HomeMy WebLinkAboutBRN2010-00019 Cancelled - BRN Permit - 3/31/2010 f
Inspection Line(360)127-7262
MASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT Phone: (360)427-9670,ext.352
Mason County Bldg. III 426 W. Cedar P.O. Box 186
Shelton,WA 98584
` BURN PERMIT BRN2010-00019
OWNER: CLIFFORD ELSNER
CONTRACTOR: LICENSE: EXP:
RECEIVED: 3/31/2010
SITE ADDRESS:
ISSUED: 3/31/2010
PARCEL NUMBER: 322027500120
EXPIRES:
LEGAL DESCRIPTION: TR L OF SURV 3/6
PROJECT DESCRIPTION: DIRECTIONS TO SITE:
BURN PERMIT FOR LANDCLEARING ST RT 3, L ON ST RT 300 / NORTH SHORE RD, R ON BELFAIR
TAHUYA RD, R ON DEWATTO, 2ND LOT ON THE LEFT
BURN TYPE: FEES
Land Clearing Type By Date Amount Receipt
Burn Permit GMM 3/31/2010 $160.50 S1201000000000000584
Total $160.50
i
BRN2010-00019 Please refer to the following pages for conditions of this permit. 1 of 4
• CASE NOTES FOR
t BRN2010-00019
CONDITIONS FOR
BRN2010-00019
1) Perm�r� s two (2) inspections maximum, additional inspections will require a$73.00 re-inspection fee.
X
2) Applicants must call 360.427.7761, EACH day to report burning activity. Last 3 numbers of permit required at time of call in.
x ('2$
3) Applicants must call 360.586.1044 (ORCCA) EACH day to report/request any air quality issues associated with burning.
�2
4) Valid permit must be on-site while burning.
X
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,
all fires must be extinguished immediately.
X 0']p
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 or obnoxious odors when burned.
X C��
7) All material must originate from the property on whichthe burning is to occur.
X_ Q!!
8) The fire must not create a nuisance from smoke, obscure visibility on public roads and highways or endanger life and property.
X I -
9) The maximum pile size is twenty (20) feet in diameter, with a minimum ten (10)feet firebreak around each pile.
X 0 P.2—
10) Each pile must be at least one hundred (100)feet from any structure and atleast fifty(50)feet from standing timber.
X�_@
BRN2010-00019 Please refer to the following pages for conditions of this permit. 2 of 4
11) Do n t b { if wind is blowing more than seven (7) MPH.
t X
12) Do not burn 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
PROVIDE 24 HOUR FIRE WATCH.
X _`c_C
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 capable of pumping 20 gallons per minute through a one-inch (diameter) 50-foot hose.)
X Cl�4
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
responsible for any rekindling on the fire/burn site.
X��.
16) Provide excavator/dozer with a fire extinguisher at the site with a qualified operator.
X C-<--
17) Provide a 24-hour fire watch.
X LDS-
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
PP 9 rY 9
result of an enforcement action.
II
X L
19) Access must be passable with 2 wheel drive vehicle.
20) Fire must be completely extinguished within three 3 days after ignition.
P Y 9 O Y 9
X CJti f"
21 After the burn is complete, YOU MUST touch by hand the earth to make sure the fire has not burned down into the earth.
x G
22) Fan is regt * d.
X
BRN2010-00019 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. 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 Mason County access to
the above described property and struc fo vi and inspection.
OWN ER OR AGENT: DATE. 3 3/'YV
BRN2010-00019 Please referto the following pages for conditions of this permit. 4 of 4
z CONCRETE MECHANICAL MANUFACTURED HOME r
U)
o Footings I Setbacks Gas Piping By Ribbons m
CD o Interior Date By Interior-Date By Date By
o Exterior Date By Exterior-Date By Set-up 0
Point Load I isolated Footings INSULATION Date By T
BG I SLAB INSULATION ---- ----- -- -n
Date By Data By FIRE DEPARTMENT p
Foundation Walla 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
Tyke
Dale By Date By Data By
D.W.v DRYWALL Type-
Int.Brace Wall Date By W
Date —______ —
y oat e By FINAL INSPECTION Z
fD Water Line Fire Separation C
v
Date By Date By Date By
� O
Pass or Request Inspect. c
0 Type of Insp. Fail Date Date Done By Comments o
0
0
v
N
w
O-
8
O_
ct
in
O
Uf
(D
El
i
BURN PERMIT
Mason County Dept. of Community Development
PO BOX 186 - 426 W Cedar St, Shelton WA 98584- 360.427.9670 ext 352
www.co.mason.wa.us
BRN201 0 =0001 9
Issue Date Expiration Date
Applicant: CLIFFORD ELSNER Contractor: Wr n,&�
Address: 1690 SIPES LN BREMERTON WA 98311 Address:
PH1: 1.360.692.4507
PH2: Contact
Number(s)
O Reg#:
Contact Number s - Must be a 24 hour number L(�
Parcel Number: 322027500120 Section 02 Township: 22 Range 3 Fire
Legal Description: TR L OF SURV 3/6
Site Address:
1.Valid permit must be onsite while burning
2. 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.
3.All materials must originate from the property on which the burning is to occur.
4. The fire must not create a nuisance from smoke,obscure visibility on public roads and highways, or endanger life and
p ro pe rty.
5. Maximum pile size is twenty(20) feet in diameter, a minimum ten (10)feet firebreak must be constructed around each pile.
6. Each pile must be at least one hundred (100) feet from any structure and at lease fifty (50) feet from standing timber.
