HomeMy WebLinkAboutBLD2011-00189 Cancelled Garage DDR2011-00063 - BLD Permit / Conditions - 3/30/2012 ' Inspection Line(315U)421-/2152
MASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT Phone: (360)427-9670, ext. 352
Mason County Bldg. III 426 W. Cedar,P.O. Box 186
Shelton, WA 98584
RESIDENTIAL BUILDING PERMIT BLD2011-00189
OWNER: RILEY COOTS RECEIVED: 3/14/2011
CONTRACTOR: LICENSE: EXP: ISSUED: 5/13/2011
SITE ADDRESS: 351 E DARTMOOR DR SHELTON EXPIRES: 11/13/2011
PARCEL NUMBER: 321275300109
LEGAL DESCRIPTION: LAKE LIMERICK 4 LOT: 109
PROJECT DESCRIPTION: DIRECTIONS TO SITE:
GARAGE TURN RIGHT O ART OR AFTER TH LA E LIMERICK STORE STAY
RIGHT ABOUT 1 LE N THE LEFT
General Information Construction&Occupancy Information I I Sq r F tage Information
No. of Bedrooms: Type of Constr.: VB
Type of Use: SF Insp.Area: No. of Bathrooms: Occ. Group: U of a Deck:
Type of Work: ACC Fire Dist.: 5 No. of Stories: 1 Oc ad: uildin Garage-Attached 251
Valuation: Building Height: 10 Occ Sta s: im asem t:
Manufactured Home Inforrilatio-K, Setpac Inf at n Shoreline& Planning Information
Water Body: na
Make: Length: Ft. ron S 100 '�Shol, line: r o y: No
Model: Width: Ft. Rear: N 20 0 Sig,
Ft. Shoreline Desi
ide 1: 9 Not Applicable
Year: Serial No.: e 2: 0 Ft. Comp. Plan Desig.: Rural
Plumbing Fixtures Mechanical Fixtures FEES
Type t Type Qty. Type By Date Amount Receipt
Plan Check Fee TW 3/14/2011 $73.00 S12011000(
Planning Review Fee TW 3/14/2011 $205.00 S12011000(
EH Plan Review TW 3/14/2011 $103.00 S12011000i
Building State Fee LAW 3/21/2011 $4.50 S12011000(
Building Permit Fee GMM 3/30/2011 $141.00 S12011000(
Total $526.50
BLD2011-00189 Please refer to the following pages for conditions of this permit. Page 1 of 4
CASE NOTES FOR
BLD2011-00189
CONDITIONS FOR
BLD2011-00189
1) Contractor registration laws are governed under RCW 18.27 and enforced by the WA State Dept of Labor and Industries, Contractor Compliance Division.
There are potential risks and monetary liabilities to the homeowner for using an unregistered contractor. Further information can be obtained at
1-800-6y77-0982. The person signing this condition is either the homeowner, agent for the owner or a registered contractor according to WA state law.
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2) Owner/Agent is responsible to post the assigned address and/or purchase and post private road signs in accordance with Mason County Title 14.28.
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3) Owner/builder assumes all responsibility if drainfield/reserve area is encumbered.
A. Drainfield/ Reserve requires a 1 Oft setback from all footing/foundations.
B. Septic tank(s) requires 5ft setback from all footing/foundations.
C. No foundation drains within 30ft, down gradient of drainfield/reserve area.
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4) Xpprovedeer dimensions and setbacks on submitted site plan. Setbacks are measured from the furthest projection of the structure.
5) All approved plans are required to be on-site for inspection purposes. If an inspection is called for and plans are not available on site, then approval will
not be granted. In addition, a re-inspection fee (refer to current fee schedule, minimum 1 hour) will be charged and must be collected by the Building
Departrvi h rior to any further inspections being performed or approvals granted.
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6) The plan review check list and corrections are part of the approved plans and must remain thereto. It is the responsibility of the applicant to make the
corrections indicated on the plans. Once the plans are marked "APPROVED", they shall not be changed or altered without authorization from the Building
Official. The permit holder is responsible to retain the complete approved set of plans on site for the duration of the project. Failure to comply and/or
removal of approved documents will result in failure of required building inspections.
