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Home My WebLink AboutBRN2024-00063 - BRN Inspections - 11/12/2024 EM Mason County gM Mason County - Division of Community Development 615 W.Alder St. Building 8 Shelton, WA 98584 360-427-9670 ext 352 www.masoncountywa.gov BRN2024-00063 BURN PERMIT PROJECT DESCRIPTION: BURN PERMIT FOR LAND CLEARING ISSUED: 11/12/2024 SITE ADDRESS: UNKNOWN MASON COUNTY EXPIRES: 12/12/2024 PARCEL: 319024190002 APPLICANT: GORZYNSKI RAYMOND&BARBARA OWNER: GORZYNSKI RAYMOND&BARBARA 6013 SILVER OAKS CT SE 6013 SILVER OAKS CT SE TUMWATER,WA 98501 TUMWATER,WA 98501 360-791-0798 FEES: Paid Due Burn Permit Fee $175.00 $0.00 Totals : $175.00 $0.00 REQUIRED INSPECTIONS Burn Inspection CONDITIONS * *IF BURNING WITHOUT CALLING IN, THE FIRE WILL BE EXTINGUISHED AT OWNERS EXPENSE AND POSSIBLE SUSPENTION OF PERMIT.* * Each pile must be at least one hundred (100)feet from any structure and at lease fifty(50)feet from standing timber. * All other necessary permits from Mason County, Washington State, Federal Agencies, and/or other agencies/groups that are required for this proposed development and construction must be obtained PRIOR TO DEVELOPMENT AND CONSTRUCTION. * The fire must not create a nuisance from smoke, obscure visibility on public roads and highways, or endanger life and property. * Maximum pile size is twenty(20)feet in diameter, a minimum ten (10)feet firebreak must be constructed around each pile. * Upon completion of all conditions, applicant must have inspection &approval before ignition. Call (360)427-9670, ext. 352 * APPLICANT'S MUST CALL 360.426.4441 EACH DAY TO REPORT BURNING ACTIVITY. * All materials must originate from the property on which the burning is to occur. Printed by:Genie Mcfarland on:11/12/2024 04:09 PM Page 1 of 2 Mason County g� Mason County - Division of Community Development 615 W. Alder St. I Building 8 Shelton, WA 98584 360-427-9670 ext 352 www.masoncountywa.gov BURN PERMIT BRN2024-00063 * After the burn is complete make sure the fire has not burned into the earth by checking the fire location for hot spots. * Valid permit MUST be onsite while burning. If permit is not on site during burning the fire will be extinguished at your cost * Fire must be completely extinguished within three (3)days after ignition. * The following materials are prohibited and must not be burned: garbage, dead animals, asphalt, petroleum products, paints, rubber products, plastics, paper, cardboard, treated wood, construction/demolition debris, metal or any substance (other than natural vegetation)that releases toxic emissions, dense smoke, or obnoxious odors when burned. * A BURN BAN when implemented by Fire Marshal will take effect as noted and all permits become null and void.After a burn ban. has been implemented, all fires must be extinguished immediately. * Provide EXCAVATOR/DOZER(with fire extinguisher)on site with qualified operator. * On Site Water is required for permits between April 15th and Oct. 15th.A pump truck or trailer with 300 gallons of water loaded and 200 ft of hose. (The pump must be capable of pumping 20 gallons per minute through a one inch (diameter)50 foot section of hose.) * Do not burn if wind is blowing more than seven (7)miles per hour. DO NOT BURN IF WIND BLOWING FROM * Fan required. * Permit includes two (2) inspections maximum, additional inspections will require a re-inspection fee. (at current rate). * Access must be passable with 2 wheel drive vehicle. * A responsible adult and equipment shall be on site and in attendance at the fire while burning. Must provide 24 hour fire watch. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of Laws and Ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state/local law regulating construction or the performance of construction. " Issued By: C n 0 LC A Contractor or Autha`ri d Agent: zz Date: /b Z Z ZZ Printed by:Genie Mcfarland on:11/12/2024 04:09 PM Page 2 of 2 d EXPIRATION DATE: Permit##: BRN �o24 - MASON COUNTY BURN PERMIT APPLICATION 615 W Alder St• Shelton,W 98584 SHELTON 360.427.9670 x352•BELFAIR 360.275.446 x352 •ELMA 360.482.5269 x352 APPLICANT/OWNER INFORMATION• CONTRACTOR INFORMATION: Owner �yA*N b �09_Zgryb L� Owner AP.r,Q Mailing Address 4015 S'. 1y&l. 04" '-T sb Mailing Address t?C ` og _5 4t City i�r.M-lfvtr State�J A—Zip _ City—CAST 01 State_L)A_Zip g0 Phone Cell Phone 7 Phone g-l'lq Other Phone Lien/Title Holder &A.: N s Contractor Reg.# k (IbOLT 99Cj VA Exp. E-mail address 2. a E-mail address �a fCxq+-@ �(�4\ne� CoM Drivers Lie.# D.O.B. Drivers Lic.