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HomeMy WebLinkAboutBLD2024-01332 WRIA14 SFR - BLD Application - 11/5/2024 Permit No:RFER WED MASON COUNTY COMMUNITY DEVELOPMENT NOV 0 5 2024 Permit Assistance Center,Building,Planning BUILDING PERMIT APPLICATION 615 W. Alder Street PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION: NAME:NICK REYNOLDS NAME: MATLTNG ADDRESS:POBOX2133 MATLTNG ADDRESS: C=:ALLYN STATE:`t1/A ZIP:98524 CITY: STATE: ZIP: CD PHONE#1:3605350424 PHONE: CELL: PHONE#2: EMAIL: EMATL:NICK.C.REYNOLDS1979QGMAIL.COM L&T REG# EXP. PRIMARY CONTACT: OWNER 0 CONTRACTOR❑ OTHER❑ NAME SAME AsABDVE EMAIL MAILINGADDRESS CITY STATE ZIP PHONE CELL PARCEL INFORMATION: PARCELNUMBER(12 DigitNumber) 221144190010 ZONINGR5 LEGAL DESCRIPTION(Abbreviated)LOT 1 OF SP#3163 AF#2198379&PTN OF NE SE FIRE DISTRICT SITE ADDRESS —E Wild Grape Way Grapeview WA 98546 CITY DIRECTIONS TO SITE ADDRESS HWY 3 TO GRAPEVIEW LOOP TO WILD GRAPE TO END IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES[] NOB SNOW LOAD:_ sf IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (check all thwappll): SALTWATER❑ LAKE❑ RTVER/CREEK❑ POND❑ WETLAND 0 SEASONAL RUNOFF❑ STREAM❑ TYPE OF WORK: NEW E] ADDITION❑ ALTERATION❑ REPAIR❑ OTHER ❑ USE OF STRUCTURE(Residence.Garage.Commercial Bldg.Etc)SFR IS USE: PRIMARY[a SEASONAL❑ NUMBER OF BEDROOMS 4 NUMBER OF BATHROOMS 3 HEATED STRUCTURE? YES(R7io7eBldg)Q YES(Parift7.fB1dg)❑ NO❑ DESCRIBE WORKNEW SFR CONSTRUCTION SQUARE FOOTAGE:(p,npased) 1ST FLOOR2040 sq.R 2ND FLOOR sq.ft_ 3RD FLOOR sq.ft. BASEMENT sq.ft. DECK sq.ft. COVERED DECK ( sq.fL STORAGE sq.ft. OTHER sq.ft. GARAGE sq.ft. Attached❑ Detached❑ CARPORT sq.ft. Attached❑ Detached❑ MANUFACTURED HOME INFORMATION: *4 COPTES OF THE FLOOR PLAN REQUIR D* MAKE MODEL YEAR LENGTH WTP-rq--- BEDROOMS BATHS SERIAL NUMBER ENVERONMENTAL HEALTH: SEWAGE/SEWER SOURCE: SEPTIC 0 SEWER❑ / NEW E] EXISTING❑ PLUMBING IN STRUCTURE? YES a NO❑ Ifyes,attach completed Water Adeguac),Form PERIMETERTOUNDATION DRAINS PROPOSED? YES❑ NOQ EXISTING SQ.FT. EXISTING BEDROOMS PROPOSED BEDROOMS 4 TOTAL BEDROOMS 4 OWNER acknowledges that submission of Inaccurate Information may result in a stop work order or permit revocation.Acknowledgement of such is by signature below.I declare that I am the owner and I further declare that I am entitled to receive this permit and to do the work as proposed.I have obtained permission from all the necessary parties,including any easement holder or parties of interest regarding this project. The owner or legal representative,represents that the information provided is accurate and grants employees of Mason County access to the above described property and structure(s)for review and Inspection. This permit/application becomes null&void if work or authorized construction is not commenced within 180 days or If construction work is suspended for a period of 180 days. PROOF OF CONTINUATION OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS PE�RMI�T APP TI OF 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON X i� V"/ � COUNTY CODE 14.08.42) -6i�/U✓2 Ll Signatur of OWNER(Must be signed by the OWNER) Date DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS BUILDING DEPARTMENT y PLANNING DEPARTMENT FIRE MARSHAL PUBLIC HEALTH Permit No:*'ZI 14,20 �J MASON COUNTY COMMUNITY DEVELOPMENT - Permit Assistance Center, Building,Planning PLUMBING & MECHANICAL PERMIT APPLICATION OWNER INFORMATION: CONTRACTOR INFORMATION: NAME:NICK REYNOLDS NAME: MAILING ADDRESS:Posox2133 MAILING ADDRESS: CITY:ALLYN STATE:WA ZIP:9M24 CITY: STATE: ZIP: I"PHONE:36053SO424 PHONE: CELL: god PHONE: EMAIL EMAIL:NICK.C.REYNOLDS1979QGMAILCOM L&I REG# EXP. / PARCEL INFORMATION: PARCEL NUMBER(/2 Digit Number):221144190010 Zoning: LEGAL DESCRIPTION(Abbreviated):LOT 1 OF SP#3163 AF#2198379&-PTN OF NE SE SITE ADDRESS:xxx E wild Grape Way CITY GRAPEVIEW DIRECTIONS TO SITE ADDRESS: HWY 3 TO GRAPEVIEW LOOP TO WILDGRAPE TO END TYPE OF JOB: NEW 0 ADD=ALT=REPAIR=OTHER=USE OF BUILDING LOCATION OF FIXTURES/UNITS—1ST FLOOR=2ND FLOOR=BASEMENT=GARAGED OTHERO PLUMBING FIXTURES(SHOW NUMBER OF EACH) MECHANICAL UNITS Type of Fixture No.of Fixtures Fees Fuel Type:Electric=C.PCC= atural Gas[�Ductles="" Toilets 3 Type of Unit No.of Units Fees Bathroom Sink 3 Furnace Bath Tubs 3 Heat Pump 1 Showers Spot Vent Fan _ Water Heater 1 Propane Tank 1 Clothes Washer �4'Z Gas Outlets Kitchen Sinks 1 Wood/Gas/Pellet Stove Dishwasher 1 Kitchen Exhaust Hood 1 Hose bibs 2 Dryer Vent A-2 Other Solar Panel Other Base Fee Base Fee TOTAL PLUMBING TOTAL MECHANICAL OWNER acknowledge submission of inaccurate information may result in a stop work order or permit revocation.Acknowledgement of such is by signature below. I declare that I am the owner,owners legal representative,or contractor.I further declare that I am entitled to receive this permit and to do the work as proposed.I have obtained permission from all the necessary parties,including any easement holder or parties of interest regarding this project.The owner or authorized agent represents that the information provided is accurate and grants employees of Mason County access to the above described property and structure(s)for review and inspection.This permitlapplication becomes null&void if work or authorized construction is not commenced within 180 days or if construction work is suspended for a period of 180 days. PROOF OF CONTINUATION OFTHIS PERMIT IS BY MEANS OF INSPECTION.INACTIVITY OF THIS PERMIT APPLICATION OF 180 DAYS WILL INVALIDATE THE APPLICATION. X Signature of Owner Date DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS BUILDING DEPARTMENT TL I Z/(,�- PLANNING DEPARTMENT , FIRE MARSHAL Rev. 1/27/2016 JBN APPROVED bigdl Page 1 of 4 Oa,.b13 01/03/2025 MASON COUNTY 1Zl 0DVA'PLANNING ROAMT H A MELODY YM HtAi1 D A MXuurlE Y Epp p 2p CASEMENT FOR DAVID I COOLS1`0 BOX WARNING. 3K478 7 R LLO1, BE7JXDt TPA A85M '�.Qce Y I �� RRSS.�RGS.S. :It L WILD GRAPE LAY JIM 9 IE� PA DETAIL. PARCEL OWHOI 4 !' /a Q l 40 RA INIUMDIG�YVEm1T5. J�R��N�ANrC OF 46 WNER RIVATE .H 4-r7-Noos. PARCEL 42! ATSA•, S WITH BIP TfuN �„•�i SEE Y2114 11 30060 /�/���� % o'y� PARCEL 11-1 -0001 r: RASCSENVW IeMS AND WITHIN THIS S)kxr ROAM ISA07Nl; 1T1 PRRANRS PR1I BU7►17R IMPACT ^V S i PARCEL O 10005NER AREAS. DCCRLA.SL AREAS. 