7. Do not burn if wind is blowing more than seven (7) miles per hour.
8. Do not burn if the wind is blowing from
9. A responsible adult and equipment shall be on site and in attendance at the fire while burning. Must provide 24 hour fire
watch.
10. On Site Water is required between April 15th and Oct. 15th.An 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.)
11. Provide EXCAVATOR/DOZER (with fire extinguisher) on site with qualified operator.
12. Fire must be completely extinguished within three (3) days after ignition
13. Fan required.
14. Upon completion of above conditions, applicant must have inspection &approval before ignition. Call (360)427-9670, ext.
262
15.Applicants must call 360.427.7761, EACH day to report burning activity. Last 3 numbers of permit required at time of call in.
16.Applicants must call 360.586.1044 (ORCCA) EACH day to reporttrequest any air quality issues associated with burning.
17.After the bum is complete make sure the fire has not burned down into the earth by checking the fire location for hot spots.
18. 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 or party is responsible for any rekindling on the burn site.
19.A BURN BAN when implemented by Fire Marshal will take effect as noted and all permits become null and void.After a burr
Official Use Only
Inspector:
Date:
Sketch of Site/Comments
BRN2010-00019 0 3/3 1/2
BURN PERMIT
Mason County Dept. of Community Development
1� PO BOX 186 - 426 W Cedar St, Shelton WA 98584 - 360.427.9670 ext 352
www.co.mason.wa.us
BRN201 0 =0001 9
Issue Date Expiration Date
Applicant: CLIFFORD ELSNER Contractor:
Address: 1690 SIPES LN BREMERTON WA 98311 Address:
PH1: 1.360.692.4507
PH2: 1.360.649.6667 Reg#:
Contact Number(s) - Must be a 24 hour number
Parcel Number: 322027500120 Section 02 Township: 22 Range 3 Fire
Legal Description: TR L OF SURV 3/6
Site Address:
1. Valid permit must be onsite while burning
2. 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.
3. All materials must originate from the property on which the burning is to occur.
4. The fire must not create a nuisance from smoke, obscure visibility on public roads and highways, or endanger life and
property.
5. Maximum pile size is twenty (20) feet in diameter, a minimum ten (10) feet firebreak must be constructed around each pile.
6. Each pile must be at least one hundred (100) feet from any structure and at lease fifty (50) feet from standing timber.
7. Do not burn if wind is blowing more than seven (7) miles per hour.
8. Do not burn if the wind is blowing from
9. A responsible adult and equipment shall be on site and in attendance at the fire while burning. Must provide 24 hour fire
watch.
10. On Site Water is required between April 15th and Oct. 15th. An 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.)
11. Provide EXCAVATOR/DOZER (with fire extinguisher) on site with qualified operator.
12. Fire must be completely extinguished within three (3) days after ignition
13. Fan required.
14. Upon completion of above conditions, applicant must have inspection &approval before ignition. Call (360)427-9670, ext.
262
15. Applicants must call 360.427.7761, EACH day to report burning activity. Last 3 numbers of permit required at time of call in.
16. Applicants must call 360.586.1044 (ORCCA) EACH day to report/request any air quality issues associated with burning.
17. After the burn is complete make sure the fire has not burned down into the earth by checking the fire location for hot spots.
18. It is advisable to pump the entire content of the water tank onto the burn site to assure the fire is completely extinguished.
The permitted individual or party is responsible for any rekindling on the burn site.
19. A BURN BAN when implemented by Fire Marshal will take effect as noted and all permits become null and void. After a burr
Official Use Only
Inspector:
Date:
Sketch of Site/Comments
BRN2010-00019 03/31/201c
MASON COUNTY BURN PERMIT APPLICATION
(�0t�
426 W CEDAR ST. • 00 BOX%86 • SHELTON WA 98584 bw '70 to
SHELTON 360.427.9670 • BELFAIR 360.275.4467 • ELMA 360.482.5269
APPLICAN IN MATION: CONTRACTOR INFORMATION:
Owner I I ftccdOwner
Mai Address Mailing Address
CityfQ,M,QA_TjY'X_ StateL.VAZip City Ste Zip
PhoneaPO logQ--4Ib Cell Phone Li49_ UU Le-1 Phone erPho
- = '-`T ' ' Contractor Reg.# Exp.
�m-ri`scc-nviucr
E-mail addwss E-mail address
Brwem He#- 4)6B Drivers Lic.# D.O.B.
TAX PARCEL NUMBER &ooJoLba —'7 S CEO ! o�p Sec. Twn. Rng. _Fire District c�
SITE ADDRESS(please include street name,number&city _ _
Directions to the site
Parcel within 200'of: �ae�,,P/ Lake River/Creek Pond v/Wetland�p/SeasonARu , YStream m�Slopes or Bluffs> 150/ Y Will timber be cut and sold in parcel preparation?Does Site require FPA o yr. Mratorium Yes/No Is site b ' g c verted or replan
Reason For land Clearing
Is this application the result of a Stop Work Notice,Correction Notice or other enforcement action?Ye o
Burning 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 15'"and Oct. 15s'. 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 gualified 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 burn 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 acce s to the above described property and structure for review and inspection.The
person in charge of th fire will liable for the cost of suppression if the fire gets out of control or if APPROVED DENIED
becomes nec t tin uis ire as the result of an enforcement action.
X Date 3 /- o INTIALS
Owner/Owners Representative/ ontractor indicate which one) DATE