HomeMy WebLinkAboutMEP2005-00085 Dock - MEP Application - 12/16/2005 PERMIT NO.:
DATE RECEIVED:
MASON COUNTY
DEPARTMENT OF COMMUNITY DEVELOPMENT
RESOURCE ORDINANCE (Chapter 17.01 MCC)
411 N. 5TH Street/ P.O. Box 279, Shelton, WA 98584
ENVIRONMENTAL PERMIT APPLICATION
MASON ENVIRONMENTAL PERMIT CONDITIONAL USE ❑ VARIANCE ❑
The purpose of the Resource Ordinance is to protect Mason County's natural resource lands and critical
areas and is under the authority of Chapters 36.32, 36.70A, 39.34, 58.17, 76.09, 84.33, 84.34 and 90.58
RCW.
PLEASE PRINT
1. ,leiz`1 G�SSQ�'
Owner: Owner Mailing Address:
/7/6-2 ,SE /��t�ya���
Site Address:
1/3/ 14tayj Lk ��= �. City: �zljCo c Cv� State: �a Zip: �ln
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City: �cGp 6 L'i cJ State 460 Zip: Lien/Title Holder
Phone: Daytime -r( 03 ) 39 9 7?7 9
Address:
Fire District#:
City: State: Zip:
Signature: 25 �
2. Parcel Number: ^a 3 3 _ 5'�c2 Legal description:
Parcel Size: �� �' o)9s' C?
3. Directions to`site�:L
SIC61 "t G?e ,t/ar-r /� et Aey 3 . z6Q l oA i l�.J�./� "ICJ �t Y29 ICt�E
74-4-6art I-e 2A i"(150" Za e ell 5.
State what sections require a permit: In-Holding Lands, Chapter 17.01.062 ❑
4. Long-Term Commercial Forest,Chapter 17.10.060 ❑ Wetlands,Chapter 17.01.070 ❑
Mineral Resource Lands,Chapter 17.01.066 ❑ Frequently Flooded Areas, Chapter 17.01.090 ❑
Aquifer Recharge Areas,Chapter 17.01.080 ❑ Landslide Hazard Areas, Chapter 17.01.100 ❑
Erosion Hazard Areas, Chapter 17.01.104 ❑ Seismic Hazard Areas, Chapter 17.01.102 ❑
Fish and Wildlife Habitat Conservation Areas, Chapter 17.01.110,,�'
5.
Identify current use of property with existing improvements: r(fC
6.
Identify and describe the proposed project,including the type of materials to be used, construction methods,principle
dimensions and other pertinent info rrr}atio-n/(Attach additional sheets if
needed):
7.
Will there be an alteration of a wetland and/or wetland vegetation area? Yes ❑ No z
8. Any water on or adjacent to property:
Saltwater ❑ Lake 2"" River ❑ Pond ❑ Wetland ❑ Seasonal Runoff ❑
Other
9. If septic is located on project site, include records. AIA
Connect to septic? ❑ Community Septic? ❑ Public Water Supply? ❑ Well? ❑
10.
Type of Job: New ZAdd ❑ Alt ❑ Repair ❑ Demolition ❑ Other
This permit is granted pursuant to the Resource Ordinance (Chapter 17.01 MCC) and nothing in this permit
shall excuse the applicant from compliance with any other federal, state, or local statutes, ordinances, or
regulations applicable to this project, but not inconsistent with the Resource Ordinance. The permit may be
rescinded pursuant to the event the permittee fails to comply with the conditions of this ordinance.
MASON ENVIRONMENTAL PERMIT: $510.00/$305.00(with another permit)
MASON CONDITIONAL USE ENVIR.PERMIT: $1,225.00
MASON RESOURCE ORDINANCE VARIANCE: $1,225,00
HEARINGS EXAMINER: $490.00
I:\PLANNING\R&GPAC\ENVIRONMENTAL REVISED 01-04-05
Show the following on the site plan
Lot Dimensions Flood Zones
Existing Structures Fences
Water Lines Driveways
Drainage Plans Shorelines
Septic System Topography Indicate Directional by(N,S,E,W,etc.)
Proposed Improvements Easements In relation to plot plan
Name if Flanking Street
APPLICANT TO DRAW SITE PLAN BELOW:
APPLICANT TO DRAW TOPOGRAPHY BELOW:
(� 'Q Dock