1NCMASl i��y 110-BI/FFQI 22IIh 11-oa°)0 ( vlllepvSON(1UMI84ti..SUCH L7oAL1CS NAve BEEN _- - Vt _'_ - ; ACCEPTED lM7O t1Hi CO(TRTY.I' ROAD SYSTEM) 4 U WITH ANGEtA C HACICEi AI'P�-- � � - LEGEND a p ur n7rRmRR DfmPONrOf��PtT}HN 370 E LEFFTLH LOOP V •. 9ET/6 IOM EAR o 7HB SNORT SUBDIVISION SHALL AF.SC"NLEY't CPAI'EVfEW, VA '� \ U $ I/Pf.LSTIC' YOAbI CAP TO TN[MMUIRLYIN7S Of CHAPTER 16 b Of a7546 94ze c. 1 P (f HoLNER LS 16"r sm."COUNTY COOL PARCEL ORNrR D(<A'IN FIp�.O �IOV �rr y}�•$ Q • FOI11WD DADN RAR 3 IMCIARAT70M 0►SIWRT�-yyQQ��QN .rt rn11 n wu63 • ,�'g Qo f // jg Y YELLOW CAP AUDMR'S Ff1E NO. �1gp'S7D a -E -n"f" wOTCL DIRECTOR'S APPROVAL gn 1 �7 N.>sIL•! .rw i APP1OVED/CR MCCORDM PURSUANT TO E ` •• f . MARON Ccoup"TRil to 30 AT r CH L--- LEND SHORT SUBDIVISION NO. 3141 .o R / •' {f'l. NRYLAMU AREA , DATE APPR01'ED 44 'n: ...�` lJ 3 AC'Rcs � �.•-�,• II Q� BUFFER A KRA44 DQ77EASC O65 ACRES \../ ( •/ ®. AC S • DOtR7OR OF COYfUNlTY y6Rv1CTS 8UPTa ®- 1WHAM ARIA ' BRODIAL4"'"GE'� AUDITOR'S CERTIFICATE. 073 ACRPO CITEGORY•t IET1.UtO8• '''I. RUMIR AKRA4:C INCREASE ALLYN.XVA 3G852. IRaO/Q1�RENTED Y Of J� t ICJ 076 A(Rd.S PAR791,OWNER �f,/�, 1H� AT QAY ,`�• ;• ( . 22113-76-OCIOC 20 Z%S 1�rt V p wunn y or SNORT PLATS PAGE 11"1 / t ACC N Ar rNE Rmux: tl/ DANDS 2HO M A[FJ6 �• / A'�eTi• • +•Wa 11 AUDITOR'S Paz NO alK�t�3 /`i�l N / • / 117E Al"to SW IeSr TI dt - APPROVED K WAasi �+C`Y,fp1L�/jY�vAfD'w rn A R `� EFt Setbacks I.—Ilz I wmpson 0127/2025 PEED OWNER ♦44� f! \ \ A.) Drainfield/Reserverequirey'10'setback from-footingR ndations 22113 32 ODO.TD pp B.)Septiotank(s)mqukes5'setback from all f°o"Ifoun lions NOTE.' SURVEYOR'S CERT:FICATE C.)No foundatioNPerim t6r rains within 30H,down radi it of a \ 4 9 SOIN Of MR EATM PAW= oil TTIAM THIS YAP CORREC7tY RAYRLSENTT A SURVEY DralnheldTbseive afea' CONTAINED PRMW MRS LAND 31G)MAYION HAM MADE wY ME OR UNDER MY DfRECTENN DI O do D.)No Cut 8ankis{(gpBaIs'than 5h and ovlbr45 degrees ithin BEER CREATED WITHOUT CREATING A MTAUCE CONFORMANCE WITH•1}D:FdOgLA a19 Or \ACRES 50ft,down gradient of Drainfiaid/Reserve a)ea WATER SUPPLY NO BUIDOW PERMIT WILL fW THE SURVEY RECORDING ACT AT Ts�UEYr • 1 MWED WrTTOUT FIRST SATISFYING POTABLE WATER or WCK FAVW VS • .1° C+` \ ' 17M 9 AS RPS Br MAIN I $COUNTY MAIM SERVICES OlHfllOR !(Sli/\TAM"\sI TQf 4 L � * ` q WATER WrTNDRRAPALS FROM ANY AND ALL EXEMPT DARED F. noutui ria La ERw • R Rc o WLyAb'APPLY 10 PARCEL S CREATED FROM LILT ORA:INAL IOY PARCEL NO /2025 76 "10. AND LIMIM 1O 3.000 GALLONS PER DAY TOTAL. - UM,LSS A WATER RIGHT S OBTAINED FOR THE . O \ •I R R: ADDITTOM.1 1OLU�ABOK THE EXEMPT 6.ODD s \ g GAUDRs THE AMOUNT Of WATER THAT CAN BE L� rf S yS V x = WTNRDRAWN FOR EACH LOT IF. ST-MMED BELOW IOT 1 1250 GAL.OW PER DAY LOT 2 - L>SO GALLOKS PER DAY LOT 3 - 1250 CALLOW PER •� qo.x�8 DAY LOT I - 1260 GALLONS PER DAY +� ,+a �~► ANY NEW OR WYLSL7) ACCb`CS ROARS;DRIVEWAYS 1 ' W q PARCEL.NO 22114-It 00000 -20 EAYEYF'N7 tnN i C+1P, OMtM, 27.*D ACRES PER ASSASSOR INGRIS'S. EY;RFNS xx f ACCORDANCE MELT OR L MASON MCP, RXCOUXTY'S STANDARDS E ._ 24 Pa ACRES C'AlArU ATXD `'1 ANC ITT11TIP-1 S �;i FIRE APAR. WITH MASON OARS. M ONCOUT FOR _ FIRE AI- Aph ACCESS 17 ROADS,ACrICN COUNTY 21 1-034 DEC • �CARCOR7 5 ��yT�lti4 TTPl' 1. !'NAL'T1W 1117 // THE AfrEES E MORE Y/.pSR ATC THAN l.i CRADL FIRE SPRIN/t7A6 MUST at IWTAIIYD IN AIJ.HOMES ACC=ID BY THE « It OAR CATEOpRrJ• APPROVED ACCE\'' ROAD SHORT PLAT �x► $ ACAQ�• .' i r"US DA7VI3AM'MENT S UINNY7 TO THE Fa HP'Rr>♦!� E IA= NUPYYR,-sETHACA RDOUIREY13NT5 Or MASON COUNTY ('ODE a 62110 NICK REYNOLDS gg(ape• M RMNV'W MAa ..51 1/4. NE 1/4 IN ` k,g d a q, �`., �. ...• ./ /,% ...wE I/1. 3E 1/4 SIL[.9Uw r4 mnew 01 NORM 1/R &2 WEST °N NOTES. I(� Porn.A22H. .1 o6°6r REMAND Otn'M RESTORATION 1A 1 Po No.as- PrRT oECNARn. WA VaxA R UIRED V ry M. APPROVED WATMAND MITIGATION HOLMAN & ASSOCIAUS k' C pC•►A f__AT 7•L+ PLAN, VIP?022 IXO?0 I PrfEmuru"in aeTET61e RRANION A HICHDId'NYnN DAWN Y NELSON R7 I _S?1 ��.f+ ru W°A ms S :szn L W11.SOY WAY DAMM, T WTLIAYs 9m10N W4SWlIC/6W IN6Pr A yy GNAPKV7rW. WA Oa5.6 PO BUX 391 ro"WING THr sALX o/ANY OP THE SNORT PLATED LO75 WC'X kEYNOHIS I Cso1.4W two rxw+E A.r.ykv ea.dY =9.=( PAM'XL OWNER r.HA1`P.ttEW WA 9M.f IBN OR HISHOW ALT KI)REPRRb ES THTATIVE RERVE'THE SCALE I' • 100 FEET �¢1 n114 76 M)DOO PARCEL OWNER RIGHT TO E'M7ER ALL IO75. FOR THE PURM0.1ti OOF'INSTAILM;. ?211. >6-002M1 MAINTAINING,AND AOMMIUMC 77R: WETLAND HU N RL'MRA TION ?I � n t AND ENHANCEMENT AREAS AS SHOWN ON THS MAP AND AS The destruction or alteration of wetlands and wetland buffers _. ___ .. APPROM NY MASON fOUNTY FOR YET:OY: 00000 through clearing, harvesting,shading, intentional burning,or 2 O1 planting of vegetation that would alter the character of a designated wetland or buffer is not permitted. ■ MOM ■ ■ ■ ■■� ■■ MEN■■■■■■■■■■■■■ ■■■■ ■■■ ■■■■■ �■■�■MEN■■■■■■! ILWW. L' A MENN■■■■ ■N ■■■■ USE MORE or I ME MEMO ■■■ . ill ■■■��■ � G ■■�' ■■■■■■1 Ii I ■ ■■■BAE ■■■■ ■ a s r 1. i dPw IL L .:'�f1w.�!►.:,«rwl►�+oV!^�+�M-,vs-= lIYAMlMIIR`Rf.••,7•+:��It:.�3e�11M�.eMew«Me�<� �` �9a..rt-.4,�w�lrC+1�1 • _.._ N1007 �I---1 —f--�--J- I i 1� Lj --�-�- T_ Mason County WA GIS Web Map a >L 1 �+f 11/6/2024, 9:39:54AM 1:3,066 0 0.03 0.05 0.1 mi County Boundary Non-fish i I I F 1 1 1 0 11 0 0.04 0.08 0.16 km ❑ No Filled — Shorelines of the State ❑ Tax Parcels(Zoom in to 1:30,000) — Unknown ® National Wetlands Inventory(Hyperlinked) — Waters with no type designation Sources:Esri,HERE,Garmin,Intermap,increment P Corp.,GEBCO,USGS, FAO, NPS, NRCAN, GeoBase, IGN, Kadaster NL, Ordnance Survey, Esri DNR Water Courses NHD Water Courses Japan,METI,Esri China(Hong Kong),(c)OpenStreetMap contributors,and the GIS User Community Fish — Name Mason County WA GIS Web Map Application Mason County disclaims accuracy,reliability,or timeliness of website info,not liable for losses from reliance on it.https:/Avww.masoncountywa.gov/disclaimer.php s; CON Name Parcel# 221 H � 6 /6 BLD# 2 6 - Mason County Department of Community Development Small Parcel Stormwater Management Application/Worksheet (page 2 of 2) Based Upon the information you have provided a Stormwater Site Plan IS Required for this development activity. Title 14,Chapter 14.48 of the Mason County Code(MCC)regulates compliance requirements for Stormwater Management in this jurisdiction.A