HomeMy WebLinkAboutBLD2008-00600 Final Garage DDR2008-00100 - BLD Permit / Conditions - 8/8/2008 Inspection Line(360)427-7262
MASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT Phone: (360)427-9670,ext.352
Mason County Bldg. III 426 W. Cedar P.O. Box 186
Shelton, WA 98584
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RESIDENTIAL BUILDING PERMIT BLD2008-00600
OWNER: DON VERBECKE RECEIVED: 5/20/2008
CONTRACTOR: MCCORMICK CONST. LLC 360-731-2270-277-3355 LICENSE: MCCORCL962RL EXP: ISSUED: 6/27/2008
SITE ADDRESS: 110 NE JOLLY ROGER LN BELFAIR EXPIRES: 12/27/2008
PARCEL NUMBER: 123305400037
LEGAL DESCRIPTION: BEARDS COVE DIV 7 LOT: 37
PROJECT DESCRIPTION: DIRECTIONS TO SITE:
GARAGE LARSON LAKE TO LARSON LANE RD T JOLLY ROGERS TO SITE ON
RIGHT
General Information Construction&Occupancy Information Square Footage Information
No. of Bedrooms: Type of Constr.: V-5
Type of Use: SF Insp.Area: No. of Bathrooms: Occ. Group: U-1 Lot Size: Deck:
Type of Work: ACC Fire Dist.: 2 No. of Stories: 1 Occ. Load: Building: Garage-Detached 320
Valuation: Building Height: Occ. Status: Primary Basement:
Manufactured Home Information Setback Information Shoreline& Planning Information
Make: Length: Ft. Front: E 4.0 Ft. Shoreline: Ft. Water Body: NONE
Model: Width: Ft. Rear: W 10.0 Ft. Slope: Ft. SEPA?: Unkn
Side 1: N 32.0 Ft. Shoreline Desig.: b6mtlApplicable
Year: Serial No.: Side 2: S 9.0 Ft. Comp. Plan Desig.: Rural
Plumbing Fixtures Mechanical Fixtures FEES
Type Qty. Type Qty. Type By Date Amount Receipt
Plan Check Fee KS 5/20/2008 $108.71 S12008000
Planning Review Fee KS 5/20/2008 $190.00 S12008000
Building State Fee MAU 5/21/2008 $4.50 S22008000
Building Permit Fee MAU 5/21/2008 $167.25 S22008000
EH Plan Review TW 6/4/2008 $40.00 S22008000
Total $510.46
BLD2008-00600 Please referto the following pages for conditions of this permit. 1 of 4
CASE NOTES FOR
BLD2008-00600
CONDITIONS FOR
BLD2008-00600
1), Contractor(registration 1 s are governed under RCW 18.27 and enforced by the WA State Dept of Labor and Industries, Contractor Compliance Division.
There are potential ri an id-mmetaTy+ab lities to the homeowner for using an unregistered contractor. Further information can be obtained at
1-800-647'0982. T person signing his condition is either the homeowner, agent for the owner or a registered contractor according to WA state law.
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2) T'he intern ti,onar coder quires a#ire apparatus access road for every facility, building, or portion of a building that is more than 150' from an approved
access r d:' Roads a re require meet the minimum Mason County Fire Marshal standards for Fire Apparatus Access Roads up to the point where
such ro s conne with a coup Maintained public road or to another fire fit' county p apparatus access road which connects to a county maintained public road.
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3) All appr ved. ns ar o�e on-site for inspection purposes. If an inspection is called for and plans are not available on site, then approval will
not be a0 n a re-inspection fee (refer to current fee schedule, minimum 1 hour) will be charged and must be collected by the Building
Depart t pri further inspections being performed or approvals granted.
X
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4) Owner/A e spoi sible to post-the-assigned address and/or purchase and post private road signs in accordance with Mason County Title 14.28.
X
5) The plan revie hec-c?st and corrections are part of the approved plans and must remain thereto. It is the responsibility of the applicant to make the
correc ndic ans.-Once the plans are marked "APPROVED", they shall not be changed or altered without authorization from the Building
O '
al. T e,per hol r is responsible to retain the complete approved set of plans on site for the duration of the project. Failure to comply and/or
removal o appr ed oc ments will result in failure of required building inspections.
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6) This cture ;'a e u -heated space. If at any time this building is to be used fo ther than what it is approved for, a change of use
permit shall b -and approved prior to the change.
