING TOTAL MECHANICAL OWNER/BUILDER acknowledges submission of inaccurate information may result in a stop work order or permit revocation.Acknowledgement of such is by signature below. I declare that I am the owner,owners legal representative,or contractor. I further declare that I am entitled to receive this permit and to do the work as proposed. I have obtained permission from all the necessary parties,including any easement holder or parties of interest regarding this project.The owner or authorized agent represents that the information provided is accurate and grants employees of Mason County access to the above described property and structure(s)for review and inspection.This permit/application becomes null&void if work or authorized construction is not commenced within 180 days or if construction work is suspended for a period of 180 days. PROOF OF CONTINUATION OF WORK IS BY MEANS OF INSPECTION.INACTIVITY OF THIS PERMIT APPLICATION OF 180 DAYS WILL INVALIDATE THE APPLICATION. X Signature of Applicant Date X Owner/Owners Representative/Contractor Print Name (Circle one) DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS O Building JfL O Fire Marshal O Permit Tech (OTC permit only) 1 isrf u`; on-hrlu" ittt[ :i/\Amnaf.co.muson.waus/communiiv_dev/ Rev:3/08/2017 Site Evaluation Date: Z17 Homeowner: �� ��L dal-KSite Address: Nr L«2 lu ;c qE5�s County: Nsc(� Miles from office: 0G Home Consultant: 4-_4'-A"nn PURPOSE: Today,we met to inspect your site. The purpose of this visit is to determine the conditions and general appearance o ur building site. There are items that are specific to your property that the Home Consultant is not qualified to review. The following items are the property owners sole responsibility; Selecting placement of home, accuracy of setbacks, easements, flood plain elevations, wetland regulations, fall to septic tank, ground stability, topography, -ovenants and restrictions, road conditions, drainage, and permits. Homeowner may need to contact a professional surveyor to determine exact topography. If iomeowner is unsure if these items are satisfactory or desire further explanation, we strongly urge you to obtain an inspection or project review with a local 3uilding official. property description:(Circle those that apply)Heavily wooded, Lightly woode brush is'cie-a-r-e-a-miopek fairly flat. N Is there access to the site? Y N Will the grade of the road/driveway allow the safe entry of material trucks? Y �1) Is the site cleared of all trees and other debris? N Was the general slope determined with the use of a level? (Laser oKye Level)? Y N Did the owner stakeout where the home would be placed? N Are the property boundaries clearly marked? f L! NOTES:(rJmot 110J &A occup+e 8 �at��c��� }tcu12- 01 r- IAA T �� 49- S,� �': Ac; 1'n' sz-4 �ts��`� 14 N� .rti S •Ile '. S i ii //tt C� I..XI�S� -tf1Q 't4c�4:r ►1�/��!E Ln'C2 , w�c4 �Lv� �e iTnL S;t� �-e �t`2e Cc'tZcx� 1�At Q40 DESCRIPTION OF PROPERTY. Drawing of property should show the following (if known): Property dimensions, home location, slope (if any) and direction, nearest transformer, well, septic drainfield, any existing buildings, wetland buffers, easements, driveway, fire hydrant(s), topography. Map drawing is based on information provided by the owner. N I t -P W a If I/we(homeowner/property owner)do not intend to reside in the newly constructed home but intend to sell the home and property as a speculation project,a General or Specialty contractors license may be needed. I/we agree to investigate and comply with state laws. These laws may require me/us to have a contactors license for the sale o a newly constructed single family residence. Homeowner Signature: ` Date: o y1 /1 7 ZAHomeowner Signature: /' Date: Home Consultant: Date: 01996-2016 HiLine Homes 253-770-2244 WA#HILINH*983BD I OR CCB# 