complete copy of the ordinance can be found on the Mason County website: http//www.co.mason.wa~us/code/commissioners/index.htm Please follow the links to "Title 14,Chapter 14.48 Stormwater Management". Regulated activities shall be conducted only after Mason County Public Works approves a stormwater site plan (Mason County Code Title 14 Chapter 14.48 section 14.48.70).You will receive a copy of the Public Works document entitled"Managing Storm Drainage on Small Lots, The Small Parcel Stormwater Site Plan".This document will assist you in preparing the necessary information and plans for Public Works to review and approve. Per Department of Public Works this document will constitute an approved plan if all of the relevant details* are to be installed in their entirety AND no part of the stormwater system adversely affects any septic system(see Environmental Health information below). If an alternative system is to be used a plan will need to be submitted to Public Works for approval. A design by a registered professional may be required for more complex sites. *These details are found in the document Managing Storm Drainage on Small Lots, The Small Parcel Stormwater Site Plan on the pages that begin with"Handout" PLEASE INITIAL BELOW TO INDICATE THE STORMWATER MANAGEMENT PLAN FOR THIS SITE A)X The relevant details from Managing Storm Drainage on Small Lots, The Small Parcel Stormwater Site Plan will be installed in their entirety AND the system will be located as not to adversely affect any septic systems on this,or any other,parcel. B) An alternative plan and/or professional design will be submitted to the Department of Public Works for approval AND the system will be located as not to adversely affect any septic systems on this,or any other,parcel. Tf you have further questions pertaining to parcel drainage and Stormwater management Mason County's Public Works Department can provide additional instructions,guidance and examples. (Section 14.48.130)contact Public works at: Phone: (360)-427-9670 EXT.450 Mail:P 0 Box 1850, Shelton WA 98584 Physical:415 N 6th St, Shelton WA 98584 if this development has,or will have,a septic/drainfield system you may need to contact Mason County Division of Environmental Health to ensure that the stormwater system will not adversely affect the septic system of this,or any other,parcel.You may also wish to consult with the septic design professional involved with the project.Mason County Division of Environmental Health can be reached at: Phone: (360)-427-9670 EXT.352 Mail:P 0 Box 1666, Shelton WA 98584 Physical:426 W Cedar St, Shelton WA 98584 A condition will be added to the building permit that states,in part,that all conditions the stormwater site plan will be met prior to a request for final inspection of the building permit. Owner/Builder/Agent Acknowledges that submission of inaccurate information may result in a stop work order or permit revocation. Acknowledgement of such is by signature below.I declare that I am the owner,owner's legal representative,or the contractor.I further acknowledge that the information provided is accurate and employees of Mason County