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7) This structure is approved as un-heated space. If at any time this building is to be used for anything other than what it is approved for, a change of use
permit shall t }ap I,p ied for, reviewed and approved prior to the change.
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8) THE FOUNDATION SYSTEM SHALL BE PLACED ON UNDISTURBED, NATIVE SOIL. X
BLD2011-00189 Please refer to the following pages for conditions of this permit. Page 2 of 4
9) The "approved" site plan is required to be on-site for inspection purposes. It an inspection is requested and the"approved" site plan is not on site, tnen
approval will not be granted. In addition, a re-inspection fee (refer to current fee schedule, minimum 1 hour)will be charged and shall be collected by the
Building Depa e nt prior to any further inspections being performed or approvals granted.
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10) This structure is limited to U-occupancy use only (private garages, carports, sheds, and agricultural buildings.) Any other use will be in violation of the
international c9 and Mason County Regulations unless a "Change of Use" permit is applied for, reviewed and approved.
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11) All construction must meet or exceed all local ordinances and the international codes requirements as adopted and amended by Mason County and the
State of Washington. Occupancy is limited to the approved and permitted classification. Any non-approved change of use or occupancy would result in
permit revocatio
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12) All changes to"approved" building plans that effect compliance with the international codes as amended and adopted, or any other Mason County
ordinance or regulati n,.must be reviewed and approved by Mason County prior to construction.
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13) CONSTRUCTION PROCESS TO BE FIELD CORRECTED AS REQUIRED PER MASON COUNTY BUILDING DEPARTMENT AND THE ADOPTED
BUILDING CODE.
The construction of the permitted project is subject to inspections by the Mason County Building Department. All construction must be in conformance
with the international codes as amended and adopted by Mason County. Any corrections, changes or alterations required by a Mason County Building
Inspector shall be ade prior to requesting additional inspections.
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14) All property lines shall be clear) identified at the time of foundation inspection. X f—C
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15) All building permits shall have a final inspection performed and approved by the Mason County Building Department prior to permit expiration. The failure
to request a final inspection or to obtain approval will be documented in the legal property records on file with Mason County as being non-compliant with
Mason County ordi�yans and building regulations.
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16) All permits expire 180 days after permit issuance, or 180 days after the last inspection activity is performed. The Building Official may extend the time for
action for a period not exceeding 180 days, upon the receipt of a written extension request indicating that circumstances beyond the control of the permit
holder have prev tee action from being taken. No more than one extension may be granted.
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17) Pressure treated wood manufactured after January 1, 2004 may contain high concentrations of copper which could quickly corrode metal fasteners,
connectors, and flas in . Install metal connectors approved for contact with the new types of pressure treated material.
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18) Prior to final approval, all upland areas disturbed or newly creaY d by construction activities shall be seeded, vegetated or given an equivalent type of
erosion protection (silt fencing or straw matting). X ,,((
BLD2011-00189 Please refer to the following pages for conditions of this permit. Page 3 of 4
• 1.9) Application ackngwledges that the structure is only permitted for a use consistent with the current zoning of the parcel. zoning is aural Kesiaential b.
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20) ALL SURFACE WATER AND POTENTIAL RUNOFF WILL BE CONTROLLED ON SITE AND SHALL NOT ADVERSLY AFFECT ANY ADJACENT
PROPERTIES NOR INCREASE THE VELOCITY FLOW ENTERING OR ABUTTING TO ANY STATE OR COUNTY CULVERTING/DITCHING SYSTEM
OR ROAD W AY2 %
21) Landings and stairs must meet the same setback conditions as any permitted structure; and, must be shown on your site plan. Please check your
"Approved Site P n to ensure these structures are shown and meet the setback conditions listed.
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22) By definition, propane tanks and heatpumps are structures, which must meet setback conditions. Please check your"Approved Site Plan"to ensure
these structures meet the setback conditions listed.
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This permit becomes null and void if work or construction authorized is not commenced within 180 days, or if construction or work is suspended for a period of 180 days at any
time after work is commenced. Evidence of continuation of work is a progress inspection within the 180 day period. Final inspection must be approved before building can be
occupied. Proof of continuation of work is by means of a progress inspection.The owner or the agent on the owners behalf, represents that the information provided is accurate
and grants employees of Maso C y access t the bove described property and structure for review and
inspection.
OWNER OR AGENT: �� DATE:
BLD2011-00189 Please refer to the following pages for conditions of this permit. Page 4 of 4
00 '
a CONCRETE MECHANICAL MANUFACTURED HOME 00
Footings !Setbacks Date By Ribbons - - --_— 0
Gas Piping fA
o Intenor Date By Interior-Date By Date By
00 Exterior Date BY Exterior-Date By
Set-up ---. _
INSULATION F
Point Load J Isolated Footings Date By m
BG f SLAB INSULATION ----
Date By Data By FIRE DEPARTMENT
Foundation Walls Floors Date By
Date By Data By DECKS
FRAMING Walls Date By
Date By Data By PROPANE TANKS
PLUMBING vault Date By
Date By OTHER
Groundwork Attic
Date By Date By Type.pats By
D.W.v DRYWALL Type-
Date
Brace Wall Date By W
Oate By Date By
w
FINAL INSPECTION
y Water Line Fire Seperation
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Dale By Date By Dato By
s Pass or Request Inspect. c
Type of Insp. Fail Date Date Done By Comments ono
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Building Permit # I/- MASON COUNTY
10,
BUILDING 111 426 W. CEDAR
SHELTON, WASHINGTON 98584
(360) 427-9670
CORRECTION NOTICE
Job Location 3.51 Z241-7?` , W2C
This structure has been inspected by Mason County Building Department
and the following VIOLATION of County Laws and Ordinances has been
found: Items Listed below must be corrected to gain code compliance
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You are hereby notified that the above corrections shall be made
BEFORE PROCEEDING WITH ANY FURTHER WORK
i Call for re-inspection when corrections are made before continuing
❑ Make corrections, items will be checked on next inspection
This is not a complete irApection
Department T �
Date _ /Z Inspector
DO NOT REMOV THIS TAB
Pgrrait# � ' ' I MASON COUNTY
BUILDING III 426 W. CEDAR
SHELTON, WASHINGTON 98584
(360) 427-9670
CORRECTION NOTICE
Job Location 3� (
This structure has been inspected by Mason County Building Department
and the following VIOLATION of County Laws and Ordinances has been
found: Items listed below must be corrected to gain compliance
I
You are hereby notified that the above corrections shall be made
BEFORE PROCEEDING WITH ANY FURTHER WORK
❑ Call for re-inspection when corrections are made before continuing ❑ Please contact our office
❑ Make corrections, items will be checked on next inspection regarding possible structural
❑ OK to damage incurred by recent
"natural1man made"
❑ This its not a complete inspection disasters.This is NOT
Date Department j i / CORRECTION NOTICE.
Inspector i .y0)C11
n l�, 4 NOT i ' 'FIlk A# ' ' THP& T , -0mv
RECEIVED
JUN 1 t LO;i
- MASON COUNTY-
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SITE PL^ ) F;E ON SITE• j
CHANT._ _ Pi2OVAL
PLA ANNING '°6
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ALL SETBACKS ARE MEASURED' vy
FROM THE FURTHEST f
PROJECTION OF THE BUILDING '
PLAN PLOT REVISIOf�J
DATE Lo-- 15, 90 11
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MASON COUNTY DCO PLANNING 4k 7"m za� ruE
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SITE PLAN REO'_l!''_'� TO r,E ON SITE I �- �- AO 9 �r iJ- -t ,4
CHANGES SU6.jc.:T TO APPROVAL
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APPROVED I
MASON COUNTY DCD PLANNING
817E PLAN SITE
CHANGES SUBJECT TO APPROVAL.
