HomeMy WebLinkAboutSPI - SPI Application - 4/8/2003 MASON COUNTY
PLANNING DEPT. PRE-INSPECTION APPLICATION
PLEASE PRINT // $200.00 Fee Required
1. Owner: 4L&I 5zVj2 z Applicant:..8,emg,. fti rt� nB.� '&o/�
Site Address: ,Zcj ,✓F Zgd6CzQzp 0,&�s Applicant Address: .jyz9�
Owner Address: city.� St�Q zip MIKA
City: 4A_ St Zip ge, r Phone:_(sy��) �9a? 99 day
Phone:_ day Phone: 69z tSiS evening
2. Parcel No. 79 - 929,7 ?
Parcel No. MAQ- Z34
Legal Description: 73,�e2,E Planner: GBM RAM PBC SAL
3. Purpose of Pre-Inspection : il- -„�s�,p� ,B���e�.✓� Sim .Go�nro�✓ ,cs
Ld0" —C° Z -$'FTd!Z&jC 1 �Pc��PiCrr�.r/S
y/5e'c'f WdZQ /J'nJA ///T- /�iPIOfLTkT�f�
4. Use of Building: 5,e�-X 'SE-,s-yam 4c ,ei.✓
5. Do any of the following exist on or adjacent to property?: slope [+ Saltwater❑ lake river❑
pond F1, wetland 1_1 seasonal runoff❑ other❑ stream ❑ seasonal creek ❑
Directions to Site: �,AygEz&i �z-7-A., .ga.a,,f gy "Irl '-M '4%d6c
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: Date: AK
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 279
Shelton, WA 98584
(360) 427-9670
Please include a $200.00 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:
Please illustrate below the proposed building site in relation to water&property lines:
SRG/Nord/MyDo mem&rTypedStulf/Pre-Inspection
Please illustrate below the proposed building site in relation to water and property lines:
Departmental Review
(For Office Use Only)
Planning Department Findings: