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Home My WebLink AboutGRD93-0027 - GRD Permit / Conditions - 9/7/1993 MASON COUNTY Mason County Bldg. 111 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 F-Ii, A 1.1) X (1 1 ,, A 1,� it"it # A gea COO,!, k it; 1 4'9!/-9670 GRI393-0027 PAR(A. 1 1;1 1, 1 it I - t�)f, JOB ADDRFS'i � . . . . . . . . . . . . . . . Ow"r R - JO%Fp" VU,I IMF I'll pffItAIT -r10H CONIKACIOR -, OWNER IN CONIRACTOR & VIDID BY EXPIpA UL 13Y 'E k 0 'Y (1 R A 1)f- ? . . . . . . . N A k EA 6 R A It 11,D p R 0 J L:C r 17 L I." li I p I 1 0 N t.- X I A V A I li 114 « (1 k A I Nti A N I I I I Idl I I Nit 111"10AI:0., 1 1, OCA 11 m, : 01 I imfil? IoNt, Ili $ lokl'I--10N {III N fit tildf oVl jt4 mllt4 I 111�14flpj. I (I "Amilli It t PlAf(A-, A F0,611 1' , 1 to 1 4111 1 1' I( Ak,OtN M VH ,, I 1,.t I ON I '1 1 01W--1114 1,11 VI) Fill_I M1 Al I I lit I Ilk Y lit-, -I)N t f, ( I Jilj: I f p DAY'3 . OR IF #A)N") 1`F(0C11.0N MY 140k 1 ", 1 Mot 1) 1 fit; A IA k1lift lit Itto litily" At JIMI At jj-p I " COMMENCH.k , IV10f..*NC-E- tiF c(INI tMiAl [ON (IF WORK 1 ',, A I'liMiRf tN!41- 1 1 IliN lit flifN fill- Chit DAY 1,t (KI1111 , fil-Mil ji Or1 �73 011) PONT. rev: 14il1/I CONCRETE MECHANICAL MOBILE HOME Footings-Setback date by Ribbons date by Gas Piping date b Foundation Walls date by Set Up date by INSULATION date by BG/SLAB Insulation Floors Final date by date by date by FRAMING Walls FIRE DEPT. date by date by date by PLUMBING OTHER Groundwork Attic date by date by D.W.V. WALLBOARD NAILING date by date by Water Line FINAL INSPECTION date by date by date by GRID q"5-CT)ar) MASON COUNTY LAND MODIFICATION PERMIT Grading, Excavation, Fill, Slopes, Drainage Department of General Services 426 W. Cedar/P.O. Box 186, Shelton, WA 98584 427-9670/1-800-562-5628 PLEASE PRINT #1 Owner,S e,-'I7 )F FCC 1)pi-7 4-/-71' Phone# �7S- D S-D 7 Fire District# Site Address 8MA,6 S eo v C n f V. g Cit St k,1e9 Zip -C/7�5- Z?6- Owner Addres / LV6 Cit St Zip Describe Wor ,v L v t �e o 19 S 5'e o GENERAL SERVICES #2 Contractor Name tW Nef &hQ -10 �Jy/k Contractor Reg# Address Expiration Date City St Zip Phone# #3 Engineer's Name Phone# Address City St Zip #4 Parcel No.J;) 331 - - ee/0 60 Legal Description #5 Number of cubic yards to be excavated: C �� Gk�pic id_ Number of cubic yards to be filled: Number of cubic yards to be graded: �K�� u1 Sr1 6/'4 Ct �G1el.h #6 Will this be a baI need cut and fill entirely within the site? Yes No If No: Will fill be brought on site? Yes No Where does imported fill originate from? Does fill contain any potentially hazardous materials? Yes No ✓ #7 Will excavated materials be taken off site?Yes No If Yes: Where will excavated materials be taken? �C #8 Briefly describe existing terrain, vegetation, and improvements on subject site? y L'-'ee65 5 , <eT TV 3e LPve�er� Fe/L- k S e w!T?r E.�S�--�g �a a«sc fl 2 .4 Al2?�9 e yT !oT S ow•y�iz, �ofs��3� aJ /� AJE' ay.+l�e Ern, ffG�`*S� w.iY !�o �DTS #9 Total size of area to be cleared Z �� acre sq ft Size of area to be cleared on slopes over 10% AC/ F #10 Has a soils report been completed on the subject site? yJ If yes, include copy with application. #11 Is the subject site within 200 feet of a designated shoreline #12 Does the subject site contain any of the following features? River Lake Wetlands Saltwater Slope greater than 15% Soft compressible soils Seasonal Runoff None_�l� #13 Will the proposed land surface modification change the points where storm water or groundwater enters or exits the site? #14 Will the proposed land surface modification change the quality, quantity, or velocity of storm water/groundwater? IL— J #15 What methods, if any, will be utilized to minimize erosion and possible sedimentation into nearby waters during and after construction? �u�7ti2e �zocK /�n-D/a IL RAr %ie #16 Will this land modification result in the redirection of any surface water runoff onto adjacent properties? /L-110 #17 Will surface or subsurface runoff be collected or controlled by interceptors, curtain drains, or other water collection devices once this land modification has been completed? #18 Will the land be replanted upon completion? XPS If yes, with what types of plants? 9/,4 5 s f— 5ff2K,,58 e1„ a #19 Will this modification result in slopes steeper than those currently on the site? i"- If so, how steep? Show following on the site plan Lot Dimensions Flood Zones Existing Structures Fences Structure Setbacks Driveways Water Lines Shorelines Drainage Plan Topography Septic Systems Wells Proposed Improvements Easements Indicate Directional by (N, S, E, W) Name of Flanking Street in relation to plot plan Name of Fronting Street APPLICANT TO DRAW SITE PLAN BELOW j o e L M4-z J� G1a25�'�" I�jC ✓t7 APPROVED rAL CONSTRUCTION MUST MEET MASON BUILDING INSPECTOR OR EXCEED LOCAL CAGES. IFANY C ANGES S 1641BIJJPCTTO APPROVAL QUESTIONS PLEASE CALL THIS -2 /53 OFFICE 8 - APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW THESE PLANS MUST BE �N �,�� S SITE OR IN ECTION. E C A VA T e MG YN 4-0 `_JGt7e ,) All c;,?a"IC— Mc,'-u ,.J Z5 c1ppro,C. 6o , ( ��. a r-U NOTICE: THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANYTIME AFTER WORK IS COMMENCED. PROOF OF CONTINUATION OF WORK IS BY MEANS OF A PROGRESS IN- SPECTION. OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT I CERTIFY THAT I AM EXEMPT FROM THE REQUIRE- I CERTIFY THAT I AM A CURRENTLY REGISTERED MENTS OF THE CONTRACTORS REGISTRATION LAW CONTRACTOR IN THE STATE OF WASHINGTON AND I RCW 18.27, AND AM AWARE OF THE MASON COUNTY AM AWARE OFTHE ORDINANCE REQUIREMENTS REGU- ORDINANCE REQUIREMENTS FOR WHICH THIS PER- LATING THE WORK FOR WHICH THE PERMIT IS ISSUED MIT IS ISSUED AND THAT ALL WORK DONE WILL BE IN AND ALL WORK DONE WILL BE IN CONFORMANCE CONFORMANCE THEREWITH. NO CHANGES SHALL BE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT MADE WITHOUT FIRST OBTAINING APPROVAL FROM FIRST OBTAINING APPROVAL FROM THE BUILDING THE BUILDING DEPARTMENT. DEPARTMENT. X OWNER L C: X BY U DATE Z �� t 23 DATE f FOR OFFICIAL USE ONLY:Accepted by: S._`�►� Date: Z� DEPARTMENTAL REVIEW Planning APP COND APP HOLD i Building Environmental Other Special Conditions FEES Grading Permit Plan Review Site Inspection b�C� ✓ Violation Fee 21 ,/ Other TOTALFEES $