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HomeMy WebLinkAboutBLD2001-00794 Cancelled MFG Home - BLD Permit / Conditions - 12/11/2001 Inspection Line(360)427-7262 MASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT Phone: (360)427-9670,ext.352 Mason County Bldg. 3 426 W. Cedar P.O. Box 186 Shelton,WA 98584 �1►_c� 1 �W�1J O� �of RESIDENTIAL BUILDING PERMIT BLD2001-00794 OWNER: BRIAN BOLINGER RECEIVED: 8/6/2001 CONTRACTOR: LICENSE: EXP: ISSUED: 9/10/2001 SITE ADDRESS: 50 NE TEE LAKE PINES TAHUYA EXPIRES: 8/27/2003 PARCEL NUMBER: 322027590042 LEGAL DESCRIPTION: TR D-2 OF SP#2374 SEE SURV 3/6 PROJECT DESCRIPTION: DIRECTIONS TO SITE: MANUFACTURED HOME GO A SHORT WAYS TK RT ON TEE LAKE COUNTY RD SEE ATTACHED MAP General Information Construction &Occupancy Information Square Footage Information No.of Bedrooms: 3 Type of Constr.: Type of Use: MH Insp.Area: No.of Bathrooms: 2 Occ. Group: Lot Size: Deck: Type of Work: NEW Fire Dist.: 2 No.of Stories: Occ. Load: Building: Valuation: Building Height: Occ. Status: Basement: Manufactured Home Information Setback Information Shoreline&Planning Information Make:FLEETWOC Length: 66 Ft. Front: NE 185.0 Ft. Shoreline: 42.0 Ft. Water Body: wetland Rear: SE 55.0 Ft. Slope: Ft. SEPA?: No Model:BROOFIIEL Width: 27 Ft. Side 1:SW 42.0 Ft. Shoreline Desig.: Unknown Year:1984 Serial No.: 12755 Side 2: W 6.0 Ft. Comp. Plan Desig.: Rural Plumbing Fixtures Mechanical Fixtures FEES Type Qty. Type Qty. Type By Date Amount Receipt Mobile Home Submittal Fee KLW 8/6/2001 $175.00 56975 EH Plan Review CEW 8/6/2001 $50.00 57346 Building State Fee MEC 8/9/2001 $4.50 57346 Mobile Home Issuance Fee MEC 8/9/2001 $175.00 57346 Planning Site Inspection SAL 9/4/2001 $70.00 57346 Additional Plan Check Fee NJP 3/22/2002 $47.00 58760 Building Permit Fee SRG 2/27/2003 $175.00 62001 Total $696.50 BLD2001-00794 Please referto the following pages for conditions of this permit. 1 of 4 CASE NOTES FOR BLD2001-00794 CONDITIONS FOR B LD2001-00794 1) Owner/builder assumes all responsibility if drainfield/reserve area is encumbered. X 2) This application is subject to Buffer and Landscaping requirements as established under Mason County Ordinance 1.03.036.X Ae_ls� 3) The use, handling and storage of hazardous material or flammable and combustible liquids in excess of 10 gallons is not allowed without the approval of the Mason County Fire Marshal. X '� 4) Provisions for surface/subsurface drainage control must be implemented with new construction or development on site and MUST NOT adversely impact adjacent parcels. Under the requirements of Mason County Stormwater Ordinance, either private ditches and drains will meet requirements of the stormwater ordinance or prior approval will be granted to use an existing utility and drainage easement dedicated for that specific purpose. For further information regarding this ordinance and the REQUIREMENT to obtain an ACCESS PERMIT for the installation/construction of a driveway or access connecting from a Mason County Road, Contact the Mason County Public Works Department prior to construction at Ext 450. For any construction which is proposed to be located within 25'of a Mason County road right of way, it is suggested to contact that office to review future planned work which may affect your project 5) Proposed structure or any portion thereof greater than 30" in height from grade line, must maintain a minimum of 5'setback from all property lines, easements and 10'from all County and State Road right of ways. X � 6) In accordance with the Uniform Building Code, all sites shall have approved numbers or addresses located in such a position as to be plainly visible and legible from the street or road fronting the property. Mason County Building Department requires that this be completed prior to calling for any site inspections. A re-inspection fee based on rates as adopted by the jurisdiction and the Uniform Building Code will be assessed if the owner and/or X contractor fajyl���e address on site prior to requesting inspections. 