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Home My WebLink AboutBLD99-00925 Final Mobile Home - BLD Permit / Conditions - 4/10/2000 y 'le - MASON COUNTY • Mason County Bldg. III 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 t3 ka I L. U) I N CA 1> E_ FA INt I -F FOR INSPECTIONS CALL 427-96 D BETWEEN Spin AND gain 42.7-7262 51-099--0925 PARCEL :2.2.3 1 1 7500090 PLAT : DIV BLK : LOT : JOB ADDRE aS : 1321 NE TOONE RV I LLE AD BEI-FA I R OWNER : JOAN JORDAN 3030-372-2749 CONTRACTOR ; LEGAL : TR 0 Of SURVEY VOL. 3 PI, 98 3:T.S:' W.'w+::+:�iY.y:`.Lv'1i5A:/2':S'�L'ATY.Y:'._'0.31�'es7•"....t'�R3�ST`.:.:t��1Ci ^"..Cd:>^' .tT30Y-T-YC ,_^. CLASS U1" W+ORE . . :NEW BEDR : 2 .BATH : 1 TYFE ANOU>17 BY" 9Ail RECEIFT TYPE ANOU111 EY O►TI RECEIPT TYPE OF USE . . , rMH ;STOR I E> . . . . . . . . i OCCUP , 4RO11P . . . :? BLDG . HEIGHT . , : 0 .011' t NHSf S 175.110 MN 11106199 1663 4ENCF f 5:I.a1 KS 11165i94 52176 i 7 YPE OF CONST . , :? FIREPLACES . . , . : 0 NHBL i l75.aa KS 11195199 12076 OCCUP . LOAD . — . . 0 WOOI)STOVES . . . . . 0 STFE 0 4.511 KS 11165199 521176 DWELL .UNITS . . . . : 0 PARKING SPACES : 0 loci t 15.01 KS 11105199 51a16 INSPECTION AREA : 2 SHOREL I NE . . . . :Y FIRS I 381811 KS 11185{99 52076 �TOia1.: 457.50 V.AI DIATiON: 6#0 SETBACKS—--_ _. ___--- TOILETS . . , , . . . . . . : 0 FUEL. TYPES- - ____ .. ._ BOIL.ERS!COMf MOBILE HOME-- FRONT . , .W 400 .oft BATH BASINS . . . . , . : 0 : 0-3 Hp . : 0 REAR . . , .E 500 .0ft BATH TUBS , . . . . . . . 0 3 -- 15 HP . - 0 MODEL ,OAKBROOK SIDE ( 1 ) ,N 200 .Ott :SHOWERS . . . . . . . . , , . 0 FURN < 100K BTU : 0 15--30 HP . ; 0 - MAKE _ - - -- S I DE (s' ) .S 10 .0'Pt WATER HEATERS . . . . ; 0 FURN �--1001< BTU : 0 305 50 HP . : 0 SHRL. INE .E 500 .9ift CLOTHES WASHERS . . : 0 FURN FLOOR _. 0 501 HP . : 0 YFAft AREA _ _._. _.__. .._.-._.__._.__._.. K I fCHCN SINKS . . . . : 0 HEAT PUMP . . . . . . : 0 85 LOT --3 I LE . . : FLOOR DRAINS . , . . . . 0 VENT 1Y STEMS , . . : 0 E VAP COOL_LERS t 0 LENGTH :66 BU I LE)I NG . .. . a 0s1 DRINKING FOUNT . . . : 0 VENT FANS . . . . . . : 0 HOODS — _ . :u , . . . : 0 W 1 DTH . : 14 BASEMENT . . . : Osf LAUNDRY TRAYS _ . - 0 DOMES: . I NC I N :4) ",f R I AL# - DECKS . . . . . . . OSf DISHWASHERS . . . . . . : 0 AIR HANDLING UNITS--- GOMML. . INCIN :0 GAR/CARP :? a Osf GARS; DISPOSALS . . ,, .- 0 10000 cfm . : 0 REL_OCIREPAIR i 0 AT/b'T . :2 - UR I NAi.; . . . . . . . . . . : f) 10000 cfm . : 0 OTHER UNITS . ; 0 MI SC PL.M FIXTURES : 0 GA`? OUTLETS . : 0 C1�.:FyST.'�4:TcelA2i3�Gwa..r•-«.,..:'S:�'1^2_3rZ' .f::'_`.'^:s'M:51':YZ."Z-.n::':T._-'k-.RR'A[1Y.Y.TL.'.'�i.�.:3?•:::::'SC'r..��.....-"�:t1A�:r.'3S±.ZLGYL^.i'.leFf:'<P.i_'.L'.«3K:94':«'tTi::^:1.'.C:C'F?'pLW."',A,:C4GSSC:3]9L tSS3Y:.`'Y:'L'1. :-"J63�CF;L,T29'..^.;�i�LSR.S"i4#1tA19^:.tY:�-ti_"mil,YTY6@'«t'.