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HomeMy WebLinkAboutBLD2006-01586 Final Garage with Attached Rec Room DDR2006-00303 - BLD Permit / Conditions - 1/24/20077*1 pMASON 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 BLD2006-01586 OWNER: RICHARD MYER CONTRACTOR: CARLSTROM CONSTRUCTION 432-2199 239-3109 LICENSE: CARLSCL964PM EXP: RECEIVED: 9/5/2006 SITE ADDRESS: 120 E CLONAKILTY DR SHELTON ISSUED: 10/3/2006 PARCEL NUMBER: 321275400042 EXPIRES: 4/3/2007 LEGAL DESCRIPTION: LAKE LIMERICK 5 TR 42 PROJECT DESCRIPTION: DIRECTIONS TO SITE: GARAGE WITH ATTACHED REC ROOM FROM SHELTON TAKE HWY 3 TOWARDS BREMERTON, TURN LEFT ON MASON LAKE DR, HOUSE CLONAKILTY DR. HOUSE ON RIGHT General Information Construction &Occupancy Information Square Footage Information No. of Bedrooms: Type of onstr.: VB Type of Use: MH Insp.Area: No. of Bathrooms: Occ. Group: R-3U Lot Size: Deck: Type of Work: ACC Fire Dist.: 5 No. of Stories: 1 Occ. Load: Building:360 Garage-Attached 576 Valuation: Building Height: 15 Occ. Status: Primary Basement: Manufactured Home Information Setback Information Shoreline&Planning Information Make: Length: Ft. Front: N 87.0 Ft. Shoreline: Ft. Water Body: NONE Rear: S 80.0 Ft. Slope: Ft. SEPA?: No Model: Width: Ft. Shoreline Desig.: Not Side 1: W 5.0 Ft. Applicable Year: Serial No.: Side 2: E 69.0 Ft. Comp. Plan Desi g•: Rural Plumbing Fixtures Mechanical Fixtures FEES Type Qty. Type Qty. Type By Date Amount Receipt Plan Check Fee KS 9/5/2006 $339.66 S12006000 Planning Review Fee KS 9/5/2006 $155.00 S12006000 Building State Fee ARC 9/14/2006 $4.50 S12006000 Building Permit Fee ARC 9/14/2006 $522.55 S12006000 EH Plan Review CEW 9/16/2006 $45.00 S12006000 Total $1,066.71 BLD2006-01586 Please referto the following pages for conditions of this permit. 1 of 5 CASE NOTES FOR BLD2006-01586 CONDITIONS FOR BLD2006-01586 1) Approved p��ensions and setbacks on submitted site plan. Setbacks are measured from the furthest projection of the structure, NOT the foundation. X __ (( 2) 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 S* Plan"to ensure these structures are shown and meet the setback conditions listed. X '( 3) The international code requires a fire apparatus access road for every facility, building, or portion of a building that is more than 150'from an approved access road. Roads are required to meet the minimum Mason County Fire Marshal standards for Fire Apparatus Access Roads up to the point where such road 'ppnect with a county maintained public road or to another fire apparatus access road which connects to a county maintained public road. X 4) 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 1-800-647-0✓ person signing this condition is either the homeowner, agent for the owner or a registered contractor according to WA state law. X 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 Department px aqy further inspections being performed or approvals granted. X 6) In accordance with international codes and Title 14, Mason County Building Code, "Standards for Fire Apparatus Access Roads,"all new structures that require an address shall have approved numbers or addresses located at the beginning of long driveways when the address is not clearly visible from the access road. The numbers shall also be plainly visible and legible from the street or road fronting the property and shall contrast with their background. Mason County Building Department requires that this be completed prior to calling for any site inspections. A re-inspection fee based on rates as adopted by the jurisdiction and the international codes will be assessed if the owner and/or contractor fail to post the address on site prior to requesting inspections. X v BLD2006-01586 Please referto the following pages for conditions of this permit. 