7) THE FOUNDATION SYSTEM SHALL BE PLACED ON UNDISTURBED, NATIVE SOIL., : Y
8) They p rove ired to be on-site for inspection purposes. If an inspection is requested and the"approved" site plan is not on site, then
approv will n e -ka-addition,a re-inspection fee (refer to current fee schedule, minimum 1 hour)will be charged and shall be collected by the
Buildin De ctfnen prior to any further inspections being performed or approvals granted.
X
BLD2008-00600 Please referto the following pages for conditions of this permit. 2 of 4
9) •Thi str ct e is lira ttto U-occupancy use only (private garages, carports, sheds, and agricultural buildings.) Any other use will be in violation of the
i�,terna tQyT and Mason County Regulations unless a "Change of Use" permit is applied for, reviewed and approved.
X - - 1
10) Proposed ru� Te
maintain a minimum of a 5' setback from all property lines, easements and 25' from all County and State Road right of ways.
Setbacks r� eas the furthest projection of the structure.
X Y
11) All changes to ilding plans that effect compliance with the international codes as amended and adopted, or any other Mason County
or ance or reoula st be reviewed and approved by Mason County prior to construction.
12) CONSTRUCTION PROCESS TO BE FIELD CORRECTED AS REQUIRED PER MASON COUNTY BUILDING DEPARTMENT AND THE ADOPTED
BUILDING CODE.
The cons ct on off e d-project is subject to inspections by the Mason County Building Department. All construction must be in.conformance
wit in rr a es-a5-amended and adopted by Mason County. Any corrections, changes or alterations required by a Mason County Building
spector, de rior to requesting ad inspections.
f X
13) Owner/applicant must obta�p a seperate j5 for, a placement of any size propane to ruing a fixed appliance within a dwelling structure or unit
prior to the placement of the tank. X
14) All property lines shall be clearly identified at the time of foundation inspection. X r'
15) All building per s shall have a final inspection performed and approved by the Mason County Building Department prior to permit expiration. The failure
to re orr vrtd`obtain approval will be documented in the legal property records on file with Mason County as being non-compliant with
on Co c s and building regulations.
16) All permits expire 80 days af��e[rnit issuance, or 180 days after the last inspection activity is performed. The Building Official may extend the time for
action for p seed+flg 180 days, upon the receipt of a written extension request indicating that circumstances beyond the control of the permit
holder h�e ent;ea ction from being taken. No more than one extension may be granted.
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17) Pressur a ood�ma factured after January 1, 2004 may contain high concentrations of copper which could quickly corrode metal fasteners,
connectors, n lashin nstall metal connectors approved for contact with the new types ressure treated material.
18) Owner/b a sibility if drainfield/reserve area is encumbered. X
19) Water q 'I s not t be degraded to the detriment of the aquatic environment as a result of this project.
X
BLD2008-00600 Please refer to the following pages for conditions of this permit. 3 of 4
20) Prior to final approval, all upland areas di ed or n - �-e
onstruction activities shall be seeded, vegetated or given an equivalent type of
erosion protection (silt fencing or straw matting). X
21) All construction and demolition debris must be removed from the beach after project�'ple �l,of construction debris must be on land
in such a manner that debris cannot enter or cause water quality degredation of Stat wate
22) Temporary erosion control measures must be implemented j re�er�t Wa ation of adjacent waters or wetlands. Silt fencing must be
installed and maintained until upland vegetation has become establishe
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23) pro mensions and setbacks on submitted site plan. Setbacks are measured from the furthest projection of the structure.
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24) All other necessary permits from Mason County, Washington State and/or Federal A t quiced-fog-this proposed development and
construction must be obtained PRIOR TO SAME DEVELOPMENT AND CONSTR CTION.
25) All Best Management Practices must be strictly adhered to during all phases of the development proposal X
26) Lan � statf�'must meet the same setback conditions as any permitted structure; and, must be shown on your site plan. Please check your
pprov n'to ensure these structures are shown and meet the setback conditions listed.
X
This permit becomes null and void if work orconstruction authorized is not commenced within 180 days,or if construction or work is suspended for a period of 180 days at any time after work is
commenced. Evidence of continuation of work is a progress in within the 180 day period. Final inspection must be approved before building can be occupied. Proof of continuation of
work is by means of a progress inspection.The owner of-tfhe agent on he owners behalf, represents that the information provided is accurate and grants employees of Mason County access to
the above described property and structure for rer and inspe
OWNER OR AGENT: DATE:Llz�
BLD2008-00600 Please referto the following pages for conditions of this permit. 4 of 4
W
o CONCRETE MECHANICAL MANUFACTURED HOME
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CD Date B __...._________._._ �
C) Footings/Setbacks Gas piping y Ribbons W
o Intenor Date By interior-Date By Date By 0
o Exterior Date By Exterior-Date By
Set-up m
vPoint Load/Isolated Footings INSULATION Date By
BG 1 SLAB INSULATION ----.....
Date By Data By FIRE DEPARTMENT Z
Foundation Walls Floors Date By
Date By Data By DECKS
FRAMING Walls Date By
Date By Data By PROPANE TANKS
PLUMBING vault Date By
Date By OTHER
Groundwork Attic
Date By Date By Type.
Date By
D.W.W DRYWALL Type
Int.Brace Wall Date By
Oate By Date By
FINAL INSPECTION p
Water Line Fire Separation NO
Date By Date By Date l p
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`° Pass or Request Inspect. c
Type of Insp. Fail Date Date Done By Comments v
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MASON COUNTY RESIDENTIAL PLANS SUBMITTAL CHECKLIST .�
Owner's Name.' t1 Date:-aU -&5 Reviewed By: ewe_
Documents:
_f uilding Permit Application Complete STORM WATER WORKSIIEET COMPLETE? 5 .
✓Manning Intake Checklist Complete
ite plan includes: Allowable building area,roof overhangs,decks,etc.
Fire Apparatus Access Road info required? Yes(10
Energy Code Application Form-O Electric wall heater O Electric central furnace O LPG Furnace
O Heat pump with electric furnace O Heat ump with LPG furnace O Boiler(heat type )
O Other:Specify: on Ca N4442 C4-)
nL Mechanical/Plumbi g*plication-WATER HEATER FUEL TYPE/LOCATION
—Engineering? Y o Snow load:.24&_ Seismic-D.0-
Stock Plan-approved snow load: Seismic:
an red Home FLOOR PLANS
ounda on T e: ANS an acture met Engi ere oting/f on Bas t
Covered. Uncov o 4 x 6 and "? ruction plans requtred.
Construction lans:_3 COMPLETE SETS
_ lans Legible ✓recognized Scale Elevation Views ✓Cross Section
►1 oundat.ion Pl
an _
✓Roof Framing Plan oor PI floors)— _ g � an Use of rooms noted(all floc )
Floor Framing Plan-all floor levels including loft,crawlspace,etc. (<200 S.F.??-stairs?)
ty
Plan De
tails
►✓
Roof framing details,truss lay-out maybe needed (Hip and girder location shown)
Wall Framing-Does bearing-wall height exceed 10'?(Engineering may be required)
6jtAb_Floor firaming: Floor joists: ,Floor beams:
_Z'�Vindow headers. Typical header: 4 X 10 - Win o C-) '4 X to 4 j&AO r—o6o e
Foundation:footing size,reinforcement
1')0 Concrete Walls-Does Concrete Wall Height Ex 8'?(Engineering may be required,see details)
Landings at all exits?Less than 30"above gradetip N
- ? Location(s):
_✓Window Sizes Marked on Plans
_ Braced wall panels(shear walls)marked on plans?
u o o Vt C
MMENTS:
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: ,Snow_psf.
IRREGULAR BUILDINGS R301.2.2.2.2
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 braced wall line or BWP cantilevered or offset by more than 4'
2)Roof or floor is not laterally supported on all edges
2A)Portion of roof or floor extend more than 6 ft beyond the braced wall line.
3)End of B WP extends mo
re r ve an opening more than 8 ft in width below.
4 O o
Opening in a floor pe g oor or roof exceed the lesser of 12 ft.or 50/o of the least floor or roof dimension.
5)Portions of floor level are offset vertically
6)Shear wall lines do not occur in two perpendicular directions.
7)When a story above grade is includes masonry or concrete construction(exc:fireplaces,chimneys,and veneer).
When this applies the entire story shall be designed In accordance with accepted engineering practice.
H:lpermit tech building checklistdoc Revised 11-30-2007
Names VLr 1P�rC_. Parcel#i s`7? Cw 3 r 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 surfacez.
'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.
( .. I cr1 e�' tt:"......: c f o t.: " .;' ' ;::::Table
Surface Type Length X Width = Area " All dimensions in feet
Buildings X =
X = Measurements for buildings are taken at the
X _ perimeter of the farthest projections (example:42A Cc!Q2 Deaves/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
X _ above table
Patios/Walks X =
X = Any paved, gravel or packed area per definition
above table
X =
Others X =
X = lf,t e''.1.ital ft��ri ibUs. .6,�b tha�ir3posecl:sfte
X _ riev,l lcrp ent flfeaterthan t#tl:; i if8 feet a
..................
Brrtall Par I B€arrrtvr�t�[S�t��'�j#��Sfiurrad
Total Impervious Surfa e: € t tart Of all Gr as :
If the Total Impervious Surface Are ESS THAN 2000 Square Feet, ple se read, acknowledge and sign below.
Based Upon the information you have pro NOT required for this development activity.
Owner/Builder/A io dges that submission of inaccurate information may result in a stop work order or permit revocation.
Acknowl ent of such is b e declare that I am the owner,owner's legal representative,or the contractor.I
Ruth cknowl" e ' o provided is accurate and employees of Mason County are granted access to the above-
d 'bed pro or re ecti equired.
X Owner/Agent/Contractor(circle one)Date: ZU
If the Total rvious Su f ce Area is GREATER THAN 2000 Square Feet, please read, acknowledge and sign
the informatio provided page 2 of 2.
Page 1 of 2
Name Parcel# BLD#
Mason County
Department of Community Development
Small Parcel Stormwater Management Application/Worksheet (page 2 of 2)
Based Upon the information you have provided a Stormwater Site Plan ISRequired for this development activity.
Title 14,Chapter 14.48 of the Mason County Code(MCC)regulates compliance requirements for Stormwater
Management in this jurisdiction. A complete copy of the ordinance can be found on the Mason County website:
bttp//www.co.mason.wa—us/code/commissioners/index.htm
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
Mail: P 0 Box 1850, Shelton WA 98584
Physical:415 N 6th St, 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. 352
Mail: P 0 Box 1666, Shelton WA 98584
Physical: 426 W Cedar St, 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-
described property for review and inspection as may be required.
X Owner/Agent/Contractor(circle one)Date:
Page 2 of 2
1 ^�
MASON COUNTY PERMIT NO. —J v�'J
BUILDING PERMIT APPLICATION ►- -�,-
426 W. Cedar- P.O. Box 186, Shelton, WA 98584
Shelton (360) 427-9670 - Belfair (360) 275-4467 - Elma (360) 482-5269 J I ✓1L.. p
On the web www.co.mason.wa.us
APPLICANT INFORMATION CONTRACTOR INFORMATION
Owner (><t.— Company Name % .oIMILl� �t1 ,i •L•lS�
Mailing Address r S Mailing Address
City r katA Stated—Zip Code 17 City = ' r State '*,e Zip Code
Phone Other Ph. Phon _M Z3/ —off—' Other Ph. 7 S
Lien/Title Holder N A Contractor Reg. # T xp.
E mail address E Mail Address u t
Drivers Lic. # DOB Drivers Lic.# :IGYfg3�� DOB
SEPTIC /WATER SYSTEM INFORMATION - Connect to New Septic_ Existing Septic .J
Connect to Water System Name of Water System
Well Sewer System Name of Sewer System
PARCEL INFORMATION - 12 Digit Parcel No. Fire District
Legal Description
Site Address (Please include street name, street number and city) I JO
Directions to site J;4C252+0 L4)W- Tb Lj4r-4&jli L4AP- AA-
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Will timber be cut and sold in parcel preparation?Yes/No
Is property within 200'of Saltwater Lake River/Creek Pond
Wetland Seasonal Runoff Stream Slopes or Bluffs
Is this permit submittal the result of a Stop Work Notice,Correction Notice or other enforcement action?Yes/No
TYPE OF JOB - New Add Alt Repair Other PRIMARY RESIDENCE ❑ SEASONAL ❑
Use of Building Describe Work_11L ne I -,
No. of Bedrooms No. of Bathrooms - Square Footage- 1 st Floor Ck,IP 2nd Floor
3rd Floor Basement Deck . Covered Deck Other Sq. ft.
