HomeMy WebLinkAboutRLC93-00544 - RLC Application - 12/25/1993 Date Received: `'� -•L >•� )
MASON COUNTY
DEPARTMENT OF COMMUNITY DEVELOPMENT
RESOURCE LANDS AND CRITICAL AREAS CHECKLIST
The following checklist is designed to assist an applicant for a Building Permit, On-Site Sewage System Site
Evaluation and Disposal Permit, Access Permit, Land Modification Permit, Boundary Line Adjustments, Land
Segregations, Hazardous Waste Permit, or Shoreline Permit in determining whether their property is affected by
regulations under the Mason County Interim Resource Ordinance (77-93)*. This checklist is an important
opportunity foridentifying earlyin the permit process whether there will be any environmental regulations affecting
the proposed development.
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Site Address/ /t� 1y� G�i+ti'Q/ Phone #(r36) 377- 6-K'76
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Owner Address /3/ C_/L,4C
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Tax Parcel No. (Confirm with Assessors Office) tate bzip��L-3
--1��� Legal DescriptionVp
Project Description
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Directions to site (Please attach map)
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Answer th
Wflciei and resour ritical areas
,,e only Departmen Q 'lanning
Do any of
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❑ [A 2. Rivers, streams, or creeks with year-round flow? r✓��/
❑ (A 3. Rivers, streams or creeks with intermittent flow but are within a clef ly defined channel?
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❑ 4. Lakes or ponds less than 20 acres in size?
❑ 5. Wetlands: Areas that are inundated or saturated by surface water that under normal circumstances
support vegetation adapted .for life in such conditions; such as marshes, bogs, and swamps. (See County
Maps for guidance.)
❑ 6. Slopes greater than 15% (8.5 degrees)? (See the ounty Landslide and Erosion Hazard Maps for
guidance.)
❑ 7. Floodplains? (See County Federal Emergency Management Maps and County Seismic Hazard Map
for guidance.) f
l ❑ t'A 8. Seismic Hazard Areas? (See C unty Federal Emergency Management Maps and County Seismic
Hazard Map for guidance.) ���
You may be provided nuisance protections by the County for certain resource activities. If you are enrolled in any
of the following programs:
Unty Y—e-s�No
❑
�- 1. Agricultural Open Space Taxation Program, RCW 84.33
1/ ❑ [A 2. Open Space Timber Taxation Program, RCW 84.33, or Designated Forest or Classified Forest,
RCW 84.34
Copies are available at Mason County Department of Community Dovolopmont for $5.00 each.
SITE PLAN
:ASE SHOW THE FOLLOWING INFORMATION OR PROVIDE SURVEY MAP IF POSSIBLE:
P. Location &dimensions of existing &proposed property boundaries. ► Approximate slope of land (grade &direction), topography.
► Identify legal access including, width of all road right-of-ways&easements. ► Location of significant natural features(water bodies, rivers).
► Locate all existing &proposed structures,drainfields, wells &driveways. ► Project
Y J t description
Scale 1
North Arrow
state that I have answered the above truthfully to the best of my knowledge.
rf� i yr Applicant/Owner —Da
te
FOR OFFICIAL USE ONLY
Adjacent property.
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There is a $40.00 application fee for the Resource Land & Critical Areas Checklist. Make checks payable to the Mason
County Treasurer.
When completed, this form becomes part of the permit application.