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Name l 0v 11-5 Parcel# BLD#
Mason County
Department of Community Development
Small Parcel Stormwater Management Application/Worksheet (page 1 of 2)
Per Mason County Code,Title 14,Chapter 14.48 a stormwater site plan is required whenever a building application is
made for residential development,or redevelopment', with more than 2,000 square feet of impervious surface2.
'Redevelopment means,on an already developed site,the creation or addition of impervious surfaces,structural development
including construction,installation or expansion of a building or other structure,and/or replacement of impervious surface that is not
part of a routine maintenance activity,and land disturbing activities associated with structural or impervious redevelopment.
2Common impervious surfaces include,but are not limited to,rooftops,walkways,patios,driveways,parking lots or storage areas,
concrete or asphalt paving,gravel roads,packed earthen materials,and oiled,macadam or other surfaces which similarly impede the
natural infiltration of stormwater.Open,uncovered retention/detention facilities shall not be considered as impervious surfaces.
To Calculate Impervious Surfaces Please Complete.This Table
Surface Type Length X Width = Area *All dimensions in feet
Buildings X =
X = Measurements for buildings are taken at the
perimeter of the farthest projections(example:
X = eaves/gutters)
X =
Driveways X =
X = Length of drive begins at the right of way
X =
Parking Areas X =
X = Any paved, gravel or packed area per definition
above table
X =
PatiosNValks X =
X = Any paved, gravel or packed area per definition
above table
X =
Others X =
X = If the total impervious area of the proposed site
X = development is greater than 2000 square feet a
Small Parcel Stormwater Site Plan is Required
Total Impervious Surface Area(sum of all areas)
If the Total Impervious Surface Area is LESS THAN 2000 Square Feet, please read,acknowledge and sign below.
Based Upon the information you have provided a Stormwater Site Plan IS NOT required for this development activity.
Owner/Builder/Agent Acknowledges that submission of inaccurate information may result in a stop work order or permit revocation.
Acknowledgement of such is by signature below.I declare that I am the owner,owner's legal representative,or the contractor.I
further acknowledge that the information provided is accurate and employees of Mason County are granted access to the above-
described operty for review and inspection as may be required.
Owner/Agent/Contractor(circle one)Date•
If the Total Impervious Surface Area is GREATER THAN 2000 Square Feet, please read,acknowledge and sign
the information provided on page 2 of 2.
Page 1 of 2
Name Parcel# BLD#
Mason County
Department of Community Development
Small Parcel Stormwater Management Application/Worksheet (page 2 of 2)
Based Upon the information you have provided a Stormwater Site Plan IS Required for this development activity.
Title 14, Chapter 14.48 of the Mason County Code(MCC)regulates compliance requirements for Stormwater
Management in this jurisdiction. A complete copy of the ordinance can be found on the Mason County website:
htti)//www.co.mason.wa—us/code/commissioners/index.htm
Please follow the links to "Title 14, Chapter 14.48 Stormwater Management".
Regulated activities shall be conducted only after Mason County Public Works approves a stormwater site plan
(Mason County Code Title 14 Chapter 14.48 section 14.48.70). You will receive a copy of the Public Works document
entitled "Managing Storm Drainage on Small Lots,The Small Parcel Stormwater Site Plan". This document will assist
you in preparing the necessary information and plans for Public Works to review and approve. Per Department of
Public Works this document will constitute an approved plan if all of the relevant details* are to be installed in
their entirety AND no part of the stormwater system adversely affects any septic system (see Environmental Health
information below). If an alternative system is to be used a plan will need to be submitted to Public Works for approval.
A design by a registered professional may be required for more complex sites.
*These details are found in the document Managing Storm Drainage on Small Lots, The Small Parcel Stormwater Site Plan
on the pages that begin with"Handout"
PLEASE INITIAL BELOW TO INDICATE THE STORMWATER MANAGEMENT PLAN FOR THIS SITE
A) The relevant details from Managing Storm Drainage on Small Lots, The Small Parcel Stormwater Site Plan will be installed
in their entirety AND the system will be located as not to adversely affect any septic systems on this,or any other,parcel.
B) An alternative plan and/or professional design will be submitted to the Department of Public Works for approval AND the
system will be located as not to adversely affect any septic systems on this,or any other,parcel.
If you have further questions pertaining to parcel drainage and stormwater management Mason County's Public Works
Department can provide additional instructions,guidance and examples. (Section 14.48.130)contact Public works at:
Phone: (360)-427-9670 EXT. 450
Mail: P 0 Box 1850, Shelton WA 98584
Physical:415 N 6th St, Shelton WA 98584
If this development has,or will have,a septic/drainfield system you may need to contact Mason County Division of
Environmental Health to ensure that the stormwater system will not adversely affect the septic system of this,or
any other, parcel.You may also wish to consult with the septic design professional involved with the project. Mason
County Division of Environmental Health can be reached at:
Phone: (360)-427-9670 EXT. 352
Mail: P 0 Box 1666, Shelton WA 98584
Physical: 426 W Cedar St, Shelton WA 98584
A condition will be added to the building permit that states, in part,that all conditions the stormwater site plan will be met
prior to a request for final inspection of the building permit.
Owner/Builder/Agent Acknowledges that submission of inaccurate information may result in a stop work order or permit revocation.
Acknowledgement of such is by signature below.I declare that I am the owner,owner's legal representative,or the contractor.I
further acknowledge that the information provided is accurate and employees of Mason County are granted access to the above-
described property for review and inspection as may be required.
X Owner/Agent/Contractor(circle one)Date:
Page 2 of 2
MASON COUNTY RESIDENTIAL PLANS SUBMITTAL CHECKLIST .
Owner's Name:—Cal+j Date: Reviewed By
Documents:
^ Building Permit Application Completed Stormwater Checklist
Planning Intake Checklist Completed,
Site plan includes:AIlowable building area,roof overhangs,decks,etc.
--,! Fire Apparatus Access Road info required? Yes/No
Energy Code Application Form-O Electric wall heater O Electric central furnace O LPG Furnace
O Heat pump with electric furnace O Heat pump with LPG furnace O Boiler(heat type )
O'Other.Specify:
---1 Mechanical/Plumbing Application-WATER HEATER FUEL TYPEILOCATION
'---4_Engineering? Yes/No Snow load: Seismic:
Stock Plan-approved snow load: Seismic:
Manufactured Homes—4 FLOOR PLANS
Foundation Type: ANSI/Manufacture method Engineered footing/foundation Basement
Decks: Covered? Uncovered over 4 x 6 and over 30"? Construction plans required.
Construction Plans: 3 COMPLETE SETS
Plans Lei Cross Section
Legible Reco ized Scale Elevation Views Cro
�[Foundation Plan Roof Framing Plan _Floor Plan-Use of rooms noted(all floors)
Floor Framing Plan:all oor•levels including loft,crawlspace,etc. (,200 S.F.??-stairs?)
'-�1 Deck Framing Plan, incl cov.porch framing
Plan Details: _
Roof framing details,truss lay-out may be needed (Hip and girder location shown) k 16 1657
Wall Framing-Does bearing-wall height exceed 10'?(Engineering may be require ),' 7-X-.C-P [o C-
_Floor framing: Floor joists(size&spacing): -,!5j6Ljo , Floor beams:
Window headers. Typical header. Garage header.
Foundation;footing size,reinforcement X. t'
Concrete Walls-Does Concrete Wall Height Exceed V?0 rigineering maybe required see details)
v Landings at all exits?Less than 30"above grade?Y/N
-!t,L Heated By Furnace-Location offurnace Fuel type:
- Fireplace/Stove Information Shown-Fuel Type? Location(s):
Window Sizes Marked on Plans
Braced wall panels(shear walls)marked on plans or lateral engineering?