��_IDl6STJPS;Y' PROJECT OESfiRiPTiON:NOBIIf NONE PROJECT LOCATIO110.35 NILES OUT T00011VILLE O9 ON THE LEF1. IRIS PIRNIT BECONE3 NUIi. Alt `DID IF WORK OR COISTIA)CTION AUTNORIlfO IS 161 CONNENCEO WITHIN 100 DAYS, 04 If CONSTRU01011 OR 1009 IS SUSPENOID FOR A PERIOD Of 180 DAYS AT ANY TINE AfTEN 101K 13 CONNENCEO, FVIOENCE Of CONTINUATION OF 1019 IS A 1`006ifsoo INSP(C1100 11THIN THE 180 OAT PERIOD. FINAL 103PECTION NNST BE APPROVED 8EE011 BUILDING CAN BE OCCUPIED. is OWNER OR Afif0h _ 81 0_-P tIT, rev: 113131111 COMOL. I ANGE TO ATTACHED CONDITIONS IS RFOU I RED CONCRETE MECHANICAL MOBILE HOME Footings-Setback date by Ribbons date by Gas Piping date b Foundation Walls date by Set Up date by INSULATION date S —15�e-e--O by / �1 BG/SLAB insulation Floors Final date by date by date /O—� by FRAMING Walls FIRE DEPT. date by date by date by PLUMBING OTHER Groundwork Attic date by date by D.W.V. WALLBOARD NAILING date by date by Water Line FINAL INSPECTION date by date by date by r CONCRETE MECHANICAL MANUFACTURED HOME p 1P Date By oFootings !Setbacks Gas Piping Ribbons p N Interior Date By Interior-Date Byr,•H gy Z cn Extenor Date By Exterior-Date By` Sot-up Point Load!Isolated Footings INSULATION Date By D BG/SLAB INSULATION Date By Data Ciy FIRE DEPARTMENT Z Foundation Walla Floors Date By Date By Date By DECKS FRAMING Walls Date By Date By Data — By PROPANE TANKS PLUMBING vault Da1e By Date By OTHER Groundwork Attic Date By Date By Type: Date By D.W.'V DRYWALL Type Int Brace Wall Date By m Date By m Date By FINAL INSPECTION W Water Lane Fire Seperation v Date By Date By Date By �p to Pass or Request Inspect c Type of Insp. Fail Date Date Done By Comments CD 0 cn 0 n� CD cn CD 0 0 0 1 a 0 n cn 0 m 1 0 � I MASON COUNTY Mason County Bldg. III 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 iP F R J�A 1 _r. C rC]N D 1 T 1 C► N Case No . : BLO99-092.6 FFar : JOAN JORDAN Page : 1 1 ) Approved per dimensions acid setbacks on s(ibm i tte:d site plan . Y� 1 1 ) The applicant acknowledges that the proposed mobile honto will be occupied by a ftmily e member and that the structure wri I l not he rented or leased . X 3 ) All upland area: disturbed or new% y created by construction activities shuli be seeded, vegetated or given an equivalent fiype of erosion pi otection ( silt fencing or straw matting ) . ---- ._ =- 4 ) Proposead structure or any portion tt:ereof grerater, than 30"" in hpight from grade Iitie , �►rru3t maintain a ini n imam of b ' setback from all property lines, easemontr; and 10 ' from all County and State Road right of way~ . h Th I sMaso aCountytOrdinanceion i sub!1c t to Buf�ter and Landscaping requirements at, established under 6 ) The use, handling and storage of ha zard<rus materials car f laminable and combust i b l e3 liquids in excess of 10 gal long is not allowed without the approval of -the Masan County Fire Marshal . 7 ) Provisions for surface/subsurface dra.i rage control must be i mp l emetete d with new con st r uct i +err or sieve I opme�nt on site and M11:1'T NOT adversely Impact ad J acexrtt parse i s . Under the requirements of Mason County Stormwater Ordinance, either private ditohe., and dra i nr- will meet requirements of the stormwater ordinance or prior approval * i i 1 be granted to use an existing utility and drainage easement dedicated for that spec: + fig, purpose . For further Information regarding this ordinance and the REQUIREMENT to obtain an ACCESS PERMIT for the installation/construction of a driveway or access connect i ng from a Mason County Road, i:onta,- t the Mason County Pt.ibl i r Works Department prior to construe?tion at Ext , 450 . MASON COUNTY Mason County Bldg. III 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 F'or any construction which 16 �ar�oposed to be i<,c,atpd w i t" i n n ' of u Masots county road right of way , It is suggested to contact that office to review future planned work which may affect your project ., X 13 ) PURSUANT 1 O 1997 UNIFORM BU I LI) I NG CODE , ALL SITES MUST HAVE APPROVED NUMBFRS OR ADDRESSES PROVIDED IN SUCH A POSITION AS TO BE PLAINLY VISIBLE AND LEGIBLE FROM THE STREET OR ROAD FRONTING THE PROPERTY . MASON COUNTY BUILDING DEPARTMENT REOUIPEE THAT THIS BE COMPLETED PRIOR TO CALLING rOR ANY SITE INSPECTIONS . A REINSPECTION FEE . BASED UN RATES AS ADOPTED BY 1-11E JURISDICTION AND THE 1997 UNIFORM FiU 1 I.0 i Nr CODE WILL (k-E. ASSESSED IF OWNERlCONTRACTOh FAILS 'TO POST ADDRESS ON SITS PRIOR TO REQUESTING I N ;PECT i ONS . 9) THE 170UNUAI I ON SYS1 EM SHALL_ BE PLACED ON UNDISTURBED, NATIVE SOIL . X 10 ) The approvvd plot plan is required to be on-site for inspection ppur oses . It inspect Ion is called for and plot plan Is not !�n site, Approval WiL.� NOT be granted . In addition , a tie- Inspection fee in the amount of $42 .00 per hour (minimum 1 hour ) will be charged and must be collected by this department prior to any furtheyr inspections being performed or approval granted . 11 ) . nEOUIRED INSPECTIONS ( Footing Inspection-prior to pour , Set - up Inspection-prior to skirting, Final 1nspeotion--prior to occupancy ) . 1 hereby assume all responsibility for ,the so eduling of my required inspections . tf the i- equired inspections are not r0ciirest�ed I nspected� Find signed off (approved) by the inspector I n threes prescribed order , I understand that reinspection fees and an hourly Investigation fees pursuant to the 1997 UBC , and will be assessed in addition to my original permit fees to resolve any questionable practices or problems that haver been discovered . I further understand 'that this lavestigation will be scheduled as time allows . Until resolution of any/all problems no occupancy ( Final Inspection ) will be granted for the residence . OWNER I CONTRACTOR ( IndI cat es. which ) SI gnat ure X� �. _. �_.�_.-_ ,. ... _ 121 ) AI I mc,7bi Ie/manuf act ured home I and 1ngt> or decks must be freestanding ( :elf supporting ) . The largest landing or deck permitted without drawings or a building permit is 12E3 sq ft s MASON COUNTY Mason County Bldg. III 426 W. Cedar • P.O. Box 186 Shelton, Washington 98584 trr less AND MUST be under 30"' in height from surrounding ride . Nr► se:�c:ond -utur y� deck% , ordeoks above 30" can be built without a permit . Any landing or deck that is 30 or more In height from walking surface: to finish grade requires a Permit . Any landing or deck that has A or more risers requIres ai handra ! i . 1 :3 0*nerlbui Icier assumes all responsibr l ity if draiof leldire ervv a Zl I = encumbered . Case No . : St_D99-D9?..5 MASON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT Mason County Bldg. III, 426 West Cedar Street PO Box 186, Shelton, WA 98584 H www.co.mason.wa.us (360)427-9670 Belfair(360)275-4467 Elma (360)482-5269 December 10, 2010 Donna Gardner 1351 Toonerville Dr. NE Belfair WA 98528-8705 Re: 1985 Royal Oakes 16x l4 Manufacture home (PP# 3009097) To Whom It May Concern, The above mentioned manufactured home was permitted (B1d1999-00025) and finalled on April 10, 2000. The unit was permitted as a Caretaker's unit only. The permit was conditioned" The applicant acknowledges that a family member will occupy the proposed mobile home and that the structure will not be rented or leased". In addition the Public Health department required that a"Certificate of Residential Use- Caretakers Agreement- sewage disposal" be recorded with the Auditors office for future and current interested parties acknowledgement. This is recorded under auditor's file # 1701181. At this time the unit can be retained on the parcel as a caretakers unit only. The unit shall not be rented or leased. This is considered an existing non-conforming use. If the unit is vacated and there is not a caretaker situation the unit must be removed or permitted through a Special Use permit for an Accessory Dwelling Unit. Sincerely, Tricia Woolett Permit Specialist II 360.427.9670 ext. 281 twna,co.mason.wa.us Attachment: Copy of inspection card Condition #2 Proof of final Inspection Copy of Recorded Certificate of Residential Use CC: Parcel File Inspection Line (360)427-7262 MASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT Phone: (360)427-9670, ext. 352 Mason County Bldg. III 426 W.Cedar P.O. Box 186 Shelton, WA 98584 P10 RESIDENTIAL BUILDING PERMIT BLD99-00925 OWNER: JOAN JORDAN RECEIVED: 10/6/1999 CONTRACTOR: LICENSE: EXP: ISSUED: 11/5/1999 SITE ADDRESS: 1351 NE TOONERVILLE DR BELFAIR EXPIRES: 5/3/2000 PARCEL NUMBER: 223117500080 LEGAL DESCRIPTION: TR 8 OF SURVEY VOL 3 PG 98 PROJECT DESCRIPTION: DIRECTIONS TO SITE: MOBILE HOME 1.35 MILES OUT TOONERVILLE DR ON THE LEFT. General Information Construction &Occupancy Information Square Footage Information No.of Bedrooms: 2 Type of Constr.: ? Type of Use: MH Insp.Area: 2 No. of Bathrooms: 1 Occ. Group: ? Lot Size:O Deck: 0 Type of Work: NEW Fire Dist.: 2 No. of Stories: 1 Occ. Load: 0 Building:0 0 Valuation: Building Height: 0 Occ. Status: Basement:0 Manufactured Home Information Setback Information Shoreline& Planning Information Make:OAKBROOM Length: 66 Ft. Front: W 400.0 Ft. Shoreline: 500.0 Ft. Water Body: Rear: E 500.0 Ft. Slope: Ft. SEPA?: No Model: Width: 14 Ft. Shoreline Desig.: Side 1: N 200.0 Ft. Year:85 Serial No.: Side 2: S 10.0 Ft. Comp. Plan Desig.: Plumbing Fixtures Mechanical Fixtures FEES Type Qty. Type Qty. Type By Date Amount Receipt MH Submittal Fee KW $175.00 1663 MH Issuance Fee KS $175.00 52076 Building State Fee KS $4.50 52076 Address Fee KS $15.00 52076 Planning Review-Res. KS $38.00 52076 EH Plan Review KS $50.00 52076 Total $457.50 - PI h following r nditions of this permit.BLD99 00925 ease refer to the pages for co p 1 of 3 CASE NOTES FOR BLD99-00925 CONDITIONS FOR BLD99-00925 1) Approved per dimensions and setbacks on submitted site plan. X 2) The applicant acknowledges that the proposed mobile home will be occupied by a family member and that the structure will not be rented or leased. X 3) All upland areas disturbed or newly created by construction activities shall be seeded, vegetated or given an equivalent type of erosion protection (silt fencing or straw matting). X 4) Proposed structure or any portion thereof greater than 30" in height from grade line, must maintain a minimum of 5' setback from all property lines, easements and 10'from all County and State Road right of ways. X 5) This application is subject to Buffer and Landscaping requirements as established under Mason County Ordinance 1.03.036. X 6) The use, handling and storage of hazardous materials or flammable and combustible liquids in excess of 10 gallons is not allowed without the approval of the Mason County Fire Marshal. X 7) Provisions for surface/subsurface drainage control must be implemented with new construction or development on site and MUST NOT adversely impact adjacent parcels. Under the requirements of Mason County Stormwater Ordinance, either private ditches and drains will meet requirements of the stormwater ordinance or prior approval will be granted to use an existing utility and drainage easement dedicated for that specific purpose. For further information regarding this ordinance and the REQUIREMENT to obtain an ACCESS PERMIT for the installation/construction of a driveway or access connecting from a Mason County Road, Contact the Mason County Public Works Department prior to construction at Ext 450. For any construction which is proposed to be located within 25'of a Mason County road right of way, it is suggested to contact that office to review future planned work which may affect your project. X 8) PURSUANT TO 1997 UNIFORM BUILDING CODE, ALL SITES MUST HAVE APPROVED NUMBERS OR ADDRESSES PROVIDED IN SUCH A POSITION AS TO BE PLAINLY VISIBLE AND LEGIBLE FROM THE STREET OR ROAD FRONTING THE PROPERTY. MASON COUNTY BUILDING DEPARTMENT REQUIRES THAT THIS BE COMPLETED PRIOR TO CALLING FOR ANY SITE INSPECTIONS. A REINSPECTION FEE, BASED ON RATES AS ADOPTED BY THE JURISDICTION AND THE 1997 UNIFORM BUILDING CODE WILL BE ASSESSED IF OWNER/CONTRACTOR FAILS TO POST ADDRESS ON SITE PRIOR TO REQUESTING INSPECTIONS. X 9) THE FOUNDATION SYSTEM SHALL BE PLACED ON UNDISTURBED, NATIVE SOIL. X BLD99-00925 Please refer to the following pages for conditions of this permit. 2 of 3 10) The approved plot plan is required to be on-site for inspection purposes. If inspection is called for and plot plan is not on site, Approval WILL NOT be granted. In addition, a Re-Inspection fee in the amount of$42.00 per hour(minimum 1 hour)will be charged and must be collected by this department prior to any further inspections being performed or approval granted. X 11) REQUIRED INSPECTIONS (Footing Inspection-prior to pour, Set-up Inspection-prior to skirting, Final Inspection-prior to occupancy). I hereby assume all responsibility for the scheduling of my required inspections. If the required inspections are not requested, inspected and signed off(approved) by the inspector in the prescribed order, I understand that reinspection fees and an hourly investigation fee pursuant to the 1997 UBC, and will be assessed in addition to my original permit fees to resolve any questionable practices or problems that have been discovered. I further understand that this investigation will be scheduled as time allows. Until resolution of any/all problems no occupancy(Final Inspection)will be granted for the residence. OWNER/CONTRACTOR(indicate which) Signature X 12) All mobile/manufactured