HomeMy WebLinkAboutSPI2024-00117 - SPI Inspections - 11/18/2024 ` MASON COUNTY RECEIVED SPI - o24 - Oct i r,
COMMUNITY SERVICESNOV 18 2024
Building,Planning.Environmental Health,Community Health PLANNER
615 W.Alder St.—Bldg.8,Shelton,WA 98584
Phone:(360)427-9670 ext.352♦Fax:(360)427-779015 W. `wer Sblgt
PLEASE PRINT $300.00 FEE REQUIRED
PLANNING DEPT. PRE-INSPECTION APPLICATION
Note:Pre-inspection does not survey lot lines and can only provide very general septic and water adequacy information.
1. Owner: -e erg w 0 ed C, Applicant:� �� �� c C.
Site Address: Applicant Ad ress: L1 1 6i 1 a tI 5 t
Owner Addr&ss: City: �-(N C�C St Zip q y 16
City: Q 1 0 r) St Zip Phone:(Z5 3 ) 31 9 day
Phone:) Email Address:
Email:
(if different than applicant) Legal Description: N►n/ N E N E N y or
CLQQUALL_QM RE) .
2. Parcel No. "1 Qd - 1 - ce,o
Parcel No. y11 q O�- 1\ - rj 4 D 1
3. Purpose of Pre-Inspection: W C _)G n�4r1 P
i C a1r\
4. Use of building: R kvj w-ry c
5. Do any of the following exist on or adjacent to property?: slope( saltwater( lake( river
pond( ) wetland(X� seasonal runoff( other( stream N seasonal creek
Directions to Site:
If the information is incomplete, then Mason County must disclaim any errors resulting from deficiencies in the original
application. Pre-inspection reports remain valid only until development changes occur in the vicinity which affect the lot
evaluated in this inspection, or the laws regulating development of the site change after the time of inspection.
Applicant Signature: , <<Q� C ef C-P_ PS Date: t 3 /I
If you would like to be on site during inspection,please check here: (I'<
Return application to: Mason County Community Services,Planning Division
615 W.Alder Street
Shelton,WA 98584
(360)427-9670 ext.352
Please include a$300.00 check or money order payable to Mason County Treasurer
When completed,this form becomes part of the parcel file.
FOR OFFICE USE ONLY:Accepted by: Date:
MORE ON BACK SIDE
Rev. April 2021
Please illustrate below the proposed building site in relation to critical areas (slopes,streams, lakes, wetlands, etc.)
existing improvements, as well as property lines. APPLICATIONS SUBMITTED WITHOUT ADEQUATE
ILUSTRATIONS WILL NOT BE ACCEPTED AND WILL BE RETURNED TO THE APPLICANT.
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Departmental Review
(For Office Use Only)
Planning Department Findings: