The URL can be used to link to this page

Home My WebLink AboutGRD96-00038 Cancelled - GRD Permit / Conditions - 1/9/1997 • MASON COUNTY Mason County Bldg. III 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 0 Ft /X D 1 N C P 1 - R IVI II T FOR INSPECTIONS CALL 427--9670 GAD06-•0038 PARCEL : 123315100055 PI.AT -BEPLO D I V : BLK : LOT ; 55 JOB ADDRESS : NEE 790 1 ARSON LAKE RD BEL.FA I R OWNER : BRIAN ROWL.AND CONTRAC:TOP.: R&L CONSTRUC-TION 427-5940 ENGINEER : F1L.L7 . . . . . : . . aY TYPE AMOU BY ATE pFrE�PT CUT 7 . . . . , . . . . Yr ::- a —_ �, x x C) GRADE? . . . . . . . :N PRMr 1; 33 .00 LG 1 /27/i�60000 410 r AREA GRADED — : 0 : :A � PLAN 1; 22. .50 TLG 1 127 r, VOLUME . > . . . . , . 150 :0 OTAL : 55 .50 C` 4 PROJECT DESCRIPTI :grading . FfII a fl _p . imately 15 ' cy in backyard PROJECT LOf:AT lON :HW 3 TO PEL FA R N()#ITfI SHOR ROAN TO LAR::AN LAKE Rb ABOUT 8 MILES S THIS PERMIT BECOMES N L. AND V 1D IF WORK R CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, Oil IF CONSTRUCT I O Oil )RK IS SUS _NDED F tat"OR A PERIOD 180 DAYS AT ANY 'I I ME AFTER WORK IS COMMENCED . EVIDENCF OF CONTINUATION WORK IS A PROGRESS INSPECTION WITHIN 'THE 180 DAY PERIOD . f r OWNER OR AGENT : DATE : 61e_t111, revo 04/1I/42 COMPLIANCE TO ATTACHED CONDITIONS IS REQUIRED u 1 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 FRAMING by date by date by Walls FIRE DEPT. date by date by date by PLUMBING ttic OTHER Groundwork d to b date b y D.W.V. WALLBOARD NAILING date by date by Water Line FINAL INSPECTION date by date by date by i I I ( I V — • MASON COUNTY Mason County Bldg, III 426 W. Cedar P,O, Box 186 Shelton, Washington 98584 PE. RM I `T- C 0 N D I 'T 1 C7h>I :�-3. ' Case No . , GPD96-0038 Fort BR1AN ROWLAND Pager 1 1 } Temporary Erosion control measures ( si fencing, reseeding, and straw bales ) must be Implemented to prevent water qualit Impacts of adjacent waters or adjacent property; use of rocks at too of t I ope or ort terrace err aces wa I I s i :, enoour aced . X 'L )' Approved per site plan I,! topographic Dross-section . x 3 ) ALL SURFACE TF.R AND POTENTIAL. RUNOFF WILL BF CONTROLLED UN SITE AND SHALL NOT ADVERSI_Y FCT ANY ADJACENT PROPERTIES NOR INCREASE THE VELOCITY FLOW ENTERING OR ABUTTING 0 ANY STATE OR COUNTY CULVERTING/DITCHING SYSTEM OR ROAD WAY X -------------------------------------- a . • MASON COUNTY Mason County Bldg, III 426 W. Cedar P.O, Box 186 Shelton, Washington 98584 41 All f i 1 ! s shalt be oompaoted to a minimum of 90 par cent of Coax Imum dens Its, . X 5 ALL CL FAR ING, CUT"TING, GRADING, EXCAVATING, TERRACING, FILLINo, AND IMIL (AR WORK WILL BE REGULATED BY THE REQUIREMENTS PURSUANT TO CHAPTER 33 OF THE N' FORM BUILDING CODE . X f s� I M r ' GARY YANDO,DIRECTOR �oN.SZA o A N DEPARTMENT OF COMMUNITY DEVELOPMENT } SN = z PLANNING - SOLID WASTE - UTILITIES o UTI I IES y T N Y y BLDG. I • 411 N. 51H ST. • P.O. BOX 578 rasa SHELTON,WA 98584 • (360) 427-9670 DISCLAIMER/WAIVER OF COUNTY LIABILITY: PERMITS ON EXISTING LEGAL LOTS OF RECORD, LAND DIVISION APPROVALS, SHORELINE PERMITS, VARIANCES, AND SPECIAL USE PERMITS: The undersigned property owner is aware of the uncertainty regarding Mason County's development regulations created by the Growth Management Hearing Board's Order of October 2, 1996, and in consideration of Mason County's willingness to proceed with processing of applications which might be affected by that Order, the undersigned property owner hereby agrees to waive any lawsuit, action, or claim for damages against Mason County which may arise out of Mason County's actions in acceptance, processing and/or issuance of such permits or approvals (hereinafter"permitting actions'), which damages are