2 of 5 r 7) Tre 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 app wed documents will result in failure of required building inspections. X 1 8) 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 ppli d for, reviewed and approved prior to the change. X 9) All slabs within the heated space shall be insulated to a minim u R-10 for at least 24". Monolithic slabs shall be insulated around the perimeter from the top of the slab to the bottom of the footing X p 10) THE FOUNDATION SYSTEM SHALL BE PLACED ON UNDISTURBED, NATIVE SOIL. X 11) The"approved" site plan is required to be on-site for inspection purposes. If an inspection is requested and the"approved" site plan is not 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 shall be collected by the Building Depfnent prior to any further inspections being performed or approvals granted. X (�(/ / 12) Washington State Energy Code Compliance has been approved using the following: Heat Type: Electric or other fuels, Compliance Method: IV, Window (Max U-Factor):0.40, Skylight (Max U-Factor):0.58, Doors (T peVa actor):0.40 or less, Wall insulation R-21, Floor insulation R-30, Ceiling Insulation R-38, Vault Insulation R-30, Slab Insulation R-10. X 13) Per 2003 IRC - SECTION 1609 -WIND LOADS - 1609.1 Applications. Buildings, structures and parts thereof shall be designed to withstand the minimum wind loads prescribed herein. Decreases in wind load shall not be made for the effect of shielding by other structures. Per FIGURE 1609 BASIC WIND SPEED 3-SECOND GUST)the wind speed for Mason County is 85 MPH. � J x 14) Per 2003 IRC - SECTION R905 - REQUIREMENTS FOR ROOF COVERINGS - R905.1 Roof covering application. Roof coverings shall be applied in accordance with t e applicable provisions of this section and the manufacturer's installation instructions. X 15) Concrete used for basement walls, foundation walls, exterior walls, porches, carport slabs, steps exposed to the weather, garage floor slabs and other vertical concrete w exposed to the weather shall have a minimum compressive strength of 3000 psi (IRC Table R402.2). X V 16) 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. Occup�4qpy is limited to the approved and permitted classification. Any non-approved change of use or occupancy would result in permit revocation. X BLD2006-01586 Please referto the following pages for conditions of this permit. 3of5 17) Provisions for surface/subsurface drainage control must be implemented with new construction or development on site and MUST NOT adversely impact adjacent parcels. Under the requirements of Mason County Stormwater Ordinance, either private ditches and drains will meet requirements of the stormwater ordinance or prior approval will be granted to use an existing utility and drainage easement dedicated for that specific purpose. For further information regarding this ordinance and the REQUIREMENT to obtain an ACCESS PERMIT for the installation/construction of a driveway or access connecting from a Mason County Road, Contact the Mason County Public Works Department prior to construction at Ext 450. For any construction which is proposed to be located vyi hin 25'of a Mason County road right of way, it is suggested to contact that office to review future planned work which may affect your project. X 18) All changes to "approved" building plans that effect compliance with the international codes as amended and adopted, or any other Mason County ordinance or regulation, must be reviewed and approved by Mason County prior to construction. X_ 19) 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 bee prior to requesting additional inspections. X 20) All property lines shall be clearly identified at the time of foundation inspection. X �� 21) 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 . nces and building regulations. X �, 22) 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 prever> actyon from being taken. No more than one extension may be granted. X �J''�� // 23) Pressure treated wood manufactured after January 1, 2004 may contain high concentrations of copper which could quickly corrode metal fasteners, connectors, and fl rig. Install metal connectors approved for contact with the new types of pressure treated material. X- / 24) By definition, propane tanks and heatpumps are structures, which must meet setback conditions. Please check your"Approved Site Plan"to ensure these structure he setback conditions listed. X G� 25) This parcel.is Igcat d in a smoke management zone. Please contact a fire warden at (360)427-9670 ext. 459 for further information. X C BLD2006-01586 Please referto the following pages for conditions of this permit. 4 of 5 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 anytime 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 Mason County access to the above described property and structure for rev' di spection. 7j OWNER OR AGENT: 1 DATE: BLD2006-01586 Please referto the following pages for conditions of this permit. 5 of 5 W _ oCONCRETE MECHANICAL MANUFACTUREC HOME m Footings(Setbacks Date t3, Ribbons ___._ rn rn Gas Piping CD Interior Date 8 interior-Date By Date By rnExterior Date�� J—P6 Exterior_Da SULATI te B __— Set-up _ n Point Load f Isolated Footings SU Date By BG i SLAB INSULATION Date By Date FIRE DEPARTMENT p Foundation Walls Floors Date By Date S' Oh Data By DECKS FRAMING Waft Date By Date 11 4C�. Data I Z Il cv. By L cA_ PROPAN E TANKS PLUMBING Vault Data ay Date By OTHER Groundvmrk Atdc Date By Date By Type. Date By D.W.V DRYWALL Type: Int Bra wall. Date By W Date By Date Z gy� FINAL INSPECTION p Water Line Fir*Separatlm Or Q� C Data By Date By Date Fay CD m � Pass or Request I nspeiat. c Type of lnsp. Fail Date date done By Comments Co (0 5` as Fsets,4100 ass 10 /1 Ub 10 J`r Gg lL CD tii1 �flWCrsG =-f' �� LJA. f� lsv IGC L ,.� -r. 8 .'_"' Kl�,rttv�, r",55 I 1 � � 17,11 � �-+� v�SN r�u.,, T u I,eu S _ dA b uw,n.t % Ff Ah L o� or S REQUIRED BRACED WALL PANEL REQUIRED BRACED OUT OF PLANE WALL PANEL OFFSET IN EXTERIOR BRACED ————— WALLPANELS ------------ — -------- -- ❑1 I ❑❑� ---------- —_— SECTION VIEW SECTION VIEW ,r I I I I Figure R3012222(1) I I I I I I BRACED WALL PANELS OUT OF PLANE I I I I I I MORE THAN 1 FT MORE THAN 1 FT EXTERIOR ELEVATION EXTERIOR ISOMETRIC 4 FT WITH 2 x 12 For Sl:1 foot.304.8 n— Figure R301.2M2.2(3) BRACED WALL PANEL EXTENSION OVER OPENING CANTILEVER/SET MORE THAN B2/2 BACK SHALL ONLY - IS IRREGULAR ROOF EIGHT ir======-i F'r ======�1 I B1 II II II BI2 II II II If II ® II L II II II SECTION THRU CANTILEVER ><4 FT WITH 2 12 SECTION THRU SET BACK LL=___=J L=______J L______J L_______J For SL•1 inch 25.4 mqP I fmt-.304.8 mm. f T MORE THAN B7/2 ISIRREGULAR Figure R301.2 22 2(2) PLAN VIEW PLAN VIEW BRACED WALL PANELS SUPPORTED BY CANTILEVER OR SET BACK Figure R301.2222(8) OPENING LIMITATIONS FOR FLOOR AND ROOF DIAPHRAGMS I I I I FLOOR JOISTS CANNOT BE TIED DIRECTLY TOGETHER FLOOR JOISTS CANNOT BE TIED DIRECTLY TOGETHER L------JI I I DASHED UNE I II I I BRACED WALL LINE BTELOW LJ THERE IS NO BRACED PLAN VIEW WALL LINE ON THIS EDGE OF THE ROOF SECTION VIEW Figure R301.222.2(3) SECTION VIEW FLOOR OR ROOF NOT SUPPORTED ALL EDGES _ Figure 143012222M PORTIONS OF FLOOR LEVEL OFFSET VERTICALLY BRACED WALL LINES AREA NOT PERPENDICULAR II n I' II II II II ----__----,\ I II II II II �� -----�\ II ROOF OR FLOOR SHALL BE PERMITTED U TO EXTEND UP TO 8 FEET BEYOND THE u \\\`�___—____ \��--_—_--J I BRACED WALL LINE NO BRACED WALL PANEL ABOVE ————————————————————J PERMITTED AT THIS LOCATION PLAN VIEW PLAN VIEW For SI:1 foot 304.8 mm. Figure R301.22.2.2(4) Figure R30122.22(8) ROOF OR FLOOR EXTENSION BEYOND BRACED WALL LINE BRACED WALL LINES NOT PERPENDICULAR MASON COUNTY RESIDENTIAL PLANS //SUBMITTAL CHECKLIST Owner's Name: �� �k+'tom! V Date: I 1 l U Reviewed By: Documents: `Building Permit Application Completed n,, _ _Planning Intake Checklist Completed, /`�1 U t— C4, }�Site plan includes:Allowable building area,roof overhangs,decks,etc. C Fire Apparatus Access Road info required? Yes 4:9) _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: _Mechanical/Plumbing Application-WATER HEATER FUEL TYPE Engineering? Yes o Snow load used: Seismic Zone(circle one): D 1 or D2 Geotechnical report or assess me ? Construction Plans:_3 COMPLETE SETS Plans Legible _Reco ' ed Scale _Elevation Views _Cross Section _Foundation Plan _Roof Fra 'ng Plan _Floor Plan-Use of Rooms Noted _Floor Framing Plan-all floor levels represente Loft,crawlspace,etc. Deck Framing Plan,including covered.porch fra ' g Plan Details: Roof framing details,truss lay-out may be needed _Wall Framing-Does bearing-wall height exceed 10'?