HomeMy WebLinkAboutRLC94-00565 Cabin - RLC Inspections - 3/24/1994 ....: ... .. . .. ..
MASON (COUNTY
:_DAPTMENT OF COMMUNITY DEVELOPMEni V
RESOURCE LANDS AND CRITICAL AREAS CHECKLIST MOM
The following checklist is designed to assist an applicant tar a Building Permit, On-Site Sewage System Site
Evaluation and Disposal Permit, Access Permit, Land I'✓lodification 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 for identifying early in the permit process whether there wi/lbe any environmental regulations affecting
the,o,-cposed development.
Site Address ------ _-- _ City -
Owner Address_it-L" Qk'54 0t J 4W4 --S W ----City- uA_! e)Ai State 04- Zip 4 o c7 _
Tax Parcel No. (Confirm with Assessors Office) 2230 - "77_- q0tob _Legal Description_
-TV . Io - g 5 p# 1 190 'ERIc�,SCti LAKE VOID 13 .P46P A-o
Project Description &J TD0 _1Z I\Lr__ A(
T. 7-3N • X 2. W • LA)•M• M...N6 ,
Directions to site (Please attach map) Old 1[,Z BEJ!`.Q C,QEEX — DJ:: ,11�-V Of, tAl
Please provide or attach a vicinity map which includes cross streets, major roads, creeks, etc.
�2t�KS0�
_ VA T3�Ft2CL� -
K5MA 1Ay rya
Answer the following to the best of your knowledge. County-wide maps showing general locations of critical areas
Official and resource lands are available for review at Mason County Department of Community Development, Planning
Use Only Department.
Do any of the following exist on this property or within 200 feet of this property?
Ye! No - ,\
i ❑ ❑ [� 'i. Saltwater shoreline or a lake 20 acres or larger? 1fw/w',
❑ � 2. Rivers, streams, or creeks with year-round flow? VW
❑ ( 3. Rivers, streams or creeks with intermittent flour but ar ithin a ciearl defined channel?
Y
V ❑ 4. Lakes or ponds less than 20 acres in size? V U/L_�
E! ❑ 5. Wetlands: Areas that are inundated or saturated by surface water that under normal circumstances
support vegetation adapted for life in such ce, iti s; su has marshes, bogs, and swamps. (See County
Maps for guidance.) 40 ff v �
❑ [.�}' G. Slopes ire*zterhan 15°/ (8.5 degree)? ( ee the County Landslide and Erosion Hazard Maps for
guidance.) , 15� nO ,„ �6&✓
,S+�L�
❑ w�' 7. Floodplainsl (See County Fedr,ral Emergency Management Maps and County Seismic Hazard Man
for guidance.)
�L)
3. Seismic Zzard❑ � c Areas? (Se 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:
cep , Yc. No
❑ [' 1. Agricultural Open Space Taxation Program, RC',iV 84.33
E/ ❑ R' 2. Open Space Timber Taxation Program, RCW 84.33, or Designated Forest or Classified Forest,
RCW 84.34
•• SITE PLAN!
PLEASE 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 rood right-of-ways &easements. ► Location of significant natural features (water bodies, rivers).
. Locate all existing & proposed structuros,drainfields, wells & driveways. ► Project description
Scale 1"= 160��t) / North Arrow I-N—
!p
r;
M
QD N Sig 1p
-�
L�0LP
,Q.nay
a MvNSOt
a h
9 TEtL MStF-2 LL)
w� Qjo
I state that I ove truthfully to the best of my knowledge.
--Applicant/Owner Date
FOR OFFICIAL USE ONLY
Adjacent property.-4(-
-- �_- — —_
CJ�
aAfA
llsrrlg' nUntyturop. Lriil Maps, tF,i ptop�rty f cfslgrr� �d asi
1 ken term arnm�r lac 1 a€ st 5f..orallrt ......
•
�nfydidrnt� I artd 5 t�cies rldt ap (y
Resource L:a d
...:... .....
to
............... :.;:::
There is a $40.00 application fee for the Resource Land & Critical Areas Checklist. Make checks payable to the Mason
County Treasurer.
When completed, this form becomes part of thn permit application.
1