attributable to the County's decision to take permitting actions despite the risk that changes to the County's development regulations might later make the County's permitting actions invalid. ! ,� �I P C�c Jc'cfrtnJ 0 Z o S- Date (Parcel No. or Legal Description) Property owner's signature(Notarized) (or the County may accept the signature of the owner's authorized agent upon proper proof of authorization) ACKNOWLEDGEMENT CERTIFICATE (INDIVIDUAL) STATE OF COUNTY OF On this !day of �l/ , in the year ,before me Notary Public, personally appeared('?FJ;2/-! 7 Q/J(�L personally known to me to be the on whose name is subscribed to this instrument, and acknowledged that he/she executed it. WITNESS my hand and official seal. -For County use only- Reviewed by applicant on /ZW//,/h (Date) otary's signature Staff Initial: My Commission Expires: GRID-9 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 3 (z i I ru 12ow 1 wN 13 Phone# a -7 ' 6 5 3 0 Fire District# Site Address A)I- 710 Ll4rSo j Cit P 4 r' St Zip 9A S d'y Owner Address MM-P City St Zip Describe Work u ^P n ��nn bAc #2 Contractor Name S Contras or Reg# Address Expiration Date City t Zip Phone# V� #3 Engineer's Name Phone# Address St Zip #4 Parcel No. Legal D scription i1 2 ✓E'i 5S 0 �L #5 Number of c is y ar o be excavated:L `� i�!-1 dJ 1.11� L Number of cubic yards to be filled: / �C� ) �(ul 1 (�� IV 1 pj Number of cubic yards to be graded: ( V / #6 Will this be a balanced cut and fill entirely within the site? An r,,� � -&4 vNm Yes i No X C �J If No: Will fill be brought on site? Yes No &Wus Maypw Lld Where does imported fill originate from? �� Does fill contain any potentially hazardous materials? Yes No X Ow6wV #7 Will excavated materials be taken off site?Yes No 1K If Yes: Where will excavated materials be taken? #8 Briefly describe existing terrain, vegetation, and improvements o/n� subject site? "J o ;J fro Z f �I""J f/U O'J S! / . 9rrt l S an,N #9 Total size of area to be cleared A)LA- acres/sq ft Size of area to be cleared on slopes over 100/. 4 _ AC/SF #10 Has a soils report been completed on the subject site? '. f.. If yes, include copy with application. #11 Is the subject site within 200 feet of a designated shoreline A)D #12 Does the subject site contain any of the following features? River Lake Wetlands Saltwater Slope greater than 15% Soft compressible soils Seasonal Runoff Non4- #13 Will the proposed land surface modification change the points where storm water or groundwater enters or exits the site?—N O #14 Will the proposed land surface modification change the quality, quantity, or velocity of storm water/groundwater? AZ 6 #15 What methods, if any, will be utilized to minimize erosion and possible sedimentation into nearby waters during and after construction? 51 /1" Te',-J c P u { 4e &14", el� * P #16 Will this land modification result in the redirection of any surface water runoff onto adjacent properties? /✓D #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? Ye #18 Will the land be replanted upon completion? V-eS If yes, with what types of plants? QIAIS ati ci 14,1-1( v ! �4 fi anJ #19 Will this modification result in slopes steeper than those currently on the site? IVO 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 s r I APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW VA S U� r✓� '" R D f 1 j S ire, eP 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 OF THE 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 X BY DATE DATE FOR OFFICIAL USE ONLY:Accepted by: Date:' DEPARTMENTAL REVIEW Planning APP COND APP HOLD Building Environmental Other Special Conditions FEES Grading Permit Plan Review Site Inspection Violation Fee Other TOTALFEES $