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Home My WebLink AboutRLC94-1050 - RLC Inspections - 5/11/1994 MASON COUNTY ` 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 Site Evaluation and Disposal Permit, Access Permit, Land Modification Permit, Boundary Line Adjustments, Land Segregations, Hazardous Waste Permit, or Shoreline Permit in determining whether their property is affected by regulations under the Mason Counly Interim Resource Ordinance (77-93)". This checklist is an important opportunity for identifying early in the permit process whether there will be any environmental regulations affecting the proposed development. Owner_54eoesl l)ASI<ll _ Phone 11( 206 ) Z7S--066V Site Address_ n ID1D i lgatK Blvd city Zip 2 Owner Address_i360� Gc1• �R�f¢�r p«1C L,�tJ, a331 City B600a 4011 Stateb",Zip fgS/Z Tax Parcel No. (Confirm with Assessors Office)—T�s'�"r'/ / ypf3 -Legal Description_ __C' o lof l Project Description A)ec4j t Directions to site (Please attach map) Sy5f Q3S� /.ueS�- ti'L! oh Lgrsen BUS �o ,�-/— lCe.5 h lk e/teare 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 locations of critical areas omot.i and resource lands are available for review at Mason County Department of Community Development, Planning u..only Department. Do any of the following exist on this property or within 200 feet of this property? Cho- 0 o ld� 1. Saltwater shoreline or a lake 20 acres or larger? ❑ 2. Rivers, streams, or creeks with year-round flow? ❑ 3. Rivers, streams or creeks with intermittent flow but are within a clearly defined channel) (� G/j❑ � 4. Lakes or ponds less than 20 acres in size? In \ 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.) /„ 1 (� ❑ 6. Slopes greater than 15% (8.5 degrees)? (See the C unt Landslide guidance.) r L ( t Y and Erosion Hazard Maps for ❑ 1 , 7. Floodplains? (See County Federal Emergency Managem en for guidance.) /10 Hazard t Maps and County Seismic Map ❑ B. Seismic Hazard Areas? (See County Federal Emergency Management Maps and County Seismic Hazard Map for guidance.) M You may be provided nuisance protections by the County for certain resource activities. If you are enrolled in any of the following programs: 'ountv y37 a o 1. Agricultural Open Space Taxation Program, RCW 84.33 ❑ 2. Open Space Timber Taxation Program, RCW 84.33, or Designated Fo ✓ ` RCW 84.34 tJ rest or Classified Forest, • Copies are available at Mas on County DeparUnant of Community Devolopmont for 85.00 each. '� 51 I t PLAIN PLEASE SIIOW TI1E FOLLOWING INFORMATION OR PROVIDE SURVEY MAP IF POSSIBLE: ► Location &dimensions of existing &proposed property boundaries. ► Approximate slope of lend (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,drainflelds, wells & driveways. ► Project description Scale 1"= North Arrow 70 T fi C6 5 top IVVx i3o.vt z e— 0 0 3,Lt°ib Zo D 7.15- LAP�50lt,J l I state that I have answered the above truthfully to the best of my knowledge Applicant/Owner . 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Make checks payable to the Mason County Treasurer. Whan completed, this form becomes part of the permit application.