HomeMy WebLinkAboutRLC94-01187 - RLC Inspections - 5/31/1994 • Date Received:_ j* y 4
MASON COUNTY 77
EPARTMENT OF COMMUNITY DEVELOP NT qq4
RESOURCE LANDS AND CRITICAL AREAS CHEC ®I
The following checklist is designed to assist an applicant for a Building Permit, On-Sl ewag0 istem Site
Evaluation and Disposal Permit, Access Permit, Land Modification Permit, Hazardous Waste Permit, or Shoreline
Permit in determining whether their property is affected by regulations under gth_e �fep rce
Ordinance (77-93J This checklist is an important opportunit for identifying ear in e c ss'-h#ther
there will be any environmental regulations affecting the proposed development.
Owner ���-,c`. ✓� ;S, Phone #(paw S7Q-d7d5
Site Address .,-?U �) N,f=, dlci zu,ki City L. r Zip Ljr I d4
Owner Address -5cf rye _City 5Ame_ State Zip -'5r—+'v)f
Tax Parcel No. Z 2 31 1) - -7 4P - OD 2 tD Legal Description
-r?- 36 OF 5u12yF-9 to%Ia2 (NW sw)
Directions to site (Please attach map) �. J�- rv►i I PS DQ!S4 E1 2h n C n_ ��SS
Please provide or attach a vicinity map which includes ross streets, major roads, creeks, etc.
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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?
County Yee No
❑ ❑ VL 1. Saltwater shoreline or a lake 20 acres or larger?
❑ ❑ 0 2. Rivers, streams, or creeks with year-round flow?
f— ❑ E- 3. Rivers, streams or creeks with intermittent flow but are within aGllearly defined channel?
❑ ❑ 4. Lakes or ponds less than 20 acres in size?
❑ ❑ [L 5. Wetlands: Areas that are inundated or saturated by surface water that under normal circumst nces
support vegetation adapted for life in such conditions; such as marshes, bogs, and swamps. (See County
Maps for guidance.)
46
❑ ❑ 2 6. Slopes greater than 15% (8.5 degrees)? (See the Couun�t Landslide and Erosion Hazard Maps for
guidance.) �� � A� ,�I 1 V e/0, ��� ?�, � �
❑ ❑ 51 7. Floodplains? (See County Federal Emergency Management Maps and County Seismic Hazard Map
for guidance.)
,6 ❑ [3 8. Seismic Hazard 'Areas? (See County Federal Emergency Management Maps and County Seismic
Hazard Map for guidance.) //� ;f)
(✓ ,L`
You may be provided nuisance protections by the County for certain resource activities. If you are enrolled in any
of the following programs:
tg Yea No
❑ M 1. Agricultural Open Space Taxation Program, RCW 84.33
❑ [2J 2. Open Space Timber Taxation Program, RCW 84.33, or Designated Forest or Classified Forest,
RCW 84.34
)ilable at Mason County Department of Community Development for $5.00 each.
RESOURCE LANDS & CRITICAL AREAS
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 road right-of-ways&easements. ► Location of significant natural features (water bodies, rivers).
► Locate all existing &proposed structures,drainfields, wells &driveways.
Scale 1"_ ` lC North Arrow
NGMA
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30, a9
I state that I have answered the above truthfully to the best of my knowledge.
' - �— � Applicant/Owner S'- a - �I Date
FOR OFFICIAL USE ONLY
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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 the permit application.