home landings or decks must be freestanding (self supporting). The largest landing or deck permitted without drawings or a building permit is 120 sq ft or less AND MUST be under 30" in height from surrounding grade. NO second story decks, or decks above 30" can be built without a permit. Any landing or deck that is 30"or more in height from walking surface to finish grade requires a Permit. Any landing or deck that has 4 or more risers requires a handrail. X 13) Owner/builder assumes all responsibility if drainfield/reserve area is encumbered. X This permit becomes null and void if work or construction authorized is not commenced within 180 days, or if construction or work is suspended for a period of 180 days at any time after work is commenced. Evidence of continuation of work is a progress inspection within the 180 day period. Final inspection must be approved before building can be occupied. Proof of continuation of work is by means of a progress inspection. The owner or the agent on the owners behalf, represents that the information provided is accurate and grants employees of Mason County access to the above described property and structure for review and inspection. OWNER OR AGENT: DATE: BLD99-00925 Please refer to the following pages for conditions of this permit. 3 of 3 r • � S Q� � �' G/v,:,s Rw�. I `� .I �� _. ��w�� PERMIT NO.: BLD MASON COUNTY BUILDING PERMIT APPLICATION /6 426 W.Cedar/P.O.Box 186,Shelton,WA 98584 I O Shelton 360 427-9670 Belfair 360 275.4467 Elma 360 482-5269 Seattle 206 464-6968 APPLICANT INFORMATION CONTRACTOR INFORMATION Owner : Oaru T t iy AA Contractor Name Mailing Address pp a- " 3' it, 3 Mailing Address City StatekZ4 Zip Code 98S 2y City to Zip Code Phone(3G r, ) .?7.2-1;,it/9Other Ph.(.?& 7g, a. Ph J Xther Ph.( Lien/Title Holder Contractor Reg. # Address Expiration SEPTIC/WATER SYSTEM INFORMATION-Connect to New Septic E ' 'ng Septic Connect to Sewer System Name of Sewer System fater System Name of Water System PARCEL INFORMATION-12 digit Tax Parcel No. cita 3/I cc o �o Fire District_ Legal Description�"]_�q p I: S (.A2�t� 11 0L .? oeC 9V Site Add ress(Please Include street name, street number and city) - 7 Directions to site /. .3.5 rviilcs p .i � 'j�a-. Her i�/l� v L� Will timber be cut and sold in parcel preparation? (Yes/No) Is your property within 200' of the following: Body of Water (Name) �A•/f k yk fZ r vr=Q Saltwater Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluffs TYPE OF JOB New Add Alt Repair Other Use of Building e C k-t Describe Work .-n54./1 Use,,( _S-I e La,--f" e"41IVC 1,0—W, No. of Bedrooms_2__No. of Bathrooms_SQUARE FOOTAGE-1st Floor !q.2 _2nd Floor 3rd Floor Loft Basement Deck Other sq. ft. Garage Attached Detached Carport Attached Detached MOBILE HOME INFORMATION-Make�,,-,k Model Model Year /jesS Length _Width / L/ Serial No.T7.Z%UW 9011 gSwflw of Bedrooms -7 No. of Bathrooms_ Type of Heat Purchase Price $S- Replacement Unit ?