are granted access to the above- describedpro arty r review and inspection as maybe required. X Owner/Agent/Contractor(circle one)Date: j/�✓Z Page 2 of 2 f Name NICK REYNOLDS Parcel# 221144190010 RLD# Mason County Department of Community Development Small Parcel Stormwater Management Application/Worksheet (page I of 2) Per Mason County Code, Title 14, Chapter 14.48 a stormwater site plan is required whenever a building application is made for residential development,or redevelopment',with more than 2,000 square feet of impervious surface2. 'Redevelopment means,on an already developed site,the creation or addition of impervious surfaces,structural development including construction,installation or expansion of a building or other structure,and/or replacement of impervious surface that is not part of a routine maintenance activity,and land disturbing activities associated with structural or impervious redevelopment. 'Common impervious surfaces include,but are not limited to,rooftops,walkways,patios,driveways,parking lots or storage areas, concrete or asphalt paving,gravel roads,packed earthen materials,and oiled,macadam or other surfaces which similarly impede the natural infiltration of stormwater. Open,uncovered retention/detention facilities shall not be considered as impervious surfaces. To Calculate Impervious Surfaces Please Complete This Table Surface Type Length X Width = Area ' All dimensions in feet Buildings X 30 X 68 = 2040 Measurements for buildings are taken at the X _ perimeter of the farthest projections (example: eaves/gutters) X = Driveways X = X = Length of drive begins at the right of way X = Parking Areas X X = Any paved, gravel or packed area per definition above table X = Patios/Walks X X = Any paved, gravel or packed area per definition above table X = Others X = X If the total impervious area of the proposed site X = development is greater than 2000 square feet a Small Parcel Stormwater Site Plan is Required Total Impervious Surface Area (sum of all areas) If the Total Impervious Surface Area is LESS THAN 2000 Square Feet,please read, acknowledge and sign below. Based Upon the information you have provided a Stormrvater Site Plan IS NOT required for this development activity. Owner/Builder/Agent Acknowledges that submission of inaccurate information may result in a stop work order or permit revocation. Acknowledgement of such is by signature below. I declare that I am the owner,owner's legal representative,or the contractor.I further acknowledge that the information provided is accurate and employees of Mason County are granted access to the above- described property for review and inspection as may be required. X Owner/Agent/Contractor(circle one)Date: If the Total Impervious Surface Area is GREATER THAN 2000 Square Feet,please read, acknowledge and sign the information provided on page 2 of 2. Page 1 of 2 WATER WELL REPORT ECOLOGY Notice oflnwnlNo.wE42666 _� 1.ee of N'.rk: .:,b•�• n„•.t+.Lv I btque 1 tokigy Nell ID It`%a.BNA109 <,mtnwrnm Site Nell N.une(If rmwr Ihaw Ilia:rcll). Ilxtwnmu,km�'--� tkt£1'ul tmWIMUM]IA Vo. Water R,ghi Kivu it vnirnoh Nu. rr.".4 U., A D.mc,rtc U htdtr.. 