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Home My WebLink AboutGRD2024-00002 - GRD Application - 2/26/2024 e� COUP, MASON COUNTY PERMIT NO. ,2e od4jl— DEPARTMENT OF COMMUNITY DEVELOPMENT oOcc R, BUILDING•PLANNING•FIRE MARSHAL WWW.CO.MASON.WA.US ))427-9670 So� I� /C D y Mason County Bldg. 8, 275�467 B V G 1854 615 W.Alder Street,Shelton,WA llnwo..� )482-5269 Elma ext.352 LAND MODIFICATION PERMIT (Grading Permit) FEB 2 6 2024 OWNER INFORMATION: CONTRACTOR INF0RM!1+ NAME:Housing Kitsap NAME:TBD MAILING ADDRESS:2244 NW Bucklin Hill Road MAILING ADDRESS: CITY:Silverdale STATE:WA ZIP:98383 CITY: STATE: ZIP: PHONE:360-535-6100 CELL: PHONE: CELL: EMAIL:mild@housingkitsap.org EMAIL : L&I REG# EXP. PARCEL INFORMATION: PARCEL NUMBER(12 DIGIT NUMBER) 122205800021 FIRE DISTRICT Mason County#5 LEGAL DESCRIPTION(ABBREVIATED) :Section 20,Township 22 North,Range 1 West,Mason County,Washington. SITE ADDRESS No Address CITY Allyn DIRECTIONS TO SITE ADDRESS Parcel is NW of 221 E Wheelwright Street North. IS PROPERTY WITHIN 200 FT: SALTWATER❑ LAKE❑ RIVER/CREEK❑ POND ❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑ DOES PROPERTY HAVE SLOPE(S)WITHIN 300 FT OF THE PROJECT-GREATER THAN 14% YES❑✓ NO❑ WILL TIMBER BE CUT AND SOLD IN PARCEL PREPARATION? YES ❑ NO(] TYPE OF JOB: EXCAVATION ❑ FILLING [I GRADING(] CUTTING ❑ OTHER ❑ TOTAL SIZE OF PARCEL 2.03 ACRES/SQ FT SIZE OF AREA TO BE EFFECTED 2.03 ACRES/SQ FT ESTIMATED AMOUNTY OF CUBIC YARDS approx 2250 cut 5650 fill DOES THE SITE HAVE SLOPES 14%OR GREATER YES(] NO[] DESCRIBE SCOPE OF WORK Housing Kitsap is proposing to short plat an existing approximately 2.1 acre lot into 9 residential lots. WILL FILL BE BROUGHT ON SITE? IF YES,SITE ADDRESS:yes,fill brought in from an approved site TBD WILL EXCAVATED MATERIAL BE TAKEN OFF SITE?IF YES,SITE ADDRESS: no DOES FILL CONTAIN POTENTIAL HAZARDOUS MATERIALS? YES❑ NO 0 HAS A SOILS REPORT BEEN COMPLETED ON SITE?IF YES,INCLUDE A COPY. YES 0 NO❑ WILL PROPSAL RESULT IN REDIRECTION OF ANY SURFACE WWATER RUNOFF? YES❑ NO 0 WILL WORK ALTER WHERE STORMWATER OF GROUND WATER ENTERS OR EXISTS THE SITE? YES❑ NO❑r WILL QUALITY,QUANTITY OR VELOCITY OF STORM/GROUND WATER BE ALTERED? YES 0 NO❑ WILL THE RUNOFF BE COLLETED/CONTROLLED BY INTERCEPTORS,CURTAIN DRAINS OR OTHER DEVICES? YES NO❑ WILL THE LAND BE REPLANTED UPON COMPLETION? YES 0 NO❑ WILL THE PROPOSAL RESULT IN SLOPES STEEPER THAN THOSE CURRENTLY ON SITE? YES NO❑ IS THE SITE WITHIN 200 FT OF A DESIGNATED SHORELINE OR A WETLAND? YES❑ NO 0 OWNER/BUILDER 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 contractor. I further declare that I am entitled to receive this permit and to do the work as proposed. I have obtained permission from all the necessary parties, including any easement holder or parties of interest regarding this project.The owner or authorized agent represents that the information provided is accurate and grants employees of Mason County access to the above described property and structure(s)for review and inspection.This permit/application becomes null&void if work or authorized construction is not commenced within 180 days or if construction work is suspended for a period of 180 days. PROOF OF CONTINUATION OF WORK IS BY MEANS OF INSPECTION.INACTIVITY OF THIS PERMIT APPLICATION OF 180 DAYS W INV AL'Iq T�THE APPLICATION. X c7�� Signature of Applicant Date X OWNER/REPRESENTATIVE/CONTRACTOR Print