HomeMy WebLinkAboutSPI2011-00062 - SPI Application - 12/2/2011 MASON COUNTY
PLANNING DEPT. PRE-INSPECTION APPLICATION
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1.
14 4`14 Owner: �1�1�y rj�N kz!5W� ") Applicant: 5A14Ik A tZl�
Site Address: f �j'T , o�� Applicant Address: _ ,
Owner,/lddress: Z.37�i �1 �le�2,� c,g)ei City: St Zip
City: f` O� St lcl/a Zip '7 ' Phone:( &OJ 2_7 ,�
Phone:(3<d) 672 - i�77 `>' day
«c -Phone:(3f;o Y7! — 7 ;' evening Plante
Email Address: go ci-iv d SMP UI�� C TOR
Pla Typ of Use
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2. Parcel No. ���7/� - �� - CSOC� 3
Parcel No. - -
Legal Description: G►Jcork-i 4:�4r(' 3
3. Purppse of Pre-Inspection : � "IE✓t/ti
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4. Use of building: lX�9k /'� G�� �'��r'G� w liJly ���a.� ✓�e/�
5. Do any of the following exist on or adjacent to property?: slope( saltwater( lake river
pond( ) wetland seasonal runoff( other( stream seasonal creek
Dir tions to Site:
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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: l7— /
Ifyou would like to be on site during inspection,please check here:
Return application to: Department of Community Development, Planning Division
P.O. Box 186
Shelton, WA 98584
(360)427-9670
Please include a$255 .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:
MORE ON BACK SIDE
Revised: 12/30/08
Please illustrate below the proposed building site in relation to critical areas(slopes, streams, lakes, wetlands,etc.)
existing improvements, as well as property lines. APPLICATIONS SUBMITTED WITHOUT ADEQUATE
ILUSTRATIONS WILL NOT BE ACCEPTED AND WILL BE RETURNED TO THE APPLICANT.
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Departmental Review
(For Office Use Only)
Planning Department Findin s:
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