182300 rev.7-12-16 BUILDING BUILDING PERMIT INFORMATION RECEIVED PLAN # 1768 NOV 15 2017 HiL 1NE USPS: PO BOX 799 ELMA, WA 98541 (360)482-4227 �= E s 306 SOUTH 4TH STREET SATSOP, WA 98583 615 W. Alder Street HILINH*983BD LICENSE EXPIRATION 11/08/2019 UBI #601-584-067 ENGINEER: Abdelouahab Abrous -- WA Lic: #36110/OR Lic #81419PE 253-770-2244 Fax: 253-720-2226 wabrous@hilinehomes.com This will be a New Single Family Residence (SFR) BUILDING Type of work: NEW HOME CONSTRUCTION-WOOD FRAME NEW HOME AREA SUMMARY: MAIN / 1ST 884 # of stories 2 SINKS 5 SECOND 884 Bedrooms 3 TOILETS 3 TOTAL 1768 Bathrooms 2.5 TUBS 0 GARAGE 528 Porch 198 SHOWERS 0 TUB/SHWR COMBO 2 PLUMBING DEEDUBS PLUMBING Olympia, WA (360-456-7469) DEEDUP1990KQ(5-19-2018) HVAC CHEHALIS SHEET METAL Chehalis, WA (360-352-1996) CHEHASM252MH (9-24-2019) ELECTRICAL MJD ELECTRIC Tenino,WA(360-273-7371) MJDELE1878KS(5-11-2019) STANDARD Kw range 7.5 Kw WHOLE HOUSE FAN BRAND: BROAN dryer 5.0 Kw HOUSE: QTRE110 CFM:110 w/h 2.5 Kw ELECTRICAL PANEL SIZE: 200 Amps TEMPORARY PANEL (minimum): 60 Amps EXHAUST FANS All Full Baths: Panasonic Whisper Green FV-05-11VKS1 Multi Speed Module Powder & Utiliy room: Panasonic Whisper Value exhaust fan FV -08VS3 BUILDING DEPT INFO MASON COUNTY: 426 W CEDAR STREET SHELTON, WA 98584 (360) 427-9670 X352 PERMIT REQUIREMENTS: http://www.co.mason.wa.us/community dev/building/indeex.php This sheet contains information for client/permit specialist to use for questions on the application only. THIS SHEET IS NOT TO BE SUMITTED MASON COUNTY RESIDENTIAL PLANS SUBMITTAL CHECKLIST Owner's Name: yormij _ _ 11 Date: Project description: hEw 6 F C_ Documents: � � a " DING RECEIVED Building Permit Application Completed. Bt - YjVlechanical/Plumbing Application Completed. NOV 15 2017 Y►//Planning Intake Checklist Completed. ite plan includes: Allowable building area, roof over gs, decks, etc. 615 W. Alder Street ✓Fire Apparatus &Access Road info required? Yes o' tormwater Checklist Completed. Energy Code Application Form - 0 Electric wall heater O Electric central furnace O LPG Furnace O Heat pump with electric furnace O Heat pump with LPG furnace O Boiler(heat type ) O Ductless Heat Pump O Other: Specify: Construction Plans: _Z3 Sets (2 full size sets�y/engineered calculatiorys & 1 reduced sized set 11X17 min.(no calculation needed ) Plans Legible ✓ ecognized Scale ✓ Elevation Views _Cross Section foundation Plan �oof Framing Plan loor Plan -use of rooms labeled (all floors) _Floor Framing Plan -all floor levels including loft, crawlspace, etc. Deck Framing Plan including covered porch, carports Plan Details: -Pn--!�L Fie,)e— 716 -T_-J5 f- 11.Z, OL Roof framing details, truss !ay-out may be ne ded (Hip and girder location shown) _,�1Nall Framing - Does bearing-wall heigaq xce d 1 )'? (Engineering may be required) M t9 /Floor framing: Floor joists (size & spa ). a .LJ't- ��1•L y� Floor beams: do - _Window headers. Typical header. Iv Garage header: / X _ Foundation: footing size, reinforcement _Concrete Walls- Does Concrete Wall Height Exceed 8'? (Engineering may be required, see details) _ Landings at all exits? Less 5an 30" abov grade? Y/N (must be shown on site plan) Water Heater. Location: Type ✓Heated By Furnace- LocatioA of Fur ce 0 Uy 4y:f2 Fuel type:_ ,Pt z c_-r1 c . ice/Stove Information Shown - Fuel Type? Location(s): vVindow Sizes Marked on Plans. E✓ raced wall s (shear walls) MUST be marked/in ted on plans. ry)6bZ IG _cC . ngineered Yes No Snow load: 5 Seismi : D21 Design Code: 2-0 15 Are plans stamped. Manufac Homes: _4 Floor Plans &areas must be labeled) Foundation Type: ANSI/Manufacture method Engin footing/foundation Basement Decks*: 4x4 min. landings required at each entrance be shown on site/plot plan) *Covered decks and/or any decks greater than a 4'x4' that exceed mgrade) requires a permit and construction plans. COMMENTS: Intake review (initials): Date: H:\pe=it tech building checldist2015.doc Revised 8.5.2016 If any of the items listed below are either indicated or missing within the construction documents; the plans must be engineered or returned to the applicant for resolution. y � ENGINEERING REQUIRED: Braced wall panels/brace wall lines are not marked on plans (R602.10) Amount and location of bracing does not meet minimum required in Table R602.10.1 DESIGN CRITERIA: All notes and details required as a result of the engineered analysis shall be transferred onto proposed building plans. Wind 85 MPH, Exposure B (unless proven otherwise). Seismic Zone: D2, Snow psf. IRREGULAR BUILDINGS R301.2.2.2.5 Irregular portions of structures shall be designed in accordance with accepted engineering practice. A portion of a building shall be considered to be irregular when one or more of the following conditions occur: 1) Exterior shear wall or braced wall fine are not in one plane vertically from the foundation to the uppermost story in which they are required. See exceptions. 2) Roof or floor is not laterally supported by shear walls or brace walls lines on all edges. 3) Portion of roof or floor extend more than 6 ft. beyond the braced wall line. 4) End of BWP extends more than 1 ft. over an opening more than 8 ft in width below. 5) Opening in a floor or roof exceed the lesser of 12 ft. or 50% of the least floor or roof dimension. 6) Portions of floor level are offset vertically 7) Shear wall lines do not occur in two perpendicular directions. 8) If a story above grade includes masonry or concrete construction*When this applies the entire story shall be designed. In accordance with accepted engineering practice. *(exception: fireplaces, chimneys, and veneer as permitted by the code). ***Applicant must take plans to a design professional to address items indicated above*** Notes/Comments for design professional: H:\permit tech building checklist2015.doc Revised 8.5.2016 Name�b j�(.(�� Ll�x 1L Parcel# �5��l} �D - BLD# 81 d 2 17 -� a Mason County n UILDING Department of Community Developmen Small Parcel Stormwater Management Application/Worksheet (page 2 of 2) Based Upon the information you have provided a Stormwater Site Plan IS Required for this developniel4t C— 9 I v Title 14, Chapter 14.48 of the Mason County Code(MCC)regulates compliance requirements for StormwfiQV 15 2017 Management in this jurisdiction.A complete copy of the ordinance can be found on the Mason Count1�b�ite:Ald@r Str@ t httpHwww.co.mason.wa-us/code/commissioners/index.htm VV Please follow the links to "Title 14,Chapter 14.48 Stormwater Management". Regulated activities shall be conducted only after Mason County Public Works approves a stormwater site plan (Mason County Code Title 14 Chapter 14.48 section 14.48.70).You will receive a copy of the Public Works document entitled "Managing Storm Drainage on Small Lots,The Small Parcel Stormwater Site Plan".This document will assist you in preparing the necessary information and plans for Public Works to review and approve. Per Department of Public Works this document will constitute an approved plan if all of the relevant details* are to be installed in their entirety AND no part of the stormwater system adversely affects any septic system (see Environmental Health information below). If an alternative system is to be used a plan will need to be submitted to Public Works for approval. A design by a registered professional may be required for more complex sites. *These details are found in the document Managing Storm Drainage on Small Lots, The Small Parcel Stormwater Site Plan on the pages that begin with"Handout" PLEASE INITIAL BELOW TO INDICATE THE STORMWATER MANAGEMENT PLAN FOR THIS SITE A) The relevant details from Managing Storm Drainage on Small