# D.O.B. TAX PARCEL NUMBE 12 digit number) Fire District SITE ADDRESS(please include street name,number&city) �ZZ SE Lpitl-, i2.b S1tr l,�oj �6Z Directions(to the site) Ll AA A L S e/4,�- I�64 wy u5l o-1 4'tr jt ok+ BURNING IS AUTHORIZED SUBJECT TO THE FOLLOWING CONDITIONS: • Valid permit MUST be onsite while burning If permit is not on site during burning the fire will be extinguished at your cost. • The following materials are prohibited and must not be burned: garbage, dead animals, asphalt, petroleum products, paints, rubber products, plastics, paper, cardboard, treated wood, construction/demolition debris, metal or any substance (other than natural vegetation)that releases toxic emissions,dense smoke,or obnoxious odors when burned. • All materials must originate from the property on which the burning is to occur. • The fire must not create a nuisance from smoke,obscure visibility on public roads and highways,or endanger life and property. • Maximum pile size is twenty(20)feet in diameter,a minimum ten(10)feet firebreak must be constructed around each pile. • Each pile must be at least one hundred(100)feet from any structure and at lease fifty(50)feet from standing timber. • Do not burn if wind is blowing more than seven(7)miles per hour.DO NOT BURN IF WIND BL9�ING FROM • A responsible adult and equipment shall be on site and in attendance at the fire while burning.Must provide 24 hour fire watch. • On Site Water is required for permits between April 15'and Oct. 15ffi.A pump truck or trailer with 300 gallons of water loaded and 200 ft of hose.(The pump must be capable of pumping 20 gallons per minute through a one inch(diameter)50 foot section of hose.) • Provide EXCAVATOR/DOZER(with fire extinguisher)on site with qualified operator. • Fire must be completely extinguished within three(3)days after ignition. • Fan required. • Upon completion of above conditions,applicant must have inspection&approval before ignition.Call (360)427-9670,ext.262 • APPLICANT'S MUST CALL 360.426.4441 EACH DAY TO REPORT BURNING ACTIVITY. • APPLICANTS MUST CALL 360 539 7610(ORCCA) EACH DAY TO REPORT/REOUEST ANY AIR QUALITY ISSUES ASSOCIATED WITH BURNING. ************IF BURNING WITHOUT CALLING IN THE FIRE WILL BE EXTINGUISHED AT OWNERS EXPENSE AND POSSIBLE SUSPENTION OF PERMIT.*************** • After the burn is complete make sure the fire has not burned into the earth by checking the fire location for hot spots. • It is advisable to pump the entire content of the water tank onto the burn site to assure the fire is completely extinguished. The permitted individual is responsible for any rekindling on the fire/bum site. • A BURN BAN when implemented by Fire Marshal will take effect as noted and all permits become null and void.After a bum ban has been implemented,all fires must be extinguished immediately. • Permit includes two(2)inspections maximum,additional inspections will require a re-inspection fee. (at current rate) • Access must be passable with 2 wheel drive vehicle Date Received: Application continued, please go to next page b Rev.Aor 19.2017 f Burn Permit # PARCEL AND SITE INFORMATION: Parcel within 200'of. Saltwater❑ Lake❑ River/Creek/Stream❑ Pond❑ Wetlands❑ Seasonal Runoff❑ : Yes one Slopes or Bluffs> 15%within 50 feet Yes o Will timber be cut and sold in parcel preparation?Yes o Does Site require FPA or 6 yr.Moratorium:Yes lto Is site being converted or replanted:Yes 6o Is site located in an Urban Growth Area(UGA)?:Yes No/Unknown [Burning is currently NOT allowed inside UGAJ Zoning: Summarize proposed land clearing items to be burned: SITE PLAN In the space provided below,please draw a top-view site plan of the parcel and notate locations of the following items with distances to/from"Burn Pile": o Burn Pile and Feeder Piles o Any existing buildings/structures(ie: Residence, Garage, Storage shed, Driveway, etc.) o Existing standing timber o Any"Critical Areas" such as Steep Slopes, Lake, River/Creek, Wetlands, Seasonal Runoff, Streams,etc 7671 2CX>r --� OWNER/CONTRACTOR:Acknowledges submission of inaccurate information may result in a stop work order or permit revocation.Acknowledgement of such is by signature below.The owner represents that the information provided is accurate and grants employees of Mason County&local fire authorities access to the above described property and structure for review and inspection.The person in charge of the fire will be liable for the cost of suppression if the fire gets out of control or if becomes necessary to extinguish the fire as the result of an enforcement action. x l �r SIGNATURE- MUST BE SIGNED BY PROPERTY OWNER DA Signed FOR OFFICIAL USE ONLY. PLANNING DEPT REVIEW: Date: Approved by: Denied by: N/A- No Critical Areas