HomeMy WebLinkAboutBRN2012-00009 - BRN Permit - 4/12/2012 inspecuon Line t30U)4u-it0c
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
BURN PERMIT BRN2012-00009 '
OWNER: RICHARD HUTCHINS RECEIVED: 4/9/2012
CONTRACTOR: LICENSE: EXP: ISSUED: 4/9/2012
SITE ADDRESS: 3231 E BROCKDALE RD SHELTON EXPIRES:
PARCEL NUMBER: 321314100001
LEGAL DESCRIPTION: NE SE LYING WLY OF BROCKDALE RD
PROJECT DESCRIPTION: DIRECTIONS TO SITE:
LAND CLEARING BURN BROCKDALE TO ADDRESS
BURN TYPE: FEES
Land Clearing Type By Date Amount Receipt
Burn Permit TW 4/9/2012 $160.50 S1201200000000000488
Total $160.50
BRN2012-00009 Please refer to the following pages for conditions of this permit. Page 1 of 4
Y CASE NOTES FOR
BRN2012-00009
CONDITIONS FOR
BRN2012-00009
1) Permit includes tw9-(2) inspections maximum, additional inspections will require a $73.00 re-inspection fee.
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2) Applicants mus call 360.427.7761, EACH day to report burning activity. Last 3 numbers of permit required at time of call in.
3) Applicantsn call 360.586.1044 (ORCCA) EACH day to report/request any air quality issues associated with burning.
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4) Valid per t st be on-site while burning.
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5) 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 m st extinguished immediately.
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6) The following materials may 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 normally releases toxic emissions, dense
smoke orb cious odors when burned.
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7) All material t originate from the property on whichthe burning is to occur.
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8) The fire create a nuisance from smoke, obscure visibility on public roads and highways or endanger life and property.
9) The max ile size is twenty(20) feet in diameter, with a minimum ten (10)feet firebreak around each pile.
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10) Each pile mu t e at least one hundred (100)feet from any structure and atleast fifty(50)feet from standing timber.
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BRN2012-00009 Please refer to the following pages for conditions of this permit. Page 2 of 4
*1.) Do not bur if wind is blowing more than seven (7) MPH.
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12) Do Wurif wind is blowing from XX direction. (This will be indicated on the posted permit at the time of site inspection.)
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13) A minimum of one qualified operator is required to be in attendance at the fire while burning. A burn site/fire shall never be left unattended. MUST
PROVIDE 4 HOUR FIRE WATCH.
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14) On Site Water is required between April 15th and Oct. 15th. The pump truck or trailer must have 300 gallons of water loaded and 200 ft of hose. (Pump
must b p ble of pumping 20 gallons per minute through a one-inch (diameter) 50-foot hose.)
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15) It is advisable to pump the entire content of the water tank onto the burn site to assure the fire is completely extinguished. Permitted individual is
responsi le r any rekindling on the fire/burn site.
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16) Provide excAvator/dozer with a fire extinguisher at the site with a qualified operator.
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17) Provide a 2 '-hour fire watch.
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18) 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 Yorcement action.
19) Access m e passable with 2 wheel drive vehicle.
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20) Fire muM
mpletely extinguished within three (3) days after ignition.
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21) After the rd::j
i complete, YOU MUST touch by hand, the earth to make sure the fire has not burned down into the earth.
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22) Fan is lui d.
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BRN2012-00009 Please refer to the following pages for conditions of this permit. Page 3 of 4
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 Mason County a ess to-the above described property and structure for review and inspection.
OWNER OR AGENT: ( DATE: L- —
BRN2012-00009 Please refer to the following pages for conditions of this permit. Page 4 of 4
tz CONCRETE MECHANICAL MANUFACTURED HOME C
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0o Intenor Date By interior-Date By Date B
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o Exterior Date By Exterior-Date B ct. y V1
Point Load r Isolated Footings INSULATION Date By X
BG I SLAB INSULATION -- n
Date By Data By FIRE DEPARTMENT =
Foundation Walls Floors Date By >
Date By Date By DECKS C
FRAMING Wails Date By
Date By Data By PROPANE TANKS
PLUMBING Vault Data By
Date By OTHER
Groundwork Attic
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D.W.v DRYWALL Type:
v Date 8y
Int.Brace Wall Date By W
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Date By FINAL INSPQCTION Z
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Type of Insp. Fail Date Date Done By Comments c
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MASON COUNTY BURN PERMIT APPLICATION
426 W CEDAR ST. •PO BOX 186 • SHELTON WA 98584 2
SHELTON 360.427.9670 • BEI,FAIR 360.275.4467 • ELMA 360.482.5269 4-.-r1 f
APPLICANT INFORMAT ON: CONTRACTOR INFORMATION:
Owner Owner 4:::a �
Mailing Address 3 / Mailing Address
City State_yA)A - Zip 91'r94 City State Zip
Phone t4&2 -1! � Cell Phone q,?o^ Z 733 Phone Other Phone
Lien/Title Holder Contractor Reg.# Exp.
E-mail address E-mail address
Drivers Lic.# Wt)j-C jV Z` 2,E R DOB_ S&9,17fC, Drivers Lic.# D.O.B.
TAX PARCEL NUMBER 3 Z 13 / — O D D O I Sec. Twn. Rng. Fire District S—
SITE ADDRESS(please include street name,number&city 32 3 1 T�,z��lcde (p P� Sf.c. �. W "i�.I�$�/
Directions to the site 3 Mi Les otk{- Q"cL-da:f e a n I e
Parcel within 200'of: Saltwata❑ Lake❑ River/Creek❑ Pond❑ Wetland❑ Seasonal Runoff❑ Stream❑
Slopes or Bluffs> 15% Yes Wil timber be cut and sold in parcel preparation?Yes/
Does Site require FPA or 6 yr.Moratorium YesA
N I Is site being converted or replanted YeVft
Reason For land Clearing rl.e w r e4dzA c c, c on s_uG-t<
Is this application the result of a Stop Work Notice,Correction Notice or other enforcement action?Yesdo
Burning is authorized subject to the following conditions:
• Valid permit must be onsite while burning
• 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 is blowing 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`k and Oct. 15t'.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 gualified 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 360.427.7761,EACH day to report burning activity. Last 3 numbers of permit required at time of call in.
• Applicants must call 360.586.1044(ORCCA)EACH day to report/request any air quality issues associated with burning.
• 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 burn 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
OWNER/CONTRACTOR:Acknowledges submission of inaccurate information may result in a stop SITE SKETCH/NOTES
work order or permit revocation. Acknowledgement of such is by signature below. I declare that I am
the owner,owner's legal representative,or 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 application 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&
local fire authorities access to the above described property and structure for review and inspection.The
person in charge otgU fire will be liable for the cost of suppression if the fire gets out of control or if APPROVED DENIED
bec x isrg� h the fire as the result of an enforcement actiop.
X i--- Date 9—/2 INTIALS
Owner/Owners Represen /Contractor(indicate which one) DATE