HomeMy WebLinkAboutRLC93-00217 - RLC Application - 11/5/1993 MASON! COUNTY
DEPARTMIENT OF CO(VIMUNN T'Y Dr VELOPMEN T
3251
RESOURCE LANDS AND CRI1`IIrAL_ARFA_S CIJECKLIST
The following checklist is designed to assist an applicant for a Building Permit, 017-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 dk;termining whether their property is affected by
regulations under the Mason County Interim Resource 01-dinance (77-93)*. This checklist is an important
opportunily foridentifying E,a�in the permit process whether there will be an I/onvironn7ental regulations affecting
the proposed development.
Owne r HOMER AND DONNA WILSON
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o !t 206_.)_._698 1454
Site Address E 720 CATPISH LAKE ROAD City SHELTON, WA _Zip 98584
Owner Address 6009 CHICO WAY NW CityBREMERTON __State WA Zip98312-1145 _
Tax Parcel No. (Confirm with Assessors Office) 32134 - 75 _ 90212/90211 Legal Description_
SHORT PLAT OF A PORTION OF SE1/4 OF SE 1/4 OF SECT 34, T21N,_R_3W,W.M. _
Project Description 1. Extend/add on a 4 ft deep by 14 ft wide room to back wall of_ existing
motorhome garage at E 720 Catfish Lk RD (Lot 21B) and 2. Build a 3520 SF House•Slncluding a—
(fay light basement) with a 2 car garage next lot over at E 740 Catfish Lk RD (Lot 21A) .
Directions to site (Please attach map) Highway 3 north to Mason/Limerick Lk Rd, turn left up hill past
Batstone tree farm to top of hill and Catfish Lk Rd on right hand side._ Go around lake to end,
of road/culdesac. E 720 on RH side (existing Structured and E. 740 has storage shed on it.
Please provide or attach a vicinity map which includes cross streets, major roads, creeks, etc.
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Answer the following to the best of your knowledge. County-wide maps showing general locations of critical areas
Official and resource lands are available for review at Mason County Department of Community Development, Planning
useonty Department.
Do any of the following exist on this property or within 200 feet of this property?
County Yee No `A
❑ El [XI 1. Saltwater shoreline or a lake 20 acres or larger? �L, nn
❑ ❑ [91 2. Rivers, streams, or creeks with year-round flow? ti'Vv
❑ ( .) [� 3. Rivers, streams or creeks with intermittent flow but are within a c early defined channel?
❑ ❑ 4. Lakes or ponds less than 20 acres in size? CAt A
❑ ❑ [ 5. Wetlands: Areas that are inundated or saturated by surface v,/ater that under normal circumstances
support vegetation adapted for life in such conditions; such as marshes, bogs, and swamps. (See County
Maps for guidance.) �AJ''i� /K,�
❑ ❑ �] 6. Slopes greater than 15% (8.5 degrees)? (See the County Landslide and Erosion Hazard Maps for
guidance.) 2•, G07J0 _
[ ] ❑ [� 7. Floodplains? (See County Federal Emergency Management Maps and County Seismic Hazard Map
for guidance.)
(_� (_] ❑ 8. Soismic Flazard Areas? (See County Federal Emergency Management Maps and County Seismic
Hazard Map for guidance.) Vw
You may be provided nuisance protections by the County for certain resource activities. If you are enrolled in any
of the following programs:
County Yee No
❑ ® 1. Agricultural Open Space Taxation Program, RCW 84.33
[� ❑ ® 2. Open Space Timber Taxation Program, RCW 84.33, or Designated Forest or Classified Forest,
RCW 84.34
i srr[ PLAN
PLEASE SHOW 1-m- FOLLOWING I1\11'.0IiMi171UN Oft PIMVIUI: SURVEY Ml1I if: 1'fl;SIBLL":
► Loontlon &dimensions of existing &proposed property haundarlas• . Appsoxlrnnto slopa of Innd (grn(lo & diroction), trpogrnphy•
► Identify legal access Including, width of nil rand right-ofhwnys &ensomonts. ► Locatlon of alnnlllr.nnt nolurnl fnntures(wntnr hndins, rivors).
► Loonts all axlnting & proposed strucluros,drelnfinlds, wells & driveways. . Prclnct de..sctiptlon
Scale 1"= 30_ New HC
Q 111 North Arrow
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I state that I have answered the above truthfully to the best of my knowledge.
r J Applicant/Owner -Date
FOR OFFICIAL USE ONLY
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There is a $40.00 application fee for the Resource Land & Critical Areas Checklist. Malre checks payable to the Mason
County Treasurer.
When complotad, this: form bocomes part of the pormit application.
►"LEAsr. sllOw i'Ih: rOLLOWING 1NI=OHMATION Oil PROVIDE SUIIVI Y MAI' 11' POSSIBLE:
► Location & dimonslona of existing &proposed property boundaries. . Approxhnnto siopo of kind Igrndn &direction), topography,
► Identify legal access Including, width of all road right-of•ways&easements. . Locntlon of nlpniliennt natural(nnuiros (water hodins, rivers).
► Locate all nxisting & proposorf structures,drninfintds, wells & drivnwnys. r Prcloct description
Scala 1"= 30"
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I state that I have answered the above truthfully to the best of my knowledge.
A licant/Owner
pp 11—b _ 9 3 Date
FOR OFFICIAL USE ONLY
Adjacent property.
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There is a $40.00 application fee for the Resource Land & Critical Areas Checklist. ►►'fake, checks payable to the Mason
County Treasurer.
When completed, this form becomes part of the permit application.
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TY TITLE URANr.r
MASON COUN S
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N.otM �1 11V M A B S Shelton. WAS 5 84 Box 278)
A Al& ASso 12061426-g7�
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