7) THE FOUNDATION SYSTEM SHALL BE PLACED ON UNDISTURBED, NATIVE SOIL. X 8) The "approved" plot plan is required to be on-site for inspection purposes. If an inspection is requested and the"approved" plot plan is not on site, then approval will not be granted. In addition, a re-inspection fee in the amount of$47.00 per hour(minimum 1 hour)will be charged and shall be collected by the Building Department prior to any further inspections being performed or approvals granted. X BLD2001-00794 Please refer to the following pages for conditions of this permit. 2 of 4 9) REQUIRED INSPECTIONS (Footing Inspection-prior to pour, Set-up Inspection-prior to skirting, Final Inspection-prior to occupancy). I hereby assume all responsibility for the scheduling of my required inspections. If the required inspections are not requested, inspected and signed off(approved) by the inspector in the prescribed order, I understand that reinspection fees and an hourly investigation fee pursuant to the 1997 UBC, and will be assessed in addition to my original permit fees to resolve any questionable practices or problems that have been discovered. I further understand that this investigation will be scheduled as time allows. Until resolution of any/all problems no occupancy(Final Inspection)will be granted for the residence. OWN ER/CONTRACTOR(indicate which) Signature X 10) All mobile/manufactured home landings or decks must be freestanding (self supporting). The largest landing or deck allowed without drawings or a building permit MUST be under 30" in height from surrounding grade. NO second story decks, or decks above 30"can be built without a permit. Any landing or deck that is 30"or more in height from walking surface to finish grade requires a Permit. Any landing or deck that has 4 or more risers requires a handrail. X 0 'f_ 11) The installation permit shall be displayed in clear view of the site access road. The approved site plan and other applicable instructions, including installation instructions, shall be available in this location OR placed in the location specified by WAC 296-150M-655. Support configuration shall be clearly marked in the installation instructions. v 12) All property lines shall be clearly identified at the time of foundation inspection. X 13) All building permits shall have a final inspection performed and approved by the Mason County Building Department prior to permit expiration. The failure to request a final inspection or to obtain approval will be documented in the legal property records on file with Mason County as being non-compliant with X Mason Countyordinances and building regulations. 14) All permits expire 180 days after permit issuance, or 180 days after the last inspection activity is performed. The Building Official may extend the time for action for a period not exceeding 180 days, upon the receipt of a written extension request indicating that circumstances beyond the control of the permit holder have prevented action from being taken. No more than one extension may be granted. X �i� 15) All upland areas disturbed or newly created by construction activities shall be seeded, vegetated or given an equivalent type of erosion protection (silt fencing or straw matting). X 16) Approved per dimensions and setbacks on revised site plan. Site plan can be found in legal file of parcel, referencing this permit#. X 17) Applicant acknowledges that this development is subject to policies and regulations of Mason County Comprehensive Plan and Development Regulations.X 18) The Washington State Clean Air Act prohibits the burning of any construction or demolition debris in an outdoor fire. 19) Permit approved based upon condition that the wetland buffer is to be reduced to no less than 40 feet in the immediate area of the residence, while expanding the buffer to 90 feet in the area. Impacted areas of the 50 foot vegetated buffer and expanded 90 foot buffer are to be replanted with native vegetation per agreement between owner and planning staff. 50 - 60 evergreen trees are to be replanted and 200 - 300 shrubs ie. ferns, rhodies, salal, and huckleberry shall be planted within disturbed and expanded buffer areas as indicated on site plan. Mitigation site plan will be sent to parcel legal file and compliance checks will be conducted to ensure that this plan is implemented. BLD2001-00794 Please referto the following pages for conditions of this permit. 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 anytime 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. OWNER OR AGENT: c DATE: BLD2001-00794 Please refer to the following pages for conditions of this permit. 4 of 4 �CONCF,ETE MECHANICAL MOBILE HOME j Footir js-Seback date by Ribbons date by Gas Pv date by Fo,ffWaWn Wails date by Set UP date INSULATION date byi ��- tG/SL AB k�sulatlon Floors Final e by date date FRANUNG Walls FIRE DEPT. date by date by date by PLUMBING Attic OTHER Groundwork date by date by WALLBOARD NAILING D.W.V. date by date by FINAL INSPECTION Water Lin© date by date by date by 2-1 l 127-7 Tom_ `� �,✓� �o ��` v �.��. -Kr ,mac%��.✓ 77 1 n - f 2 A I (` 5 C r S rr, -s \ V rJ r -s • �p a Building Permit # ei ' MASON COUNTY BUILDING III 426 W. CEDAR SHELTON, WASHINGTON 98584 (360) 427-9670 CORRECTION NOTICE Job Location This structure has been inspected by Mason County Building Department and the following VIOLATION of County Laws and Ordinances has been found: Items Listed below must be corrected to gain code compliance �S%✓' ;- 61i> T 61 ©�� /v .9 �-mac--- � � s�T ='/�c� �/�`{',-"�J l.'���=.f c►�,�5 You are hereby notified that the above corrections shall be made BEFORE PROCEEDING WITH ANY FURTHER WORK ❑ Call for re-inspection when corrections are made before continuing ❑ Make corrections, items will be checked on next inspection OK to ❑ This is not a complete inspection Department Date Z-Z /—f:�l Inspector ■ ov NUT immMoOV T I = T %A BuJd'1og Permit # Lp� / '7g MASON COUNTY BUILDING 111 426 W. CEDAR SHELTON, WASHINGTON 98584 (360) 427-9670 CORRECTION NOTICE Job Location 50 A)E; Te:e--, mks ,—rah LL v a-, This structure has been inspected by Mason County Building Department and the following VIOLATION of County Laws and Ordinances has been found: Items Listed below must be corrected to gain code compliance Lr oa LK r -ec o L You are hereby notified that the above corrections shall be made u)IMY7 l�5 Call for re-in pection when corrections are made before continuing Make cor t�, tems will be checked on next inspection OK to This is not a co plete inspection Department Date L 'L`�'03 Inspector moos NUT rk MOsV T 1 ' , T A ,%X �t +, r s - rrl5 Est SCA I C I ' " `-�� r ,0 I rVi ,--T -- soot rt Lh O A6 yp I At t� or� q,37,50 r LcL-rctls QprI -=� 11own Q 3002 Fo ~ i,�!cr• tt �lc "4 .