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HomeMy WebLinkAboutBRN2009-00035 - BRN Application - 9/23/2009 BURN PERMIT Mason County Dept. of Community Development PO BOX 186 - 426 W Cedar St, Shelton WA 98584 - 360.427.9670 BRN2009 =00035 0 2309 Is ue Date 'Expiration Date Site Address: 52 N SCHAUFLER LN LILLIWAUP 324342400010 34 24 3 17 Parcel Number Section Township Range Fire District Applicant: JOHN ORR Address: P O BOX 120 LILLIWAUP WA 98555 PH1 : 1.360.877.9963 Contact Number(s) - Must be a 24 hour number Conditions: 1. Valid permit must be on-site while burning. 2. The following materials may not be burned: Garbage, dead animals, asphalt, petroleum products, paints, rubber products, plastics, paper, cardboard, treated wood, construction / demolition debris, metal or any substance (other than natural vegetation) that normally releases toxic emissions, dense smoke or obnoxious odors when burned. 3. All material must originate from the property on which the burning is to occur. 4. The fire must not create a nuisance from smoke, obscure visibility on public roads and highways or endanger life and property. 5. The maximum pile size is twenty (20) feet in diameter, with a minimum ten (10) feet firebreak around each pile. 6. Each pile must be at least one hundred (100) feet from any structure and at least fifty (50) feet from standing timber. 7. Do not burn if wind is blowing more than seven (7) MPH. 8. Do not burn if wind is blowing from direction. 9. The minimum people required to be in attendance at the fire while burning: 1 10. On site water required? 11. Provide excavator / dozer with a fire extinguisher at the site with a qualified operator. 12. Provide a 24-hour fire watch. 13. Fire must be completely extinguished within three (3) days after ignition. 14. Fan is required. 15. Other: Fire Warden: �.� ZWb Signature Date *-YOU MUST CALL (360) 427-7761 EVERY MORNING TO REPORT IN** BRN2009-00035 09/21/200! 09/23/2009 15:50 FAX 360 427 7798 MASON CO PERMIT CTR 10 001 TX REPORT * TRANSMISSION OK TX/RX NO 0354 CONNECTION TEL 360 426 9771 CONNECTION ID ST. TIME 09/23 15:49 USAGE T 00'27 PGS. SENT 1 RESULT OK PERMIT NO.' rtl MASON COUNTY BURN PERMIT APPLICATION 426 W. Cedar• P.O. Box 186, Shelton, WA 98584 Shelton (360)427-9670 • Belfair(360) 275-4467 • Elma (360)482-5269 •www.co.mason.wa.us APPLICANT INFORMATION CONTRACTOR INFORMATION Owner Company Name_,, �- W A-►I •f ICAP Mailing Address V& Box 1 � 50,0 sc awiett � ng Address 7/f) r A r d 05"( City 4 .JKIjA UD State. ' Zip Code 2ISSS City ,,S State 4 Zip Code 9NILZ Phone Other Ph. Phone I Other Ph. 3 A � r Lien/Title Holder Contractor Reg. # `�1- Exp. E mail Address E Mail Address Sc4Me Drivers Lic.# d 4* f) ` DOB 9 -- Drivers Lic. #Qc)ttr\t,,3�G�A DOB PARCEL NUMBER. Sec. Town. Rng. Fire District Site Address(Please include street name, number and city)1�� A1n�'7P *A] iol T t' 1e �'�° Directions to it < 1 n- _k f + J o < r I rr flc {. Parcel within 00'of Saltwater Lakep River/CreekJ3 Pondp Welland p Seasonal Runoff[ Stream[Slopes or Bluffs > 15% Is property flagged or address prior to iyection Yes/No-Will timber be cut and sold in parcel preparation? Yes / No Repg�on for land clearing: M d �✓ T 1 ? �' 1 f7 e r Is this site being converted or replanted? Yes / 014 Does site require FPAor 6 yr. Moratorium? Yes/No The person in charge of the fire may be liable for the cost of fire supression if the fire gets out of control or, if it becomes necessary to extinguish the fire as a result of enforcement action. Open burning shall be prohibited during any period of impaired air quality as designated by the Olympic Region Clean Air Agency, or during extreme fire danger due to dry weather conditions as designated by the Mason County Fire Marshal's Office.Information hotline(360)427-7799 Is this permit submittal the result of a Stop Work Notice,Correction Notice or other enforcement action? Yes/No Burning is authorized subject to the following conditions: 0 Valid permit must be on site while burning. The following materials are prohibited and must not be burned: Garbage,dead animals,asphalt, petroleum products, paints, rubber products, plastics, paper,cardboard,treated wood, construction/demolition debris, metal, or any substance(other than natural vegetation)that normally releases toxic emissions, 1 dense smoke,or obnoxious odors when burned. All materials must originate from the property on which the burning is to occur. The fire must not create a nuisance from smoke,obscure visibility on public roads and highways,or endanger life and property. 1J Maximum pile size is twenty(20)feet in diameter, a minimum ten(10)foot firebreak must be constructed around each pile. Each pile must be at least one hundred(100)feet from any structure,at least fifty(50)feet from standing timber. Do not burn if wind is blowing more than seven(7)miles per hour. Do not burn if wind is blowing from (direction) A responsible adult and equipment shall be required to be on site and in attendance at the fire while burning. On site water required: [3Yes [3 No Provide EXCAVATOR/DOZER(with a fire extinguisher)on site with qualified operator. Provide 24 hour fire watch. Fire must be completely extinguished within three(3)days after ignition. Fan required Other Upon completion of above conditions,applicant must call(360)427-9670 Ext.262 for inspection prior to burning OWNER/CONTRACTOR Acknowledges submission of inaccurate information may result in a stop work order or permit revocation. Acknowledgement of such is by signature below. I declare that I am the owner,owners legal representative,or the contractor. I further declare that I am entitled to receive this permit and to do the work as proposed in the application. I declare that I have obtained the permission from all the neces- sary parties. If permission is required from any easement holder or any other party in interest regarding this application or the work proposed in the application, I have obtained permission from them to apply for this permit and conduct the work proposed. The owner or agent on owners behalf, represents that the information provided is accurate and grants employees of Mason County access to the above described property for review and inspection. This permit/application becomes null and void rf work is not completed within 30 days. Permit includes two (2) inspections mapmum, additional inspections will require a f 6f sixty four(64)dollars per inspection. C� X Date: !& /2 -- e2 7 Owner/Owners a resentative/Contractor indicate which one FOR OFFICIAL USE BEYOND THIS POINT Accepted by: i Date'- DEPARTMENTAL REVIEW APPROVED DENIED NOTES Fire Marshal FEES Burn Permit Fee Site Inspection Violation Fee State Fee Pre-Paid at Submittal Other EXPIRES: Date: Inspector TOTAL FEES Permit# MASON COUNTY BUILDING 111 426 W. CEDAR SHELTON, WASHINGTON 98584 (360) 427-9670 CORRECTION NOTICE Job Location �O /) • This structure has been inspected by Mason County Building Department and the following VIOLATION of County Laws and Ordinances has been found: Items listed below must be corrected to gain compliance aj , b"'e't Rxti� r�cwcv�s 60 S��,rc e� a /�� !%c,� S a 7-� Fx ©►� S, s Ck qrr . v�,;� LA / , 1 �2 k "t's. You are hereby notified that the above corrections shall be made BEFORE PROCEEDING WITH ANY FURTHER WORK ❑ Call for re-inspection when corrections are made before continuing ❑ Please contact our office ❑ Make corrections, items will be checked on next inspection regarding possible structural ❑ OK to damage incurred by recent "natural/man made" ❑This is not a complete inspection disasters.This is NOTa Date Department CORRECTION NOTICE. Inspector no NnT , ' imf-sV ' ' THIS T,,,rm * qr