'V 2-story garage? (Engineering maybe required) I"story of two story DI-45%,D2-55%
COMMENTS:
ENGINEERING REQUIRED
Braced wall panelstbrace wall lines are not marked on plans(R602.10)
Amount and location of bracing does not meet minimum required in.Table R602.10.1
DESIGN CRITERIA: All notes and details required as a result of the engineered analysis shall be transferred onto.proposed
building plans. Wind 85 MPH, Exposure B(unless proven otherwise). Seismic Zone: ,.Snow_�_psf.
IRREGULAR BUILDINGS R301.2.2.2.2
- grree lafpor-t-ioms-�o� :,Fn all-tc�idPsiun -i rd gi_neerrin etice=���nortio"fla�buildin"halbbe-
considered to be irregular when one or more of the following conditions occur:
1)Exterior braced wall line or B WP cantilevered or offset by more than 4'
2)Roof or floor is not laterally supported on all edges
2A)Portion of roof or floor extend more than 6 fL beyond the braced wall line.
3)End of BWP extends'more than I ft over an opening more than 8 ft in width below.
4)Opening in a floor or roof exceed the lesser of 12 R or 50%of the least floor or roof dimension.
5)Portions of floor level are offset vertically
6)Shear wall lines do not occur in two perpendicular directions.
7) When a story above grade is includes masonry or concrete construction(exc:fireplaces,chimneys,and veneer).
When this applies the entire story shall be designed. In accordance with accepted engineering practice: .
[:\permit tech building checklist.doc Revised 11-29-2007
MASON
COUNTY PERMIT NO.
BUILDING PERMIT APPLICATION
426 W. Cedar- P.O. Box 186, Shelton, WA 98584
Shelton (360) 427-9670 - Belfair (360) 275-4467- Elma (360) 482-5269
On the web www.co.mason.wa.us
APPLICANT INFORMATION CONTRACTOR N
Owner 1 V 0�s Company Name
Mailing Acloress 1= &ja). Mailing Address
City ti State b� Zip Code S �s City State Zip Code
Phone�>O t{�3--,y2S 7 Other Ph. Phone Other Ph.
Lien/Title Holder Contractor Reg. # Exp.
E mail address E Mail Address
Drivers Lic.# DOB I - Drivers Lic.# DOB
SEPTIC/WATER SYSTEM INFORMATION - Connect to New Septic Existing Septic
Connect to Water System Name of Water System
Well Water System Name of Water System
PARCEL INFORMATION - 12 Digit Parcel No Fire District
Legal Description
Site Address (Please include stregt na e, street n ber and city) 7 for 7 '� w
Directions to sit ✓� �� ftcv- c l
C` v1 ,
Will timber be cut and sold in parcel preparation? Yes/No ,
Is property within 200'of Saltwater Lake River/Creek Pond
Wetland Seasonal Runoff Stream Slopes or Bluffs > 15%
Is this permit submittal the result of a Stop Work Notice,Correction Notice or other enforcement action?Yes/No
TYPE OF JOB - New 1Y Add Alt Repair Other PRIMARY RESIDENCE 0 SEASONAL ❑
Use of Building Describe Work t
No. of Bedrooms No. of Bathrooms Square Footage- 1 st Hoor 2nd Floor
3rd Floor Basement Deck Covered Deck Other Sq.ft.
Garage Attached Detached Carport Attached Detached
MANUFACTURED HOME INFORMATION - Make Model Year
Length Width Serial No. No. of Bedrooms No. of Bathrooms
Type of Heat Purchase Price$ Replacement Unit? Yes/No
Installer Name Certification No.
OWNER/BUILDER Acknowledges submission of inaccurate information may result in a stop work order or permit revocation.Acknowledgement of
such is by signature below.I declare that I am the owner,owners legal representative,or the contractor.I further declare that I am entitled to receive this
permit and to do the work as proposed in the application.I declare that I have obtained the permission from all the necessary parties.If permission is
required from any easement holder or any other party in interest regarding this apprication or the work proposed in the application,I have obtained
permission from them to apply for this permit and conduct the work proposed. The owner or agent on owners behalf,represents that the information
provided is accurate and grants employees of Mason County access to the above described property and stnicture for review and inspection.
