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HomeMy WebLinkAboutRe-Align Drainage Ditch - RLC Application - 4/25/1996 uate rAdccswauc MASON COUNTY DEPAHTIVIENT OF COMMUNITY DEVELOPMENT RESOURCE LANDS AND CRITICAL AREAS CHECKLIST The following checklist is designed to assist an applicant for a Building Permit, On-Site Sewage System Si; Evaluation and Disposal Permit, Access Permit, Land Modification Permit, Boundary Line Adjustments, Lar. Segregations, Hazardous Waste Permit, or Shoreline Permit in determining whether their property is affected t regulations under the Mason County Interim Resource Ordinance (77-93)*. This checklist is an importai opportunity for identifying early in the permit process whether there will be any environmental regulations affectir th proposed development. pp Owner ,4 w DE�Itey Am . Phone #( )412G3767 Site Address C 597/ /VAJ!2V,4k D/C l�E�T City G�0%�yicz✓ Zip WA Owner Address JA/y)E City State Zip Tax Parcel No. (Confirm with Assessors Office) 22Z 3 - Z I - (X1dIn Legal Description_ Project Description & -441641 040VV464 017z;,l 7-o AbV10, XyIe " ,o�Oezw t46 Directions to site (Please attach map) AZLIO /EN0OF01440V 44U: At;t7_ 70 CeKIWyPAPk Please provide or attach a vicinity map which includes cross streets, major roads, creeks, etc. i i Answer the following to the best of your knowledge. County-wide maps showing general locations of critical arc oni�1.1 and resource lands are available for review at Mason County Department of Community Development, Planning u..orgy Department. Do any of the following exist on this property or within 200 feet of this property? cow v_e. _No, ❑ ❑ •pp�l 1. Saltwater shorelin© 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 circumstanc support vegetation adapted for life in such conditions; such as marshes, bogs, and swamps. (See Cout Maps for guidance.) ❑ ❑ [A 6. Slopes greater than 15% (8.5 degrees)? (See the County Landslide and Erosion Hazard Maps guidance.) ❑ ❑ ( 7. Floodplains? (See County Federal Emergency Management Maps and County Seismic Hazard h for guidance.) ❑ ❑ [ ] 8. Seismic Hazard Areas? (See County Federal Emergency Management Maps and County Seisl Hazard Map for guidance.) You may be provided nuisance protections by the County for certain resource activities. If you are enrolled in of the following programs: Count Yw No ❑ F1__V 1. Agricultural Open Space Taxation Program, RCW 84.33 ❑ ❑ ] 2. Open Space Timbor Taxation Program, RCW 84.33, or Designated Forest or Classified Forest, RCW 84.34 ' Copies are available at Mason County Department of Community Development for $5.00 each. SITE PLAN PLEASE, Si,DJW 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 rlght-of-ways &easements. ► Location of significant natural features(water bodies, rivers). ► Locate all existing & proposed structures,dralnflelds, wells &driveways. ► Project description Scale 1"= North Arrow 1 state that I have answered the above truthfully to the best of my knowledge. A plicant caner ��ll� Dat _ FOR OFFICIAL USE ONLY Adjacent property. 4,L 46 zj U�ij7cl Count S�trrce I Alt lh Ivr� y [ ill) t tI11�;s pro i dslgti�at �1 S `s� i..{.v K< y> f t.•}<: ° ;� 1, Loog-toI'l); t:orwoorcial Foro"t 5h+arelitlrl 6o1la ttc:K I'rta re►tt Inh t Iclila I I and 6, Ooos [lot apply 2. Mineral ld� glr.,t: Land DC There is a $40.00 application fee for the Resource Land & Critical Areas Checklist. Make checks payable to the Maso; County Treasurer. when completed, this form becomes part of the permit application. IOD r i y6� 5L t U yV jr f -E 2-1 7 z9+ 93� •tIG'�j J v I � MBL uJ �� P°''k�•J c►kb o N o.►sG" 4 C) �JYlo� �hodeeS Mwsrr. Lakes Dr��e. tam a 7" ._ } t�sa+ , BENSON a CLUB KASCH CAKE COUNTY PARK 1� 1 I 41 c?1 u O �u Ql- -IprS�F o ct FST1 To. si �t 4Af 1�faf TFs C Z. �� oR