�,a� F,�LLr I �� ►s b c, a57o '�oc1:C�1aY1 m7c, I �!Z j `'1 I 1000 �QQL �fCS�J✓L `Dls{r,� W1 V6E.o�' , Lu Wo —22-2c APPROVED ,11 TNi O uj MASON. BUILDING INSPECTOR 1 — J S `� C+IAN SUBJECT TO AP R VAcr L ,� �'CV 2 Z 2 v1 \ pA1'Elow W O _ C uj Lu cn 3 � � o a o � < WU' W c2[ a ,C "- Z z � woo I0z a � � i o - o 0 CL 9 C7 z C7 ��a -- ` WEIR Of cj i „ r; ocYiSEfJ SCA 1 [-- I rl Lh •DC' , 1�00L1� V` Y •�rr�wr�-X •"1 __ f-1 APPROVEr a; or� L1,37,50 ' L.1c.rch L I re--b it)0�'dn) MASON BUILDING INSPECTIJR CHANGES SUBJECT T Fottouirn� A 3002 i,�l�v t',i �c��� Sa �c1 T= 1 Lc-r 1E 0 A0, v,�i Y3 --DATE 60 Jul = 3t)lc�S• �' 11 0 Foct�`ciiarl i5 Unit�cJ ` l�Kw� crow- �c 1rt-c,I I" IGo7z, cLua:IaM e-- VQSejANGES C- -rl,-hlL ig I067 17cSc-rJC ANSGiIGLI SUBMIT 1 :� CHANGES FOR APPROVA- ,2 pL Ff(550✓•L �i5 `l�t Gt'1 ,.;7Gc-.05 PRIOR TO PERFORMIN I V- ON Tt4s C) 22-2LF THESE S, Lr r :i ALL CURRENT ON PLAN wvl. S MUST gS - Y►'tEi i;, ;. VN STATE CODES �0R INSPECTION. - B S11 L '1 L f K7LU O: . Ir _ IGO' . f. ,4 �7 .�.` nil ' '" —E) s i �l7 j X 3 O a k I C-�PON.CTArLt. MASON COUNTY DEPTARTMENT OF COMMUNITY DEVELOPMENT O A U v) o T z Planning Division N Y a0' P O Box 279, Shelton, WA 98584 1864 (360)427-9670 NOTIFICATION OF INCOMPLETE APPLICATION August 22, 2001 BRIAN BOLINGER 11634 SE 192ND ST RENTON WA 98058 Parcel No.: 322027590042 Project Description MANUFACTURED HOME Dear Applicant: You have submitted a permit application (case no. BLD2001-00794) for proposed construction or development in the county. Upon review of your application, I have determined that the contents of the application are incomplete or do not provide enough detail for review. Therefore, review of your application will not proceed until the necessary information is provided (see the comment section of this letter for details.) Once the information is submitted and the application is complete, I will continue to process your application accordingly. Please contact me at (360) 427-9670, ext. 363 if you have questions. Sincerely, cott Lo anecker Lan s Planner Ma County Planning Department 8/22/01 1 of 2 BLD2001-00794 NOTIFICATION OF INCOMPLETE APPLICATION 8/22/01 Case No.: BLD2001-00794 Comments Per our telephone conversation I have explained some of the issues that need to be addressed before we can continue with the review of your building permit application. The wetland indicated on your site plan appears to be a category III wetland per the enclosed wetland section of the Mason County Resource Ordinance. A 50 foot vegetated buffer, plus 15 foot building setback (65 feet total) is required for category III wetlands. The 50 foot vegetated area is to be left in its natural state. It appears that a portion of this buffer has been destroyed through land preparation for the siting of your home. This area needs to be restored to a more natural state, and our office will need a plan detailing how this restoration will occure, what plant species will be used, the density and number of plants. A site plan will be needed to show where this restoration work will occur. It is possible to do buffer averaging, where you may reduce the required buffer in one area and expand it in another area. This is normally done only when it is necessary to site a house or other structure in a limited area. I have flagged the wetland edge in order to help you determine where the buffer area is located. We may consider a reduction in this wetland buffer to as little as 40 feet as long as the same amount of square footage is made up somewhere else in the buffer area. If you need to do this please indicate how and where the averaging will be done in your new site plan. This area should also be marked on the ground with stakes or other markers to clearly define where the buffer is. Part of your plan will be to restore / revegetate disturbed areas within this buffer. I am also including a list of wetland consultants if you wish to contact one of them to perform a wetland delineation, or produce a restoration plan for you. If you choose to produce the plan on your own, you may wish to contact the Mason Conservation District regarding appropriate vegetation to use in the wetland buffer. Shannon Bonnett at the District has been of help in other similar situations and her phone number is 360 427-9436. Vegetation that is found in and around the building site would most likely be appropriate for a revegetation plan (ie. huckleberry, salal, evergreen tree species etc.). If you have any questions please contact me. Thank you. si22/0 1 2 of 2 BLD2001-00794 MASON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT Permit Processing/Inspections/Addressing Mason County Bldg.III 426 W.Cedar P.O.Box 186 Shelton,WA 98W (360) 427-9670 Belfair (360) 275-4467 Elma (360) 482-5269 Seattle (206) 464-6968 February 21, 2003 Brian S. Bolinger 50 NE Tee Lake Pines Tahuya, WA 98588 RE: Mason County Code Violation ENF2003-00030 Dear Mr. Bolinger, On January 31, 2003, our office received a complaint regarding occupancy of the structure permitted under Mason County permit BLD2001-00794. The permit is expired and required occupancy inspections not performed. As a result of the complaint and records research, a site investigation was performed on 2/19/03 at which time a Correction Notice and Do Not Occupy Notice was posted at all doors on the manufactured home unit with your permission. You indicated to the inspector at the time that you did not live there. You also reiterated this statement in a voice mail message that you left for me on 2/19/03. The Correction Notice on site directed you to re-new the expired permit within 15 days and request the required inspections prior to continued occupancy. Based upon your statement that you are not occupying the unit, if you fail to renew the permit prior to March 10, 2003, and request the required inspections prior to continued occupancy, I will direct Mason County PUD#3 to disconnect utility service to 284 NE Tee Lake Rd., Tahuya which is the service address for 50 NE Tee Lake Pines, Tahuya. Approval was not given for the unit to be skirted and the property lines were not identified as required. The skirting must be fully removed and all property lines marked. Photos must be provided of the rebar in the runners per the Correction Notice dated 11/21/01 (Copy enclosed). Continued or ANY occupancy of this unit is prohibited until approved by this office. Failure to immediately cease any and all occupancy will result in further enforcement action against you. Sincer , ami Griffe Building Inspecto Code Enforcement Cc: Property File , Darren Nienaber, Mason County Deputy Prosecuting Attorney COMPLETE •N COMPLETE THIS SECTIONON DELIVERY ■ Complete items 1,2, and 3.Also complete A. Sign re item 4 if Restricted Delivery is desired. X W- z ■ Print your name and address on the reverse so that we can return the card to you. g, ed by(Print ame) ate of Delivery ■ Attach this card to the back of the mailpiece, or on the front if space permits. D. Is delivery address different from item 11 ❑Yes 1. Arti le Addressed to: If YES,enter delivery address below: ❑ No BRIAN S BOLINGER 50 NR TEE LK PINFS ..,.- '❑ Reg Type TAHUYA 98 8 3.,s is ❑ Express Mail �. ..��..e^��,.,, istere�d ❑ Return Receipt for Merchandise .,....,,.:M,�._ .r,:-�s+��,.f�-�.P—... �JrrsurelJ Mail' ❑ C.O.D. """'�•-n•y.-�"""a` """'4—�-�""'�� Restricted Delive�y7(Extra Fee) ❑Yes 2. ArtiGtB Numl � - _ PS Form 381 x-nn•tsao NP14Mason County Dept. of Community Development Mason County Bldg. 3 426 W. Cedar P.O. Box 186 (360) 427-9670 Local (360)482-5269 Elma Shelton, WA 98584 (360) 275-4467 Belfair Notice to Obtain Final Inspection November 07, 2007 BRIAN BOLINGER 11634 SE 192ND ST - 7 RENTON WA 98058 Case No.: BLD2001-00794 Parcel No.: 322027590042 Protect Description: MANUFACTURED HOME The Mason County Department of Community Development is currently reviewing all permits that are expired and have not been approved for occupancy and use. Pursuant to Mason County Code, Title 14 Building and Construction, a