P OOF NTI OF WORK IS BY-MEANS OF A PROGRESS INSPECTION.Z / l
- Date- > - `! I 1
Owner/Owners Representative/Contractor (indicate which one
FOR OFFICIAL USE BEYOND THIS POINT Accepted by��f � Dat?
DEPARTMENTAL REVIEW APP OVED DENIED NOTES
Building Department 3—
Planning Department
Environmental Health Departm-ent -- - -
Public Works Department
Fire Marshal A
FEES
Building Permit Fee Site Inspection
Plan Review Fee EH Review Fee
Plumbing & Base Fee Planning Review Fee
Mechanical & Base fee Other
Wood/Gas/ Pellet Stove Fee State Fee
Violation Fee Pre-Paid at Submittal
Valuation $ TOTAL FEES
I
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MASON COUNTY Mason County Permit Center Use:
DEPARTMENT OF COMMUNITY DEVELOPMENT DDR Ol0l l - Coup
411 N. Fifth Street/P.O. Box 186,Shelton WA 98584
360.427.9670 ext. 352 Date Rcvd
Request for
Administrative Variance for Reduction in the Required Setbacks ($115.00)
For administrative review, the minimum variance on a setback request is 5 feet from the side yard lot
lines and 10 feet for front and rear lot lines or any access easement. Request for further reduction
requires a standard variance. Setbacks are measured from the furthest projection of the structure,
including roof eaves.
Applicant/Owners:
Mailing Address
bride-
City:k3h(z n State: OA Zip: 19S5&1
Telephoneocot) 41P3 r),A152.1
Email:
If this reduction is tied to a building permit, pl ase give permit case number.
BLD a a, - 9 - ; U�c�
Parcel Number(s): " a—1 -S 3 - L) '9 Zoning
Site Address: �31 � '` T I�'1QU��rIV k5-
Requested setback variance:
ft. ❑ Front ❑ Rear Y.Side gc'-
ft ❑ Front ❑ Rear ❑ Side
ft. ❑ Front ❑ Rear ❑ Side
ft ❑ Front ❑ Rear ❑ Side
Front Setbacks-From access easements and road right of ways. Minimum 10 feet.
Rear Setbacks-From the rear property line. Minimum 10 feet.
Side Setbacks-From the side property line. Minimum 5 feet except for certain shoreline designations.
An illustrated site plan is required.
Your site plan must show the following: north arrow, abutting street or easements, set backs to all
property lines and existing buildings, slopes, surface water, wetlands, critical areas, septic, well and
driveway. Show all proposed new development.
I:\Community DevelopmentTACWARIANCES\Admin Variance.doc Edited on 7/
t
FRONT AND OR REAR YARD REDUCTION REQUESTS:
For existing lots of record as of March 5, 2002;
You must meet one of the following:
2) One of the following exists on the lot (check all that apply):
❑ a) steep slopes, wetlands, or streams present;
❑ b) soils that restrict building or septic development;
❑ c) lot width at the front yard line of no more than 50 feet;
❑ d) lot size of no more than one-fourth acre;
❑ e) existing improvements of buildings, septic systems, and well areas.
SIDE YARD REDUCTION REQUESTS:
For existing lots of record as of March 5, 2002;
You must meet one of the following:
2) One of the following exists on the lot(check all that apply):
❑ a) steep slopes, wetlands, or streams present;
❑ b) soils that restrict building or septic development;
❑ c) lot width at the front yard line of no more than 50 feet;
❑ d) lot size of no more than one-half acre;
�e) existing improvements of buildings, septic systems, and well areas.
Explain how these circumstances preclude a reasonable development proposal from meeting the
setback standard for Rural Residential 2.5, 5, 10, or 20 zones.
A �R- (OKLIn ail
- W b U th
Owner/ gent( lease indicate)
—TSignature Date
Official Use Only
Approved by: ,�,� lt.%��,� Date
Denied by: Date
Reason for denial:
IACommunin' P Develo ment\PAC\VARIANCES\Admin Variance.doc Edited on 7/