HomeMy WebLinkAboutBRN2011-00016 Final - BRN Permit - 6/22/2011 Inspection Line (360)427-7262
MASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT Phone: (360)427-9670, ext. 352
Mason County Bldg. III 426 W. Cedar P.O. Box 186
Ir Shelton, WA 98584
��
BURN PERMIT BRN2011-00016
OWNER: JOHN KRAFT RECEIVED: 6/22/2011
CONTRACTOR: LICENSE: EXP: ISSUED: 6/22/2011
SITE ADDRESS: 80 E LAVENDER LN SHELTON EXPIRES:
PARCEL NUMBER: 321367590063
LEGAL DESCRIPTION: LOT: C OF SP#1658 PTN TR 6 S 2/49
PROJECT DESCRIPTION: DIRECTIONS TO SITE:
LAND CLEARING/BURN PERMIT ST RT 3, L ON LAVENDER LN TO SITE ADDRESS ON THE
RIGHT SIDE
BURN TYPE: FEES
Land Clearing Type By Date Amount Receipt
Burn Permit GMM 6/22/2011 $160,50 S1 201 1 00000000001 1 01
Total $160.50
BRN2011-00016 Please refer to the following pages for conditions of this permit. Page 1 of 4
CASE NOTES FOR
BRN2011-00016
CONDITIONS FOR
BRN2011-00016
1) Per 'ncJudes two (2) inspections maximum, additional inspections will require a$73.00 re-inspection fee.
X
2) Applicaots call 360.427.7761, EACH day to report burning activity. Last 3 numbers of permit required at time of call in.
X
3) Xpplica�st call 360.586.1044(ORCCA) EACH day to report/request any air quality issues associated with burning.
4) Xalid�ust be on-site while burning.
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,
allbe extinguished immediately.
X
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 o�e-s odors when burned.
X
7) All material must originate from the property on whichthe burning is to occur.
X
8) The fire must not create a nuisance from smoke, obscure visibility on public roads and highways or endanger life and property.
x':'/�/-
9) The maxi m pile size is twenty(20)feet in diameter, with a minimum ten (10) feet firebreak around each pile.
XG
10) Each pile must be at least one hundred (100)feet from any structure and atleast fifty(50)feet from standing timber.
BRN2011-00016 Please refer to the following pages for conditions of this permit. Page 2 of 4
11) Do not
,jWind is blowing more than seven (7) MPH.
X
12) Xo not
if wind is blowing from XX direction. (This will be indicated on the posted permit at the time of site inspection.)
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
XR0��24 H UR FIRE WATCH.
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 be p of pumping 20 gallons per minute through a one-inch (diameter) 50-foot hose.)
X
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
Xspon le any rekindling on the fire/burn site.
16) Provide excav r/dozer with a fire extinguisher at the site with a qualified operator.
X�
17) Provide a -hour.fire watch.
XL
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 ap e ment action.
X
19) Access mus passable with 2 wheel drive vehicle.
X
20) Fire must be completely extinguished within three (3)days after ignition.
���i
21) After t�u�emplete, YOU MUST touch by hand, the earth to make sure the fire has not burned down into the earth.
-�
22) Fan is re uire
X
BRN2011-00016 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 M County acces o the above described property and structures for review and inspection.
OWNER OR AGENT: DATE:
BRN2011-00016 Please refer to the following pages for conditions of this permit. Page 4 of 4
z CONCRETE MECHANICAL MANUFACTURED HOME
Footings/Setbacks Data By Ribbons
Gas Piping —I
o Intenor Date By Interior-Date By Date By
o Exterw Date By Exterior Pate B �up Q
INSULATION _
Point Load J Isolated Footings Date By Z
BG!SLAB INSULATION
Date By Date By FIRE DEPARTMENT
Foundation Walls Floors Date By
Date By Data By DECKS
FRAMING Walls Date By
Date By Data By PROPANE TANKS
PLUMBING vault Date By
Date By OTHER
Groundwork Attic
Date By Type.
Date B Y Date By
D.W.v DRYWALL Type
Int.Braco Wall Date By III
By Date By X
n�
FINAL INSPECTION Z
w Water Line Fire Sspsration rj
C
(D l
co Date By Dale By Date �� Z `+ // By /
m '"
s Pass or Request Inspect. c
CD
Type of insp. Fail Date Date Done By Comments o
/a/
0
O
7
a
o'
rA
O
r
M
N
N
3
N
CD
0
MASON COUNTY BURN 1 ERMIT APPLICATION
426 W CEDAR ST. •PO 9OX 186• SHELTON WA 98584
SHELTON 360.427.9670•BELFAIR 360.275.4467 • ELMA 360.482.5269
APPLICANT NFORMATIO CONTRACTOR INFORMATION:
Owner Owner
Mailing Address t4-' ;W?q -5?3 Mailing Address
City dl?oA/ State_LV Zip City S Zip
Phone Cell Phone_JW 47C Z206 Phone her Phone
Lien/Title Holder Contractor Reg.# Exp. / /
E-mail address E-mail address
Drivers Lic.# ITW
DOB 4-.!5' Drivers Lic.# D.O.B.
TAX PARCEL NUMBER - 5-%XLaaSec.30_Twn.2 Rng._ Fire Distr-w
SITE ADDRESS(please in*ude street name,number&city
Directions o the site&Oac Seto - x 6mlles - ST 46
B✓% _ N _
Parcel within 200'of Saltwater❑ Lake❑ River/Creek❑ Pond❑ Wetland❑ Seasonal Runoff❑ Stream❑
Slopes or Bluffs> IS% Yes/NO Will t' ber be cut and sold in parcel preparation?Yes o
Does Site require FPA or 6 yr.Moratorium Ye o Is site being converted or replanted e
Reason For land Clearing
Is this application the result of a Stop Work Notice,Correction Notice or other enforcement action?Le49
Burnine 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 156�and Oct. 15a.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 qualified 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 bum 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 of the fire will b iable for the cost of suppression if the fire gets out of control or if APPROVED DENIED
becomes necessary to extinguish e as e res It of an enforcement action.
X Date (O 0'1 l INTIALS
Owner/ wners Representat' ntractor(' dicate which one) DATE