(Yes/No) Installer Name Certification No. NOTICE: THIS PERMIT BECOMES NULL&VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS OR IF CONSTRUCTION WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER THE WORK IS COMMENCED. PROOF OF CONTINUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION. The owner or agent on owner's behalf,represents that the information provided is accurate and grants employees of Mason County access to the above described property and structures for review and inspection of this project. Acknowledgment of such is by signature below: OWNER AFFIDAVIT-I certify that I am exempt from the requirements of the CONTRACTOR'S AFFIDAVIT-I certify that I am currently registered as a Contractor Registration Law RCW 18.27 and am aware of the ordinance contractor in the State of Washington and that I am aware of the ordinance requirements for which this permit is issued and that all work will be done in requirements regulating the work for which this permit is issued and all work conformance therewith. No changes shall be made without first obtaining shall be done in conformance therewith. No changes shall be made without approval. first obtaining approval. X � Date C y X Date CK FOR OFFICIAL USE BEYOND THIS POINT 1 f Accepted by QieDate' a Submittal Amount Due 1 t5 �� Receipt No. DEPARTMENTAL'REVIEW P VE91D NiI»D CQfVpITIQN GODS Building Department lope /% - re uP5h•r'5;nfrb &bou-t se/12te- Occ Group Type Constr. c,.urCY 6rstAr 17 Planning Department Environmental Health Department V l Public Works Department I Fire Marshal i i Valuation $ i I ': FEES Building Permit Fee Iq S Site Inspection I Plan Review Fee UFC Plan Review Fee Plumbing & Base Fee Public Works Review Fee Mechanical & Base Fee Other Wood/Gas/Pellet Stove Fee Other Violation Fee Pre-Paid at Submittal •'i:+iii�tivi'rj}:;i:•{iiiiii iiii:'vii;:ii;:$iiii}i ..................................................................... Ji•iistivi:(:}•::•i/::n::•:�ii:•�ii::$•(::i:::::•'riii :::::,.::':i ;; :ii:::aiyf:::':Y,+:2:i `i;'•:i:'• t'v.';,:$?•r,,.`>:.::<ti%:..x rM•{r.•ra:r'tox K<w>ero.tv»:iv.... .::�>:::•. .. ..... �:•:•;:•>:.>::.::::'::::��:.::::•::.....;...�:<,;�: TOTAL FEES FORM MUST BE COMPLETED IN INK PLEASE PRESS HARD MASON COUNTY PROJECT SITE INFORMATION _ Case No. Name . JOG►►) J ord6kv^ PARCEL NUMBER v2-22 1/ 75 Oo o Date !� �3 � /`' ramesof how THE FOLLOWING ON SITE PLAN Show Direction by indicationg N, S, E, W in relation to the site plan sions Fences tructures Driveways SetbacksShorelines es Topographytion (including adjacent) Drainage Plan Streets Easements Fronting Streets Septic System DRAW SITE PLAN BELOW Include adjacent properties if on shoreline or withirtl00 feet of adjacent property line. adjacent property line-� i 7- I <-adjacent property line s"ao I � I I I I I 1 � I 2 Cx) pro •r �\ 6U i 00 (00 /vb,- 1 I Ul I I I I adjacent property line4 I --A 6,0 <—adjacent property line UUtir✓'V-1 SAMPLE SITE PLAN adjar�nt property lined I 3zo' r RvE I FadJacent property line D 30' 3o-T gEASowi Al_ I r1 _�PT7L__,� i CRF�K I' MOM 6 I I � CsnaEN I £ � I Hcusa I j I PrioPoxD I / I R I VACANT rtA7 o' I � p0.oPosCD � T /� I A&RLCULT�A L So' I I I , I \ I I I I \ I /00' I I I I c" -e-LL I I I I I i I adjacent property line-� ; \; E-adjacent ro ert'line TOPOGRAPHY PROFILE(Show a side view of property. Show slopes, cuts and fills. If possible include height and the degree of slopes. See sample topography profile.) SAMPLE TOPOGRAPHY PROFILE dlStahGO. '+'D ruLi"La.Ya dibt'anLG *c Slopm -rc¢ dis+anal fe t Sign re Date