Lots, The Small Parcel Stormwater Site Plan will be installed in their entirety AND the system will be located as not to adversely affect any septic systems on this,or any other,parcel. B) An alternative plan and/or professional design will be submitted to the Department of Public Works for approval AND the system will be located as not to adversely affect any septic systems on this,or any other,parcel. If you have further questions pertaining to parcel drainage and stormwater management Mason County's Public Works Department can provide additional instructions,guidance and examples.(Section 14.48.130)contact Public works at: Phone: 360-427-9670 ext 450 100 W. Public Works Dr Shelton.WA 98584 If this development has,or will have,a septic/drainfield system you may need to contact Mason County Division of Environmental Health to ensure that the stormwater system will not adversely affect the septic system of this,or any other, parcel. You may also wish to consult with the septic design professional involved with the project. Mason County Division of Environmental Health can be reached at: Phone: 360-427-9670 ext 400 415 N.6th St-Bldg#8 lower level Shelton.WA 98584 A condition will be added to the building permit that states, in part,that all conditions the stormwater site plan will be met prior to a request for final inspection of the building permit. Owner/Builder/Agent Acknowledges that submission of inaccurate information may result in a stop work order or permit revocation. Acknowledgement of such is by signature below.I declare that I am the owner,owner's legal representative,or the contractor.I further acknowledge that the information provided is accurate and employees of Mason County are granted access to the above- describ d roperty for review and inspection as may be required. X ' Owner/Agent/Contractor(circle one)Date: � '- t'Jt"'026 Page 2 of 2 Name Parcel# BLD# Mason County Department of Community Development Small Parcel Stormwater Management Application/Worksheet (page 1 of 2) Per Mason County Code,Title 14, Chapter 14.48 a stormwater site plan is required whenever a building application is made for residential development, or redevelopment',with more than 2,000 square feet of impervious surface'. 'Redevelopment means,on an already developed site,the creation or addition of impervious surfaces,structural development including construction,installation or expansion of a building or other structure,and/or replacement of impervious surface that is not part of a routine maintenance activity,and land disturbing activities associated with structural or impervious redevelopment. 2Common impervious surfaces include,but are not limited to,rooftops,walkways,patios,driveways,parking lots or storage areas, concrete or asphalt paving,gravel roads,packed earthen materials,and oiled,macadam or other surfaces which similarly impede the natural infiltration of stormwater.Open,uncovered retention/detention facilities shall not be considered as impervious surfaces. To Calculate Impervious Surfaces Please Complete_This Table Surface Type Length X Width = Area *All dimensions in feet Buildings X = X = Measurements for buildings are taken at the perimeter of the farthest projections(example: X = eaves/gutters) X = Driveways X = X = Length of drive begins at the right of way X = Parking Areas X = X = Any paved, gravel or packed area per definition above table X = Patios/Walks X = X = Any paved, gravel or packed area per definition above table X = Others X = X = If the total impervious area of the proposed site X = development is greater than 2000 square feet a Small Parcel Stormwater Site Plan is Required Total Impervious Surface Area (sum of all areas) If the Total Impervious Surface Area is LESS THAN 2000 Square Feet,please read,acknowledge and sign below. Based Upon the information