(Engi ering may be required) Floor framing: Floor joists: ,Floor eams: Window headers: Typical header: Foundation: footing size,reinforcement _Concrete Walls-Does Concrete Wall Height Exceed 9'?(Engineering ay be required) Landings at all exits? Less than 30"above grade? Y / N _Heated By Furnace-Location of Furnace Fireplace/Stove Information Shown-Fuel Type? _Window Sizes Marked on Plans 2-Story Garage? (Engineering may be required) R602.10.1, 1"story of a twoXmZayn ,D2—55% Braced wall panels(shear walls)marked on plans or lateral engineering? (Plaapproved if not provided.) COMMENTS: IRREGULAR BUILDINGS(Irregular Shape)R301.2.2.2.2 Irregular portions of structures shall be designed in accordance with accepted engineering practice. A portion of a building shall be considered to be irregular when one or more of the following conditions occur: 1)Exterior braced wall line or BWP 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 ft.beyond the braced wall line. 3)End of BWP extends more than 1 ft.over an opening more than 8 ft in width below. 4)Opening in a floor or roof exceed the lesser of 12 ft.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. 2003 IRC Plans submittal checklist simplified/WORD MASON COUNTY RESIDENTIAL PLAN SUBMITTAL CHECKLIST Owner's Name: Date: t/ Reviewed By: Documents: VBuilding Permit Application Completed —Planning Intake Checklist Completed, _V�ite plan includes:Allowable building area,roof overhangs,decks,etc. aratus Access Road info required? Yes/No lication 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: _Meehmm°ab'Plumbing Application-WATER HE FUEL TYPE Engineering? Yes (Need 2 sets of caiculatio No chnical report or assessment? Yes No Snow load: Seis a(circle one) D 1 or D2 Construct Plans: COMPLETE SE,TS/ ans Legible t/ 1 ecognized Scale evation Views _ ross Section V Foundation Plan &/ Roof Framing Plan I(Floor Plan—Use of rooms noted(all floor levels) _Floc r zawing Plan-all floor levels represented? Loft,crawlspace,etc. LZe LE awrtKg Plan,including covered.porch framing Plan DetZioof framing details,truss lay-out may be needed,truss or stick framed? �-5 KC Wall Framing-Does bearing-wall height exceed 10'?(Engineering may be required) 2y V00 b^ _ g: Floor joists: ,Floor beams: indow headers marked on plans: Typical header: VFoundation:footing size,reinforcement 4enerete Walls-Does Concrete Wall Height Exceed 9'?(Engineering may be required) Landings at all exits? Less than 30"above grade? Y / N y Furnace-Location of Furnace _ tove Information Shown-Fuel Type? Location(s): _Window Sizes Marked on Plans raced wall panels(shear walls)marked on plans or lateral engineering? (Plans may not be approved if not provided.) garage? (Engineering may be required) R602.10.1, 1'story of a two-story D1-45%,D2—55% COMMENTS: ENGINEERING REQUIRED: Braced wall panels/braced wall lines are not marked on plans(R602.10) Amount and location of bracing does not meet minimum required in Table R602.10.1 IRREGULAR BUILDINGS(Irregular Shape)R301.2.2.2.2 Irregular portions of structures shall be designed in accordance with accepted engineering practice. A portion of a building shall be considered to be irregular when one or more of the following conditions occur: 1)Exterior braced wall line or BWP 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 ft.beyond the braced wall line. 3)End of BWP extends more than 1 ft.over an opening more than 8 ft in width below. 4)Opening in a floor or roof exceed the lesser of 12 ft.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. DESIGN CRITERIA:Wind 85 mph exp B(unless proven otherwise), Seismic Zone: , Snow: psf 2003 IRC Plans submittal checklist simplified/WORD J MASON COUNTY PERMIT NO�,00G-015 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 INFORMATION Owner &K- 3 CANXI ktY9,A,_ Company Name 6 AL15-rR- t" Mailin Address /Z_ oil 4T Mailin Address 5�1i- CX4-10 City � State kJ4 Zip Code City State A Zip Code Phone_ Ln '/27 8 ZOther Ph. Phone o Other Ph. Lien/Title Holder Contractor Reg.#GAR 44LL f6j00' .Exp. , ,4W— E mail address E Mail Address Drivers Lic.# DOB Drivers Lic.