HomeMy WebLinkAboutRLC Application - 10/2/1998 MASON COUNTY
RESOURCE LANDS & CRITICAL AREAS CHEC T
PLEASE PRINT $44.00 Fee Required
Applicant: rem Z'N&/,tn Parcel No. - -
Applicant Address: / �`'
City: L6 U✓Z i e A? St�AZip Legal Description: ��T C Z u�Si
Phone: ��A/ t (c7(Q L/ �p6t't ��v� �
Owner Name (if different from applicant:
--Purpose of Pre-Inspection: ,r!DGk AT
Use of Building:
Do any of the following exist on or within 200 feet of the property: saltwater lake
river/stream pond wetland seasonal runoff y' _ slope
Directions to Site: rKl6 /�Dr'I 3 • �,( t ow 1X'4_r n Gala Td
Please illustrate in the box below the propo ed building site in relation to property lines,
significant natural features, slope grade and direction and topography (or include on separate
sheet):
rNorthow 0
This 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 affect by regulations under the Mason
County Interim Ordinance (77-93). This checklist is an important opportunity for identifying Parly in the permit process
whether there will be any environmental regulations affecting the proposed development.
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 affects the
lot evaluated in this inspection.
Applicant Signature: Date: /�—1 91s�_
Return application to: Department of Community Development,Planning Division
411 N. 5th/P.O. Box 578
Shelton, WA 98584
(360) 427-9670/1-800-562-5628
Please make checks or money orders payable to Mason County Treasurer
When completed, this form becomes part of the permit application.
Please illustrate below the proposed building site in relation to critical area & property lines:
Departmental Review
(For Office Use Only)
Planning Department Findings:
FORE ST PRACTICE BASE MAP
T O WNSHIP 21 NORTH , RANGE 03 WEST ( W . M ) SECTION 27
APPLICATION #
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MAP DATE: Februcry 23, 1997 1 it
CONTOUR INTERVAL : 40 Feet LEGEND:- See Instructions
NAD 27 DISCLAIMER : See Legend
Water/Wetlands including their location and class may be incorrectly displayed or not shown
on the Base Map. Applicants are responsible for verification and correction.
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�IOTt 'I' /��/I M" NiO THE USER
- t l Wetlands which have been field exan
rat was prepared primarily by stereoscopic SYMBOLOGY EXAMPLE on the map by an asterisk I.1.
� to, aerial photographs.Wetlands were Dominance type leither vegetative or
09r40hs based on vegetation, visible can be added to the map by the inte
�aldY in accordance with Ctasslflca- SYSTEM • Additions or corrections to the we
Gaap-Weter Habitats of the Unhed SUBSYSTEM displayed on this map are solicited.PI
Grahie Cowardin,sit al. 1977.The CLASS information to the address indicated
E2EM5N • Some areas designated R4SB, I
V (intermittent streams)may not mr