HomeMy WebLinkAboutRLC94-00344 - RLC Inspections - 1/27/1994 ` Date Received: Z7
MASON COUNTY 4
DEPARTMENT OF COMMUNITY DEVELOPMENT to
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RESOURCE LANDS AND CRITICAL AREAS CHECKLIST
The following checklist is designed to assist an applicant for a Building Permit, On-Site Site
Evaluation and Disposal Permit, Access Permit, Land Modification Permit, Boundary Line Adjustments, Land
Segregations, Hazardous Waste Permit, or Shoreline Permit in determining whether their property is affected by
regulations under the Mason County Interim Resource Ordinance (77-93)*. This checklist is an important
opportunity foridentifying earivin the permit process whether there will be any environmental regulations affecting
the proposed development. st`pOs?
Owner Lv"o l 's Phone # 04)
Site Address I Cit zip
Owner Address 1_ City tateWzip Ntt
Tax Parcel No. (Confirm with Assessors Office) 2,0 _ a fl a Legal Description
Lot i'6 L 0
Project Description 5�
Directions t site Please attach map) �1A1
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1
Please provide or attach a vicinity map which includes cross streets, major roa , creeks, etc. It AM VV41 VVL)
Ple.- So. a--(,W �Mf
Answer the following to the best of your knowledge. County-wide maps showing general locations of critical areas
ornCi&I and resource lands are available for review at Mason County Department of Community Development, Planning
Use ONY Department.
Do any of the following exist on this property or within 200 feet oft is prope` .0 I
Co_ only Yes N Sl
❑ 1. Saltwater shoreline or a lake 20 acres or larger?
❑ ❑ 2. Rivers, streams, or creeks with year-round flow?
❑ ❑ 3. Rivers, streams or creeks with intermittent flow but are within a clearly defined channel?
❑ ❑ ` 4. Lakes or ponds less than 20 acres in size?
❑ ❑ 5. Wetlands: Areas that are inundated or saturated by surface water that under normal circumstances
support vegetation adapted for life in such conditions; such as marshes, bogs, and swamps. (See County
Maps for guidance.)
❑ 6. Slopes greater than 15% (8.5 degrees)? (See the County Landslide and Erosion Hazard Maps for
guidance.)
❑ ❑ 7. Floodplains? (See County Federal Emergency Management Maps and County Seismic Hazard Map
for guidance.)
F-I r l ?v C. Gdibiiiii: Hazard Areas? (See County Federal Emergency Management Maps and County Seismic
Hazard Map for guidance.)
You may be provided nuisance protections by the County for certain resource activities. If you are enrolled in any
of the following programs:
County Yes 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 r + _ � � 0( NX
( Wit 1rL, rat�� 14 'J R w �9, 39
' Copies are available at Mason County Department of Community Development for $5.00 each.
I
SITE PLAN
PLCASE SHOW THE FOLLOWING INFORMATION OR PROVIDE SURVEY MAP IF POSSIBLE:
► Location &dimensions of existing & proposed property boundaries. ► Approximate slope of land (grade &direction), topography.
► Identify legal access including, width of all road right-of-ways &easements. ► Location of significant natural features(water bodies, rivers).
► Locate all existing &proposed structures,dralnfieids, wells & driveways. ► Project description
Scale 1"= North Arrow
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state ha I aye answered the above truthfully to the best of my knowledge.
w pplicant/Owner / / C/ Date
FOR OFFICIAL USE ONLY
Adjacent property.
Using County Resource Land Maps, this property Is designated as:
__-- 1. Long-turn: Commercial nrn:st Shorulloo Master Program
Inholding land !i. Dees not apply.
3. Mineral Resource Land
There is a $40.00 application fee for the Resource Land & Critical Areas Checklist. Make checks payable to the Mason
County Treasurer.
When completed, thin form becornes part of the permit application.