HomeMy WebLinkAboutSPI2006-00196 - SPI Application - 7/6/2006 M RECEIVED
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MASON COUNTY JUL 13 2006
PLANNING D PT. PRE-INSPECTION APPLICATIMASON COUNTY
PLEASE PRINT $205.00 Fee Required
1. Owner: �A:LtY66 Ud& IU —Mi] y Applicant:
Site Address: Applic Addr ss:
Owner ddress: City: St Zip
City: St Zip Phone:( l — day
Phone:(' day
Phone:( ) evening Planner:
Email Address: SMP comp.Plan &kX Type of Use
n Water Body�Pud CA&
2. Parcel No. � /i � -�-
Parcel No. - �' d r -' 60d
Legal Description: . �C, ,� l.C� Y I / L ) V _ y1 UV L 3
3. ose f e-Inspection
4. Use of building: k
5. Do any of the following ex' t on or adjacent to property?: slope( saltwater(i lake( ) river )
pond( wetland(seasonal runoff( other( ) stream( seasonal creek
Directions to Site: _ _
If the information is incomplete, then Mason County must disclaim any errors resulting from deficiencies in the original
application. Pre-inspection reports remain valid only until development changes occur in the vicinity which affect the lot
evaluated in this inspecti o the laws regul g d elop t of the site change after the time of inspection.
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Applicant Signature:__ Y___________ ______Date:__
!f you would like to be on site during inspection,please check here:
Return application to: Department of Community Development,Planning Division
P.O. Box 186
Shelton, WA 98584
(360)427-9670
Please include a$205.00 check or money order payable to Mason County Treasurer
When completed,this form becomes part of the parcel file.
FOR OFFICE USE ONLY: Accepted by: Date:
MORE ON BACK SIDE
Revised: 01/18/06
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Please illustrate below the proposed building site in relation to critical areas (slopes, streams, lakes, wetlands, etc.)
existing improvements, as well as property lines. APPLICATIONS SUBMITTED WITHOUT ADEOUATE
ILUSTRATIONS WILL NOT BE ACCEPTED AND WILL BE RETURNED TO THE APPLICANT.
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Departmental Review
(For Office Use Only)
Planning Department Findings: ____________________________________________
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