Name �j (CIRCLE TO INDICATE) 0�N CoU� �A MASON COUNTY PERMIT NO. --f as y- DEPARTMENT OF COMMUNITY DEVELOPMENV co CC R, BUILDING•PLANNING•FIRE MARSHAL WWW.CO.MASON.WA.US `•`� 427-9670 ShePh 3 F I V E D Mason County Bldg. 8, (360)275-4467 Belfair .exrf. 352 1854 615 W.Alder Street, Shelton,WA 9858 �P (360)482-5269 Elma ext. 352 FEB 2 6 2024 LAND MODIFICATION PERMIT (Grading Permit OWNER INFORMATION: CONTRACTOR INFORMATION: NAME:Housing Kitsap NAME:TBD MAILING ADDRESS:2244 NW Bucklin Hill Road MAILING ADDRESS: CITY:Silverdale STATE:wA ZIP:96363 CITY: STATE: ZIP: PHONE:360-535-6100 CELL: PHONE: CELL: EMAIL:naild@housingkitsap.org EMAIL : L&I REG# EXP. PARCEL INFORMATION: PARCEL NUMBER(12 DIGIT NUMBER) 122205800021 FIRE DISTRICT Mason County#5 LEGAL DESCRIPTION(ABBREVIATED) :Section 20,Township 22 North,Range 1 West,Mason County,Washington. SITE ADDRESS No Address CITY Allyn DIRECTIONS TO SITE ADDRESS Parcel is NW of 221 E Wheelwright Street North. IS PROPERTY WITHIN 200 FT: SALTWATER❑ LAKE❑ RIVER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑ DOES PROPERTY HAVE SLOPE(S)WITHIN 300 FT OF THE PROJECT-GREATER THAN 14% YESQ NO❑ WILL TIMBER BE CUT AND SOLD IN PARCEL PREPARATION? YES ❑ NO 0 TYPE OF JOB: EXCAVATION ❑ FILLING ❑ GRADING Q CUTTING ❑ OTHER ❑ TOTAL SIZE OF PARCEL 2.03 ACRES/SQ FT SIZE OF AREA TO BE EFFECTED 2.03 ACRES/SQ FT ESTIMATED AMOUNTY OF CUBIC YARDS approx 2250 cut 5650 fill DOES THE SITE HAVE SLOPES 14%OR GREATER YESQ NO[] DESCRIBE SCOPE OF WORK HousingKitsa is proposing to short plat an existing approximately 2.1 acre lot into 9 residential lots. P� P P 9 P 9 PP Y WILL FILL BE BROUGHT ON SITE? IF YES, SITE ADDRESS:yes,fill brought in from an approved site TBD WILL EXCAVATED MATERIAL BE TAKEN OFF SITE?IF YES,SITE ADDRESS: no DOES FILL CONTAIN POTENTIAL HAZARDOUS MATERIALS? YES❑ NO 0 HAS A SOILS REPORT BEEN COMPLETED ON SITE?IF YES,INCLUDE A COPY. YES Q NO❑ WILL PROPSAL RESULT IN REDIRECTION OF ANY SURFACE WWATER RUNOFF? YES[I NO E] WILL WORK ALTER WHERE STORMWATER OF GROUND WATER ENTERS OR EXISTS THE SITE? YES❑ NO 0 WILL QUALITY,QUANTITY OR VELOCITY OF STORM/GROUND WATER BE ALTERED? YES 0 NO[] WILL THE RUNOFF BE COLLETED/CONTROLLED BY INTERCEPTORS,CURTAIN DRAINS OR OTHER DEVICES? YES 0 NO❑ WILL THE LAND BE REPLANTED UPON COMPLETION? YES 0 NO❑ WILL THE PROPOSAL RESULT IN SLOPES STEEPER THAN THOSE CURRENTLY ON SITE? YES NO❑ IS THE SITE WITHIN 200 FT OF A DESIGNATED SHORELINE OR A WETLAND? YES ❑ NO 0 OWNER/BUILDER 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 contractor. I further declare that I am entitled to receive this permit and to do the work as proposed. I have obtained permission from all the necessary parties, including any easement holder or parties of interest regarding this project.The owner or authorized agent represents that the information provided is accurate and grants employees of Mason County access to the above described property and structure(s)for review and inspection.This permit/application becomes null&void if work or authorized construction is not commenced within 180 days or if construction work is suspended for a period of 180 days. PROOF OF CONTINUATION OF WORK IS BY MEANS OF INSPECTION.INACTIVITY OF THIS PERMIT APPLICATION OF 180 DAYS WILL INVALIDATE THE APPLICATION. X Signature of Applicant Date X OWNER/REPRESENTATIVE/CONTRACTOR Print Name (CIRCLE TO INDICATE) -7"U�e J rind -fie i