HomeMy WebLinkAboutGRD20241-00003 - GRD Application - 8/23/2024 Asecx co MASON COUNTY
PERMIT NO. ��q�
DEPARTMENT OF COMMUNITY DEVELOPMENT !1�?�
BUILDING•PLANNING•FIRE MARSHAL lJ��l�J/ , J
WWW.CO.MASON.WA.US (360)427-9670 Shelton ext.352
Mason County Bldg.8, (360)275-4467 Belfair ext. 352 _
txsa 615 W.Alder Street,Shelton,WA 98584 (360)482-5269 V
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VIT,S--— —
LAND MODIFICATION PERMIT (Grading Permit)
OWNER INFORMATION: CONTRACTOR INFORMATION:
NAME: ZSZIr F C A -L- NAME: (3"ec� E7(c Cat Adder Street
MAILING ADDRESS: Z40-7 00"►N 5T e MAILING ADDRESS: 62-10 E$SEA i pr%-
CITY: -rAco:l,a STATE: t,YA, ZIP: ISL(0`� CITY: PM-T e;Zc3rk ''STATE: i4A' ZIP: >16
PHONE: -7,5!3 -209 CELL: Z5'3 235- PHONE: 3ba-g3`+- Lq'L1 CELL:
EMAIL: EMAIL :
L&I REG# i3AeGEF-L t7irO;j EXP.ob / of / ZS
PARCEL INFORMATION:
PARCEL NUMBER(12 DIGIT NUMBER) L2-3 31 , Z - 000 S FIRE DISTRICT V , AN A'S01
LEGAL DESCRIPTION(ABBREVIATED) : C,00-1 m1 LAkG IF 3 2 S S , 5 SO/y/
SITE ADDRESS Zoo AJ e, iZpJ 1 W Ttej� Lk-J CITY JAH V'4A
DIRECTIONS TO SITE ADDRESS
IS PROPERTY WITHIN 200 FT:
SALTWATER❑ LAKE[a RIVER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑
DOES PROPERTY HAVE SLOPE(S)WITHIN 300 FT OF THE PROJECT-GREATER THAN 14% YES❑ NO
WILL TIMBER BE CUT AND SOLD IN PARCEL PREPARATION? YES ❑ NOE]
TYPE OF JOB: EXCAVATION ❑ FILLING ❑ GRADING>P CUTTING ❑ OTHER ❑
TOTAL SIZE OF PARCEL • CRES/SQ FT SIZE OF AREA TO BE EFFECTED +009) ACRE SQ J
ESTIMATED AMOUNTY OF CUBIC YARD rco
DOES THE SITE HAVE SLOPES 14%OR GREATER YES[] NQU
DESCRIBE SCOPE OF WORK -T441 L�4.-y
G A a 1D e D 112f f-0 v-
WILL FILL BE BROUGHT ON SITE? IF YES,SITE ADDRESS: �✓"
WILL EXCAVATED MATERIAL BE TAKEN OFF SITE?IF YES,SITE ADDRESS: 0
DOES FILL CONTAIN POTENTIAL HAZARDOUS MATERIALS? YES❑ NOE]
HAS A SOILS REPORT BEEN COMPLETED ON SITE?IF YES,INCLUDE A COPY. YES ❑ NOE]
WILL PROPSAL RESULT IN REDIRECTION OF ANY SURFACE WWATER RUNOFF? YES ❑ NOE]
WILL WORK ALTER WHERE STORMWATER OF GROUND WATER ENTERS OR EXISTS THE SITE? YES ❑ NOO
WILL QUALITY,QUANTITY OR VELOCITY OF STORM/GROUND WATER BE ALTERED? YES ❑ NOQ
WILL THE RUNOFF BE COLLETED/CONTROLLED BY INTERCEPTORS,CURTAIN DRAINS OR OTHER DEVICES? YES ❑ NOE
WILL THE LAND BE REPLANTED UPON COMPLETION? YES,0 NO❑
WILL THE PROPOSAL RESULT IN SLOPES STEEPER THAN THOSE CURRENTLY ON SITE? YES ❑ N01Z
IS THE SITE WITHIN 200 FT OF A DESIGNATED SHORELINE OR A WETLAND? YES ❑ NOC
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 contractor. I further
declare that I am entitled to receive this permit and to do the work as proposed. I have obtained permission from all the necessary
parties, including any easement holder or parties of interest regarding this project.The owner or authorized agent represents that the
information provided is accurate and grants employees of Mason County access to the above described property and structure(s)for
review and inspection.This permit/application becomes null&void if work or authorized construction is not commenced within 180
days or if construction work is suspended for a period of 180 days. PROOF OF CONTINUATION OF WORK IS BY MEANS OF
INSPEC N IN C VI Y F THIS PERMIT APPLICATION OF 180 DAYS WILL INVALIDATE THE APPLICATION,
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i App+ t Date
X ally/l r OWNER/REPRESENTATIVE/CONTRACTOR
Print Name (CIRCLE TO INDICATE)
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DAYLIGHT OM114G MAI"
(PER PLAY)
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WANING WALL \ REiMiNO WALL i i 1i 1 � 1, 1 'i i ��✓!! 2
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PROPOS CURT D C O PROPOSED CURTAIN DRAIN y y y y C/o
V yC{N RETAIN
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l0'6CC 3.AOCDO N '
CURTAIN DRAIN DETAIL
SOIL SURFACE
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° 7 1 4" footing drain at each wall.POLY /7 Connection to existing drain
7/8"-1 1{2"GRAVEL TO
24' WITHIN 12'OF SURFACE
IMPERVIOUS LAYER
4" 6"
PERFORATED RZ MIN.DEPTH
PIPE '`MIN.
CLEANOUT AND INSPECTION PORT
REOUIRED FOR CURTAIN DRAIN.
CURTAIN DRAIN MURT EXTEND AT
LEAST 6"INTO RESTRICTIVE LAYER. SITE PLAN
REGARDLESS OF RESTRICTIVE
LAYER DEPTH SCALE: 1"= 30'
a so
CLIENT:
JEFFERY&CARMEL CALL
PROPERTY INFORMATION: Wan,
G E R
PN: 22231-52-00035
SITE ADDRESS: 200 NE RAINTREE LN
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CURTAIN DRAIN DETAIL htp�
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SOIL SURFACE Fyj M6
` �° �' 14 � 7 4" footing drain at each wall.
I POLY SHEET Are/ Connection to existing drain
7/8"-1 1{2"GRAVEL TO ��C
22" WITHIN 12'OF SURFACE
IMPERVIOUS LAYER
IV, 6"
PERFORATED TZ, MIN.DEPTH
PIPE
CLEANOUTAND INSPECTION PORT
REQUIRED FOR CURTAIN DRAIN.
CURTAIN DRAIN MUST EXTEND AT
LEAST 6"INTO RESTRICTIVE LAYER, SITE PLAN
REGARDLLAEYER DEPTHRICTIVE SCALE: 1"= 30
a 30
CLIENT:
JEFFERY&CARMEL CALL
PROPERTY INFORMATION: ED
A D6EPN: 22231-52-00035
SITE ADDRESS: 200 NE RAINTREE LN
DRAWN:LP,6/3/24 PAGE 1 OF 1