HomeMy WebLinkAboutSPI2006-00048 - SPI Inspections - 3/2/2006 a ��,��•�( 00
MASON COUNTY
PLEASE PRINT
PLANNING DEPT. PRE-INSPECTION APPLICATrM205.0
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Fee Required
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Owner: _ �4ls�+rE l GIC Applicant: r� �-r
Site Address: 'I k F 13LA-c k Sml rr/ )2 plicant Address:
Owner Address: 1pl3v,F;y,,40idflLLFri/W y Ity: St Zip
City: ` St L✓/f Zip �/;?/ Phone: ) day
Phone:(j; o — day
Phone:( ?&o ) o evening Planner:
Email Address: SMP Comp.Plan Type of Use
Water Body
2. Parcel No. ,Z_-� 7' �1 `i
Parcel No. _2 2-:3 f 6 7C'= o
Legal Description:
3. Purpose of Pre-Inspection moo,. in A=r- ,,.e
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4. Use of building:
5. Do any of the following exist on or adjacent to property?: slope( saltwater ) lake( river
pond( ) wetland�� � seasonal runoff other( stream( seasonal creek
Directions to Site: i t+�r E
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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 until development changes occur in the vicinity which affect the lot
evaluated in this inspection,or the laws regulating development of the site change after the time of inspection.
Applicant Signature J Date:
If you would like to be on site during inspection,please check here:
Return application to: Department of Community Development,Planning Division
P.O. Box 186
Shelton,WA 98584
(360)427-9670
Please include a$205.00 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
MPLANN INGTACPRE-INSPECTION Revised: 01/17/06
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 ADEOUA;E
ILUSTRATIONS WILL NOT BE ACCEPTED AND WILL BE RETURNED TO THE APPLICANT.
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Departmental Review
(For Office Use Only)
Planni g Department Findjngs:
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