Loading...
HomeMy WebLinkAboutRLC94-0132 - RLC Application - 1/26/1994 Date Received: ' MASON COUNTY Rma& 0132' 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 Sit( Evaluation and Disposal Permit, Access Permit, Land Modification Permit, Hazardous Waste Permit, or Shoreline Permit in determining whether their property is affected by regulations under the Mason County Interim Resourc( Ordinance (77-93)*. This checklist is an important opportunity for identifying early in the permit process whethe there will be any environmental regulations affecting the proposed development. Owner lit r, ?0twt(,( Phone #( ) 4z'7-S3172 Site Address City Zip Owner Address IGSA City_ State Cfi� Zip el Tax Parcel No. 3z IZ7 _ 5 3 _ c�c9zZ Legal Description � ZZ4A ton f 9 p 32► z7 s3 00et03 Directions to site (Please attach map) V►1e-�4 t"t wi I I Please provide or attach a vicinity map which includes cross streets, major roads, creeks, etc. Answer the following to the best of your knowledge. County-wide maps showing general to p 9 9 cations of critical areas ofneisi and resource lands are available for review e ew at Mason County Department of Community Development, Planning Liss only Department. Do any of the following exist on this property or within 200 feet of this property? County Yes No ❑ ® 1. Saltwater shoreline or a lake 20 acres or larger? 6 ❑ © 2. Rivers, streams, or creeks with year-round flow? ® ❑ 3. Rivers, streams or creeks with intermittent flow but are ithin a clearly defined channel? 1W r ❑ ® 4. Lakes or ponds less than 20 acres in size? IQ ❑ [Q 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 County Landslide and Erosion Hazard Maps for guidance.) ��'., ' - \ k""�, rj� L� El 7. Floodplafns? (See County Federal F ncy Management Maps and County Seismic Hazard ap for guidance.) 0'W ld ❑ y] 8. Seismic Hazard Areas? (See County 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: Cou Yes No ❑ ❑ 1. Agricultural Open Space Taxation Program, RCW 84.33 [� ❑ ❑ 2. Open Space Timber Taxation Program, RCLN 84.33, or Designated Forest or Classified Forest, RCW 84.34 * Copies are available at Mason County Department of Community : ..,felopment for $5.00 each. K . Y - RESOURCE LANDS & CRITICAL AREAS SITE PLAN PLEASE SHOW THE FOLLOWING INFORMATION OR PROVIDE SURVEY MAP IF POSSIBLE: ► 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 &driv-ways. Scale 1"= North Arrow f 123� I I state that I have answered the above truthfully to the best of my knowledge. Applicant/Owner D FOR OFFICIAL USE ONLY Adjacent property.. ke / W (f /V v 6 �°l i '+':'::::::Y::v::;;:i:i�:'::'iii::::i:::�i:::::::�i::?X::�j}::i::i:!ti:::i:<:: '.::::. .: ,)iY::•,i: . ..... a ......................... .....................:................�........... . inholt�' La-rit# 4, Ones nod aisply .:::.:....:. k .:..........................................................:.::. ::::::::::::.:_. There is a $40.00 application fee for the Resource Land & Critical Areas Checklist. Make checks payable to the Ma: County Treasurer. When completed, this form becomes part of the permit application.