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HomeMy WebLinkAboutRLC94-01010 - RLC Inspections - 5/4/1994 Date Received: MASON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENThlp,� RESOURCE LANDS AND CRITICAL AREAS CHECKLIST The following checklist is designed to assist an applicant for a Building Permit, On-Site Sewage System Sit Evaluation and Disposal Permit, Access Permit, Land Modification Permit, Boundary Line Adjustments, Lan Segregations, Hazardous Waste Permit, or Shoreline Permit in determining whether their property is affected b regulations under the Mason County Interim Resource Ordinance (77-93)*. This checklist is an importar opportunity for identifying early in the permit process whether there will be any environmental regulations affectin the proposed development. Owner Mr- & Mrs. Gregory S.& Kathryn L. Denton Phone #( 206) 692-4445(W) Site Address City Zip Owner Address P.O.Box 3721 City Silverdale StateWa. Zip 98383 Tax Parcel No. (Confirm with Assessors Office) 22310 - 79 - 00600 Legal Description_ Tract 60, Blacksmith Lake Acre Tracts ( See attached legal description) Project Description prnpr`_:--��—�—, Directions to site (Please attach map) See attached Vicinity and site map, NorthwestQuarter of Section 10,Township 23 North, Range 2 West W.M. Mason County, Washington Please provide or attach a vicinity map which includes cross streets, major roads, creeks, etc. Answer the following to the best of your knowledge. County-wide maps showing general locations of critical arei WHOM and resource lands are available for review at Mason County Department of Community Development, Planning u..ONY Department. Do any of the following exist on this property or within 200 feet of this property? County Ye. No ❑�' ❑ ® 1. Saltwater shoreline or a lake 20 acres or larger? /� 0 ® 2. Rivers, streams, or creeks with year-round flow? �, ❑ ® 3. Rivers, streams or creeks with intermittent flow but are within a clearly defined channel? © ❑ ® 4. Lakes or ponds less than 20 acres in size? /v V ❑ ❑ ® 5. Wetlands: Areas that are inundated or saturated by surface water that under normal circumstancE / support vegetation adapted f r life in such conditions; such as marshes, bogs, and swamps. (See Count Maps for guidance.) R'/ ❑ ® 6. Slopes greater than 15% (8.5 degrees)? (See the County Landslide and Erosion Hazard Maps f( guidance.) 3 , ( �ja7� " � we 1- ❑ ® 7. Floodplains? (See County Federal Emergency Management Maps and County Seismic Hazard Ma for guidance.) n1D 41 ❑ ® 8. Seismic Hazard Areas? (See County Federal Emergency Management Maps and County Seismi Hazard Map for guidance.) rt,�-) You may be provided nuisance protections by the County for certain resource.activities. If you are enrolled in an of the following programs: CuuruY ye. No ❑ ® 1. Agricultural Open Space Taxation Program, RCW 84.33 ❑ ® 2. Open Space Timber Taxation Program, RCW 84.33, or Designated Forest or Classified Forest, RCW 84.34 ' Copies are available at Mason County Dopartmont of Community Dovolopmont for $5.00 oach. RESOURCE LANDS & CRITICAL ARE AS SITE PLAN PLEASE SHOW THE FOLLOWING INFORMATION OR PROVIDE SURVEY MAP IF POSSIBLE: P. Location &dimensions of existing &proposed property boundaries. P. Approximate slope of land (grado &direction),topography. ► Identify loge[access including,width of all road right-of-ways&easements. P. Location of significant natural features (water bodies, rivers). ► Locate all existing & proposed structures,drainfiolds, wells & driveways. ► Project description Scale 1"= 200' North Arrow 264.43 261. 77 \\ 2 5 9. �4 5-0 9. 65 I O63 p 1 '� e0el Ln 0 CO ro I ,�r ry) 5.00 AC.a (r)CO o IN a N 40.5 7'`/4 WcD 00 N �� 512.25 o N o v �2 I Z �IroPaSEd 0 --. E4rc:s ova zG ?G1,77• 0r LaT2 lV c� 5.o 3 AC. �n �tD EAse. M IJI �1 d- O \ , 1 M 265. 63 � G62.97 i� � 260.39 5l7,29 120.00 I state that I have answered the above truthfully to the best of my knowledge. �J Applicant/Owner .5 Dat( FOR OFFICIAL USE ONLY Adjacent property. l {• �/, ...........::n*'{•:}:•}'::L:.i'.i•::{:v:.i'::::v:::::..i'v:6i:i;f:{{4i:vi:}}}:r:•}i:•::.{:yi:•}:L•.>:�:•}}:•:�:.}:• {{•}:•}:{{•i:!:.}ii::w:::ii::C;•:i::}::v:{.}.:iii}::v:::'.::::'::::;:.:.::{::C:y{:•;::;.}}::.:}. ...!•:'s..:}x:::::•,��f...� tiQ•' .........:.::::::. ::::<::;.U: In ;:C. nt:.sf t ur. : .:L rtd:<:M:a s::: hi r.:o er:.t:;:a .;;d "sl ria d:.�s.,...>..........:::� r. •� :. :::.:........:................:...:...........................................................................................:..............................................................................•::::.�::: ..:.....::rf}}�.}}::{�:}}:J.•:•:::»•G:..:::rat. <.}::;::::>::><>::;<::<:>:::�::>'::<::::>»:<:::;;,:<•.;>':::��.:<>:>~a . .:.ter. .>:Ca stele }.�aresx:......:.:.:.. �,.....5..:p.r.e.tf.n�..M�ste....f.'.to. r.�m............, .........:..........:: :::.::::.::..:n .... ..m... .. .r►mran...:.::.:.:...f..::.::..:.:..::.::.:.::::::.:.:. g...:...:..::.. .:.9::........:..........:..::.:.............. .o.a c :1'ain. : ................. .. There is a $40.00 application fee for the Resource Land & Critical Areas Checklist. Make checks payable to the Masor County Treasurer. When completed, this form becomes port of the permit application. a �r } ' �1 �` • t 1 1, 1 / '�' �' ',' �1f I. ors ����`.'`,ram•';� /. i� ` .�� • ` ,�- 1 .r cap IV, 112 Mv 05f� '- w�.- "'�_ ,, '•- .t/tom'� �� • z(A Pop IM 08:23 07i27/'93 KITSAP BUS.MACH. SF-1210 206-876-0262 d'` PAGE 0 14TH ' LAKE ACREPrGE TR.RAC _S :. TR Y.s s MASON . COUNTY, WA. R" • • ••`^� is I r r-wf w�x[•: '<. .t " r.�r tee, +� r •.I•.i4 flaw, %Z- �.. .tl .� . • 1. f �i�TTT • r to •A 44 f Y r ol 54 r +.� r' •, it ti; ... ' �� i •.., • �•.• ;) ,� • sr.. � q+. r � � " a �• =F • r� Laf mac, r "At 4 A. do q It 55 as ..a rw••� r L +�' , �T i •,f•� g 1 �c s �T •...., Cs L: ' s.� T, aq .,•�• •S' �� }� `"c 5•.: `. • a—t ar r Z• is I I �C +a c4>.qC . • 7 1 ". I 3 f✓ t � r• 1... • w • ��.n =, a t.r�r ' +' r•fl.Ir Z. 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