Garage Attached Detached Carport Attached Detached
MANUFACTURED HOME INFORMATION - Make Model Year
Length Width Serial No. No. of Bedrooms No. of Bathrooms
Type of Heat Purchase Price $ Replacement Unit? Yes/ No
Installer Name Certification No.
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 the contractor. I further declare
that I am entitled to receive this permit and to do the work as proposed in the application. I declare that I have obtained the permission from all
the necessary parties. If permission is required from any easement holder or any other party in interest regarding this application or the work
proposed in the application, I have obtained permission from them to apply for this permit and conduct the work proposed. The owner or
agent on owners behalf, represents that the information provided is accurate and grants employees of Mason County access to the above
described property and structure for review and inspection. This permit/application becomes null & void if work or authorized construction is
not commenced wfthih �r if construction work is suspended for a period of 180 days. PROOF OF CONTINUATION OF WORK IS BY
MEANS OFA PROGRESWNSP€CTIONANACTIVITY OF THIS PERMIT APPLICATION OF 180 DAYS WILL INVALIDATE THE APPLICATION.
X Date: �512a o6Z
Owner/Owners Representative/Contractor (indicate which one)
FOR OFFICIAL USE BEYOND THIS POINT Accepted by: Date,5--,,;26
DEPARTMENTAL REVIEW APPROVED DENIED NOTES - 1"
Building Department
Planning Department
Environmental Health Department - A
Fire Marshal
FEES
Building Permit Fee Site Inspection
Plan Review Fee -71 EH Review Fee
Plumbing & Base Fee Planninq Review Fee
Mechanical & Base fee Other
Wood/Gas/ Pellet Stove Fee State Fee
Violation Fee Pre-Paid at Submittal
Valuation $ TOTAL FEES
TO BE KEPT IN THE
PA
MASON COUNTY RCEL FILE
DEPARTMENT OF COMMUNITY DEVELOPMENT
411 N. Fifth Street/ P.O. Box 186, Shelton WA 98584
360.427.9670 ext. 352
D DW?00&-0 0/p49
Rec'd by
Request for
Administrative Variance for Reduction in the Required et acks ($105.00)
For administrative review, the minimum variance on a setback equest is 5 feet
from the side yard lot 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.
Applicant/Owners: G , � —
• Mailing Address: l --T' ,T9S22
' Telephone
City: � ir�"A-- State: Zip: ��' SZ
If this reduction is tied to a building permit, please give permit
case number. BLD oIC-og 00 aw
Parcel Number(s): 2-S 3 C) Zoning S
Site Address: (to
Requested varianc ront r SA( and (please circle all that apply)
Requested setback variance: 10 ft.
An illustrated site plan is required.
Your site plan must show the following: north arrow, abutting street or
easements, set backs to all property lines and existing buildings, slopes, surface
water, wetlands, critical areas, septic, well and driveway. Show all proposed new
development.
folio ing circumstyOces must apply:
FRONT ND OR REAR YARD REQUIREMENTS:
1) xisting lots of record as of March 5, 2002;
ou must meet one of the following: (Please circle all that apply)
2) One of the following exists on the lot:
a) steep slopes wetlands, or streams present;
b . soils that restrict bui ing or septic developmen -,
c) lot width at the front yard line of no more than 50 feet,
d) lot size of no more than one-fourth acre;
czigiioo!Z]Eprovements of buildings, septic systems, and well areas..
\\CLUSTERI HOME SERVER\HOME\COMMON\PLANNING\PAC\VARIANCES\Adminstrative.var.doc Created of
SIDE YARD REQUIREMENTS:
1) Existing lots of record as of March 5, 2002;
You must meet one of the following. (Please circle all that apply)
2) One of the following exists on the lot:
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-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.
n
Lk7T i'lcr��s ►�'�'r�
Owner/Agent (please indicate)
Signature and date
Official Use Only
Approved Date O h
Denied Date
Reason for denial:
\\CLUSTERI HOME SERVER\HOME\COMMON\PLANNING\PAC\VARIANCES\Adminstrative.var.doc Created of
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MASON COUNTY
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PLANNING:
ARE MEASURED
FURTHEST
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APPROVED
MASON COUNT' DCD 1"LANNINC
SITE PLA ' !RED TO BE ON SITE
B ECT TO APPROVAL nT A �TNWG
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