you have provided a Stormwater Site Plan IS NOT required for this development activity. Owner/Builder/Agent Acknowledges that submission of inaccurate information may result in a stop work order or permit revocation. Acknowledgement of such is by signature below.I declare that I am the owner,owner's legal representative,or the contractor.I further acknowledge that the information provided is accurate and employees of Mason County are granted access to the above- described property for review and inspection as may be required. X Owner/Agent/Contractor(circle one)Date: If the Total Impervious Surface Area is GREATER THAN 2000 Square Feet,please read,acknowledge and sign the information provided on page 2 of 2. Page 1 of 2 - ` • ' PLANNING MASON COUNTY Mason County Permit Center Use: COMMUNITY SERVICES ;` DDR�d Building,Planning,Environmental Health,Community Health \, 615 W.Alder St.—Bldg.8,Shelton,Wa 98584 Date Rcvd Phone:(360)427-9670 ext.352♦ Fax:(360)427-7798 lo' Request for Administrative Variance for CCIVED Reduction in the Required Setbacks NOV 15 2017 For administrative review, the minimum variance on a setback request is 5 feet from the side-lyZr+ .4Joy lines and 10 feet for front and rear lot lines or any access easement. Request for further reduction requires a standard variance. Setbacks are measured from the furthest projection of the structure. including roof eaves and gutters. Applicant/Owners: I tL� Mailing Address: Z.I I 1' 'qu f 3 City: 8L I &OL State: UJA Zip: 9 e)62.8 Telephone: C I Ad)• (i LAq • 56 C Email: If this reduction is tied to a building permit, please give permit case number. BLD 2y l 1 - 0 1D�O 1—} Parcel Number(s): L'26 00003 Zoning 1) —� Site Address: Len n L LGutio l U16-1 I Requested setback variance: ft. ❑ Front ❑ Rear LJSide L ,5 ft ❑ Front ❑ Rear Le Side tJ ' ft. ❑ Front ❑,, Rear ❑Side 10 t ft ❑ Front Ur Rear ❑ Side Front Setbacks—From access easements and road right of ways. Minimum 10 feet. Rear Setbacks—From the rear property line. Minimum 10 feet. Side Setbacks—From the side property line. Minimum 5 feet except for certain shoreline designations. An illustrated site plan is required. Your site plan must show the following: north arrow, abutting street or easements, and set backs to all property lines and existing buildings, slopes, surface water, wetlands, critical areas, septic, well and driveway. Show all proposed new development. r FRONT AND OR AR Y REDUCTION RE UESTS: For existing lots of r ord arch 5,2002; You must meet one of the following: 1) One of the following exists on the lot(check all that apply): ❑ a) steep slopes,wetlands, or streams present; ❑ b) soils that restrict building or septic development; ❑ c) lot width at the front yard line of no more than 50 feet; d) lot size of no more than one-fourth acre; e existing improvements of buildings, septic systems,and well areas. S rY REDUCTION RE UESTS: For g lots of record as of March 5,2002; You must meet one of the following: 2) One of the following exists on the lot(check all that apply): ❑ a) steep slopes, wetlands,or streams present; ❑ b) soils that restrict building or septic development; Cl c) lot width at the front yard line of no more than 50 feet; ,I'd) lot size of no more than one-half acre; e) existing improvements of buildings, septic systems,and well areas. Explain how these circumstances preclude a reasonable development proposal from meeting the setback standard for Rural Residential 2.5, 5, 10, or 20 zones. , f m- m ALJ"�olt et , 'ItkLE ti) 4h-t, daaL-) Owner/ lease Agent indicate g (P ) ignature Date Official Use Only Approved by: �C, � Date Z� Z S (2,V l Denied by: Date Reason for denial: RECEIVED PLANNING NOV 15 20V 6 vv ` Dt�e- o ►`T do 150 ICD 100 �5 li) p�.. 2�11 •O�d 15v c.cvt�zcl., 1�0 rG IDYntn 5`rv►"� i 1 ► 1 `g 3 U 35 no�. . Pa n c(L cL C I &J�- L