# '.AQI_SS[.Z'/SP� DOB Zolor SEPTIC /WATER SYSTEM INFORMATION - Connect to New Septic Existing Septic - f Connect to Water System Name of Water System Well Sewer System Name of Sewer System PARCEL INFORMATION - 12 Digit Parcel No. u•o Fire District Legal Description Site Address (Please include street name, street number and city) /2-0 E. L,40A,0f 4/4-7y 02 . Directions to site r&#w w .Pj LAEG-r eo­� " 17.0 OP—) Ct_.o d K L- 97T o,-� 44;V a AM- a� Ak Will timber be cut and sold in parcel preparation?Yes/dW,> Is property within 200'of Saltwater Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluffs Is this permit submittal the result of a Stop Work Notice,Correction Notice or other enforcement action?Yes/No TYPE OF JOB - New_'�,�dd Alt Repair Other PRIMARY RESIDENCE ❑ SEASONAL ❑ Use of Building6�" /bo_'[-� e Work No. of Bedrooms, No. of Bathrooms Square Footage- 1 st Floor 39� hnd Floor 3rd Floor Basement Deck Covered Deck Other Sq. fit. 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 or r 'it r�voiation iJ Acknowledgement of such is by signature below. I declare that I am the owner,owners legal representa 10 a co ractor. I further declare that I am entitled to receive this permit and to do the work as proposed in the application. I declare that ave obtain the p mission from all the necessary parties. If permission is required from any easement holder or any other party in interest regarding t ' plica on or the work proposed in the application, I have obtained permission from them to apply for this permit and conduct the wo'�Fkc proposed. Th ,ffer or agent on owners behalf, represents that the information provided is accurate and grants employees of Masoon �i.above described property and structure for review and inspection. This permit/application becomes null & void u or—ized construction is not commenced within 180 days o 'f construction work is suspended for a period of 180 days. PROOF Qf ONTINUATION OF WORK IS BY MEAN FAPROGR INSP ,ON.INACTIVITY OF THIS PERMITAPPLICATION OF 180 DAYS WILL INVALIDATE THE APPLICATION. AC f X Go,J-Y G7a/.t. Date: �-- —O!v Owne wne epr sentative/Contractor (indicate which one) FOR OFFICIAL USE BEYOND THIS POINT Accepted by: Date DEPARTMENTAL REVIEW APPROVED DENIED I I NOTES Building Department Planning Department Environmental Health Department Fire Marshal FEES Building Permit Fee 52_2, Site Inspection Plan Review Fee EH Review Fee Plumbing & Base Fee Planninq Review Fee Mechanical & Base fee Other Wood /Gas/ Pellet Stove Fee State Fee Violation Fee /Vd Ew Pre-Paid at Submittal Valuation $ 37 8/. z'V TOTAL FEES f r MASON COUNTY DEPART Y DEVELOPMENT 411 N. Fifth Str t 6, ITtIA 98584 360.427.9670) e� f� O 3 Rec'd by Request for Administrative Variance for Reduction in the Required Setbacks ($90.00) 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: M yir't Mailing Address: %Z-.c; GLo��4lcit�tY p� Telephone : !; ,o 17� �y�Z City: `��ZCi.� State: �. c{ Zip: If this reduction is tied to a building permit, please give permit case number. BLD d - /r,'R (r, Parcel Number(s): SZI good 44Z_ Zoning Site Address: \20 �a JJ iL1 LZ per. Requested variance: Front / Rear/ Side Yard (please circle all that apply) Requested setback variance: ft. 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. The following circumstances must apply: FRONT AND OR REAR YARD REQUIREMENTS: 1) Existing lots of record as of March 5, 2002; You must meet one of the following: (Please circle all that apply) 2) One of the following exists on the lot.- 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. IAPLANNINGTACTORMS\DDR.doc Created on 03/07/2006 15:58:00 4 SIDE YARD REQUIREMENTS: 1) Existing lots of record as of March 5, 2002; You must meet one of the following. (Please circle all that apply) 2) One of the following exists on the lot- 6 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; 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. .Jl/E -z% 'r6�E F X�e�s-�E_ Lo�E� OF X 7i i�oP,FIZZY 45 WACCC X 5 -76/W" C-)/6y/.�?6 7TZi G 7v��S off, Owner/Agent (please indicate) Signature and date Official Use Onl y Approved "'ah�/ Y! Date Denied Date Reason for denial: 1APLANNING\PAC\F0RMS\DDR.doc Created on 03/07/2006 15:58:00