permit and final inspection for this type of activity is required under the 2006 International Building Code and your property is currently in violation status of occupancy and use. Please contact our office to make the necessary arrangements 21 days from the date of this letter. Failure to contact our office to make the necessary scheduled inspections will result in enforcement actions. To bring your site into compliance, you must schedule an inspection. One (1) $64.00 site investigation fee will need to be paid prior to inspection along with any outstanding fees currently due on your building permit. For every inspection required after that, you will be charged $64.00 again, per inspection until final inspection and conditions are met. To schedule an inspection, please call (360) 427-9670 ext. 262. If you should have any questions regarding this notification, please contact me at (360) 427-9670 ext 359. Sincerely, Terry Ryan Mason County Department of Community Development Cc: Property File November 07, 2007 BLD2001-00794 pi Mason County Dept. of Community Development Mason County Bldg. 3 426 W. Cedar P.O. Box 186 (360) 427-9670 Local (360)482-5269 Elma Shelton, WA 98584 (360) 275-4467 Belfair Notice to Obtain Final Inspection November 21, 2007 SEABECK DEVELOPERS LLC Vb 200 BROVO TER. PORT ORCHARD WA 98367-9375 Case No.. BLD2001-00794 Parcel No.: 322027590042 Proiect Description: MANUFACTURED HOME The Mason County Department of Community Development is currently reviewing all permits that are expired and have not been approved for occupancy and use. Pursuant to Mason County Code, Title 14 Building and Construction, a permit and final inspection for this type of activity is required under the 2006 International Building Code or the code your permit was issued and your property is currently in violation status of occupancy and use. Please contact our office to make the necessary arrangements 21 days from the date of this letter. Failure to contact our office to make the necessary scheduled inspections will result in enforcement actions. To bring your site into compliance, you must schedule an inspection. One (1) $64.00 site investigation fee will need to be paid prior to inspection along with any outstanding fees currently due on your building permit. For every inspection required after that, you will be charged $64.00 again, per inspection until final inspection and conditions are met. To schedule an inspection, please call (360) 427-9670 ext. 262. If you should have any questions regarding this notification, please contact me at (360) 427-9670 ext 359. Sincerely, Terry Ryan f Mason County Department of Community Development Cc: Property File November 21, 2007 BLD2001-00794 PERMIT NO.: BLD MASON COUNTY BUILDING PERMIT APPLICATION 426 W.Cedar/P.O.Box 186,Shelton,WA 98584 Shelton 360 427-9670 Belfair 360 275-4467 Elma 360 482-5269 Seattle 206 464-6968 APPLICA T INFORMATION CONTRACTOR INFORMATION Owner OJ-'% - 0 0 o Contractor Name Mailing Address C. Mailing Address City State 1,- ip Code Gosh$ City State Zip Code Phone 2 a ther Ph.(Y.0 '71 Ph.( Other Ph.( ) Lien/Title Holder 6.rlterl",5e/5 Contractor Reg. # Address A 9 Expiration SEPTIC/WATER SYSTEM INFORMATION-Connect taNeic Existing,Septic Connect to Sewer System Name of Sewer System e , 1 r ell Water System Name of Water System To Q t. PARCEL INFORMATION-12 digit Tax P rcel No.'32ZDZ.. /_�_/ Fire District Legal Description Z JET �c�-r Site Address(Please include street name, street number and city) Z Directions to site °t o 1�. S},w t- TK &fi on Tee A,ak2 [au,tty/ r�z Will timber be cut and sold in parcel preparation? (Yes/No) rVQ Is your property within 200' of the following: Body of Water(Name) &0 rJ& 1 0— Saltwater Lake River/Creek Pond Wetland Seasonal Runoff_Stream Slopes or Bluffs PERMANENT RESIDENCE SEASONAL RESIDENCE❑ TYPE OF JOB New Add Alt Repair Other Use of Building Describe Work !iou;A19Mnhf')P �nn &1111 Set-t.JJ-0 No. of Bedrooms No. of Bathrooms—,,SQUARE FOOTA E-1st Floor / >�;;c. 2nd Floor �� 3rd Floor Loft 1 Basement / 144 Deck Other i sq. ft. Garage Attached Detached Carport Attached Detached MOBILE HOME INFORMATION-Make Model ,(-aL. 4,2 I id Model Year _ Length%,�{l-, Width -2--7 _Serial No. U.)