HomeMy WebLinkAboutSPI2025-00004 - SPI Inspections - 1/22/2025 t
MASON COUNTY SPI 'l ' Ll
COMMUNITY SERVICE C E I V E D
Building,Planning,Environmental Health,Community Health PLANNER V W 1 t
615 W.Alder St.—Bldg.8,Shelton,WA 98584 J A N 2 2 2025
Phone:(360)427-9670 ext.352 ♦Fax:(360)427-7798
PLEASE PRINT $300.00 FEE REQ �`pa��
PLANNING DEPT. PRE-I M Tf&rA-Tft PP��__(:ATION
Note: Pre-inspection does not survey lot lines and can only provide very general septic and water adequacy information.
1. Owner: Christopher E Van Ackeren Applicant: Same as Owner
Site Address: 4xxx SE Lynch Road Applicant Address:
Owner Address: 60 SE Sella DR City: St Zip
City: Shelton St WA Zip 98584 Phone:) day
Phone: 541 913-og5o Email Address:
Email: -vanaokere oh—net
(if different than applicant) Legal Description:
2. Parcel No. 319029400000-
Parcel No. - -
3. Purpose of Pre-Inspection:-Pre planning building location, setbacks from creek buffer zone, and determining if
well and septic can be completed prior to 'A/1 / 0 6 when th - building pArmit morn on rn Axpires.
4. Use of building: Single family residence, approx 1800 sq feet, plus garage
5. Do any of the following exist on or adjacent to property?: slope(>1 saltwater ) lake river )
pond( ) wetland( ) seasonal runoff( ) other( ) stream( )(seasonal creek(
Directions to Site: approx 2/10's of a mile past mile post 4 on Lynch RD. take left about 600 feet east
Of Spllc nr intemection with 131nCh Rd
If the information is incomplete, then Mason County must disclaim any errors resulting from deficiencies in the original
application. Pre-inspection reports remain valid only'lintiiAvelopment changes occur in the vicinity which affect the lot
evaluated in this inspection,or the laws re ting e e of the site change after the time of inspection.
Applicant Signature: A�_ Date: I'"J 7
If you would like to be on site during inspection,please check here: X
Return application to: Mason County Community Services,Planning Division
615 W.Alder Street
Shelton, WA 98584
(360)427-9670 ext. 352
Please include a$300.00 check or money order payable to Mason County Treasurer
When completed,this form becomes part of the parcel file.
FOR OFFICE USE ONLY:Accepted by: Date:
MORE ON BACK SIDE
Rev. April 2021
1
Please illustrate below the proposed building site in relation to critical areas (slopes, streams, lakes, wetlands, etc.)
existing improvements, as well as property lines. APPLICATIONS SUBMITTED WITHOUT ADEQUATE
ILUSTRATIONS WILL NOT BE ACCEPTED AND WILL BE RETURNED TO THE APPLICANT.
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Departmental Review
(For Office Use Only)
Planning Department Findings: