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HomeMy WebLinkAboutRLC94-1146 - RLC Inspections - 5/23/1994 Date Received: S 23. o 1-4 MASON COUNTY doq y EPARTMENT OF COMMUNITY DEVELOPMENT SO 83 RESOURCE LANDS AND CRITICAL AREAS CHECKLIST 1i k The following checklist is designed to assist an applicant for a Building Permit, On-Site Sewage System Site Evaluation and Disposal Permit, Access Permit, Land Modification Permit, Boundary Line Adjustments, Lana Segregations, Hazardous Waste Permit, or Shoreline Permit in determining whether their property is affected by regulations under the Mason County Interim Resource Ordinance (77-931)1. This checklist is an important opportunity foridentifyiog earlyin the permit process whether there willbe any environmental regulations affecting the proposed development. NE (QSb I,aSev,. Owner—Zi1h f/) ��j�lVl�✓�, Phone JJ�7 I Site Address / City Zip Owner Address AI ISQZj� 14,1iS-Slotj �TE44e /��. City i , S t a t d (&LZip;g&ate Tax Parcel No. (Confirm with Assessors 0ffice)_Z1Z,33/,. _-_51 _(:�a13,1 Legal Description f3fAc4S C"oC Project Description A264 2 Directions to site (Please attach map) Please provide or attach a vicinity map which includes cross streets, major roads, creeks, etc. Is 1 Answer the following to the best of your knowledge. Countywide reaps showing general locations of critical areas 0111061 and resource lands are available for review at Mason County Department of Community Development, Planning u..0,4' Department. Do any of the following exist on this property or within 200 feet of this property? c.— c. l El El 1. Saltwater shoreline or a lake 20 acres or larger? In El 2. Rivors, streams, or creeks with your-round flow? PEl3. Rivers, streams or creeks with intermittent flow but are within clearly defined channel? ❑ 4. Lakes or ponds less than 20 acres in size? r❑, ❑ 5. Wotlands: Areas that are inundated or saturated by surface water that unde normal circumstances /J support vegetation adapted for life in such conditions; such as marshes, bogs, and swanips. (See County Maps for guidance.) ❑ G. Slopes Greater than 15% (8.5 degrees)? (See the County Landslide and Erosion Hazard Maps for guidance.) JL i El7. Floodplains? (See County Federal Emergency Management Maps and County Seismic Hazard Map for guidance.) Alt [}� ❑ 8. Soismic Hazard Areas? (See County Fedoral Emergency Management Maps and County Soismic 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: wtl Ye 1 ❑ 1. Agricultural Open Space Taxation Prouram, RCW 84,33 ❑ 2. Opon Space Timbor Taxation Program, RCW 84.33, or Designated Forest or Classitied Forest, RCW 84.34 • Copies are avallablo at Mason County Departinant of Community Developmont for $5.00 each. RESOURCE LANDS & CRITICAL AREAS SITE PLAN -3LEASE SHOW THE FOLLOWING INFORMATION OR PROVIDE SURVEY MAP IF POSSIBLE: Location & dimensions of existing & proposed property boundarles. P. Approximate slope of lend (grade & direction), topography. Identify legal access Including,width of all road fight-of-ways &easemants. P. Location of significant natural features (water bodies, rivers). Locale all existing & proposed structures,dralnflelds, walls & driveways. . Project description kale 1"=_SL North Arrow N 0 state that I have answered the above truthfully to the best of my knowledge.4 �16� Applicant/Own r Date FOR OFFICIAL USE ONLY adjacent property. /�tC2ir / AW f 494--&� Using County Rosouroo Land Maps, this praperty Il;OQ$ionatod as; 1, Long-terns Commorc:ial Forest �._ 4, Shoreline Master Program 2. Inholding land S, poes`not apply. 3. Mineral Resource Land \ I ,. A i'�frC pat© - _ DCD r,era is a $40.00 application lee for the Resource Land & Critical Areas Checklist. Make checks payable to the Mason ounty Treasurer. hen completed, this form becomes pert of the permit application.