0 1 Naam 1 i tpal I'mic"y l hww ham k R c N1t _ n" J D—okmig lw.gal.m Ll fa•)t Wr0 1J(Ithrr -` _.-. We115SAR-0 Addax. 141 E Wild Grace Way i smtrsrdws F)w: 11trrlrH: 101 N.v w.11 --.Abmtxw 7 DMM _Mud '0(ahk 1-0 oh'G-'M C'Otalt)Mn-- "Ill ,Aw- 't1aJ R un Isx Parcel No 22114-14-MID _-�--- _- Dim nsivin:Dtalucw of horing a m.,it,19S K. Wax a vane we a 1hprA of c+atpkted roll 185 K. rplard for thin wall? ❑Yes ©No CanstrseNos IMu1N: Won I f vrs,%hat wa,the variance fur! l'a.tnE k..ubn DOMM loins t. 1111A cs Srocl Mt Mckkd Thread F: 6 in. e2 190 114 is. M 1 :.I ...t 1 ❑ lAxaliom(ra insteu,:kwn,on pap 2),: w wwM(if 0 lwtyM '0 _in. _ _ _in ❑ 1 -3 0 1 a SE 1�e%of the NE '-.,Sccum 14 rimoship 21N Nangc 2W ❑ I ❑ in. —i. U I .i D ❑ "I I ❑ in. — in rt I ya I fl I>tlitudclkaampla:4'.1:3aF1 w_ ___. 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(`I No titan()ale 04*21 ompicw l Dane 05/12/21 WELL CONSTRUCTION CERTIFICATION: I cumUtictd alal'tw acta:pt tv"k oslbrhty It*ctwuuu.:wu ul th.well.runt n...urrlp[wwc rtlh all%. hingws well curimmaiun slumlards.Matenoly ut ed uml the rnfcrmation rcptwfed also w are true Is,my best krumld;ty and twlict dal Driller Q Trainee❑PE-PA.N tr Michael Dams DrIlhn Dinh .tn>Darts DrA Si�ltttwe Address 340 NE Davis Form R0 L Lena No.0797 (-joy,Sate.Lip Belfa.f.WA.M28 IF TRATNEE:Spoaro/'s Llcvrise No Can:rw1or'. _S 's Siavaturc Rcgl.lratiun 4o.DAV Xl l00A __ DaK05114121 FVY OSf►1.201 Res 1Ki Ph 11,',w.o)J rbr.,du,wnh at m on ah,r.,u,(wMal,glean roll the 11'01rr A..,wr.r•,lbvkr,.w al W1.40-o r- j%1V n,with ik'urrwg Ito.tan,wb?J l Gu N'u,b n7pun Rrl t Sr,t h r. 11rn,m.II Irk 0 truth 4 Ji 411M1J11 trtw(till N?%.(l.1)-6341 2218056 MASON CO WA 11/05/2024 02.09 PM NOTCE REYNOLDS #203II357 Rec Fee, II$304 50 Pages: 2 Return To n ,� et,4 na1 d g 74 I I w►� �.�z4 �l'�2 Grantor(s): (1) /`� �CK "``�-' (2) Grantee(s): (1) PUBLIC r Legal Description (1) J n D t' `�D �)LP3 �� 0�1�1 7�! p(I'1 (Abbreviated form:i.e. tot, block,plat or section, township, range) Assessor's Tax Parcel: (1) aZ I 11 ` - 4 ?- q 0 0 J.-L TITLE NOTIFICATION OF WATER RESOURCE INVENTORY AREA (WRIA) (We), the undersigned grantor(s), hereby place this notice on record that the described real estate situated in Mason County, State of Washington is subject to water use restrictions and conditions set by Washington State Senate Bill 6091 and Mason County Code 6.68. These restrictions and conditions are based on location of property and/or Water Resource Inventory Area or WRIA. WRIA: Maximum Annual Average Gallons Per Day: CK6 gallons Dated on this_5 tday of &)- 2 6 Signature of ran (s (1) (2) State of Washington ) County of Mason ) Page 1 of 2 1, the undersigned, a N ary Public in and for he above named County and State, do hereby certify`h on thi of 20 0� 14 personally appeare before me,who is known to be signer of the abov6 in trument, and acknowledged that he (she) (they) signed it. GIVEN under my hand and official seal the day an ear 'Ast above vyriften. �NHHNgprryr• gER SEA t Pu lic n r e to of Washington, toll•F�•ey •L residing at NorARy g a My commission expires: a� 230384: C t!►�:• PUBLIC r%�? Page 2 of 2