-(zS,6�y - No. of Bedrooms No. of Bathrooms Type of Heat �1��_-f7i l Purchase Price $ 0 Replacement Unit ?(Yes/No) Installer Name .certification No. NOTICE: THIS PERMIT BECOMES NULL&VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS OR IF CONSTRUCTION WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER THE WORK IS COMMENCED. PROOF OF CONTINUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION. The owner or agent on owner's behalf,represents that the information provided is accurate and grants employees of Mason County access to the above described property and structures for review and inspection of this project. Acknowledgment of such is by signature below: OWNER AFFIDAVIT-I certify that I am exempt from the requirements of the CONTRACTOR'S AFFIDAVIT-I certify that I am currently registered as a Contractor Registration Law RCW 18.27 and am aware of the ordinance contractor in the State of Washington and that I am aware of the ordinance requirements for which this permit is issued and that all work will be done in requirements regulating the work for which this permit is issued and all work conformance therewith. No changes shall be made without first obtaining shall be done in conformance therewith. No changes shall be made without approval. first obtaining approval. X�,r„�-►_�G�`�� Date ✓ / X Date FOR OFFICIAL USE BEYOND THIS POINT �. Accepted by Y6 ry 14, 1 Date Submittal Amount Due Receipt No.J&�*)nl) QEPARTMENT -ft VIEW APPRO ED pENIED' CONDITION CODES .. _. Building Department i`„ Occ Group Type Constr. r'J Planning Department Environmental Health Department Public Works Department I Fire Marshal Valuation $ FEES Building Permit Fee Site Inspection Plan Review Fee EH Review Fee Plumbing& Base Fee Planning Review Fee Mechanical& Base Fee Other Wood/Gas/Pellet Stove Fee State Fee Violation Fee Pre-Paid at Submittal ( ) TOTAL FEES VSFFORUSTBE COMPLETED IN INK aRESSHARD MASON COUNTY PROJECT SITE INFORMATION Case No. Name Ai/W4 /5 011-4Jel— PARCEL NUMBER-L�-�OL,S1 Cry )-- Date 7 Lo� SHOW THE FOLLOWING ON SITE PLAN Show Direction by indicationg N, S, E, W in relation to the site plan Lot Dimensions Fences Existing Structures Driveways Structure Setbacks Shorelines Water Lines Topography Well Location (including adjacent) Drainage Plan Names of Streets Easements Names of Fronting Streets Septic System DRAW SITE PLAN BELOW Include adjacent properties if on shoreline or within 100 feet of adjacent property line. adjacent property line-) 10�tL n 6Tn 614�t I E-adjacent property line I I I I I I I I I I I 1 I I I I I I I I I I I I I I I I I I I I I I I I I I I � I I I I I I I 1 I I I I I I adjacent property line-> ' ' <-adjacent property line SAMPLE SITE PLAN adja�nt property line-> 3io' Fadjacent property line rR�SCRvE gel SE.4SC wJ AL_ 7I� L F-0 I- T I C m&ovu Crz.�IG � iicusc. � I j sQpt: I 1 , I If--- I I VAGn�T I c.AftAC 6 pfka CD � /\ T A&RLCLLLTWRAL 50 90. I I \\ I I I \ I /0O, I I L—eLL I I 1 l /00 IMIA.,ZO \ I \\ adjacent ro ert line-� ; ��. \; Fad'acent ro ert' line TOPOGRAPHY PROFILE(Show a side view of property. Show slopes, cuts and fills. If possible include height and the degree of slopes. See sample topography profile.) SAMPLE TOPOGRAPHY PROFILE d15+.2"C-a- +e ruLtLLY'G &-sta r,C.r- r o SIopd t-oe dis+a�ca Signature Date