HomeMy WebLinkAboutMEP Replace Floats and Pilings - MEP Application - 4/25/2007 PERMIT NO.:
DATE RECEIVED:
MASON COUNTY
DEPARTMENT OF COMMUNITY DEVELOPMENT
RESOURCE ORDINANCE (Chapter 17.01 MCC)
411 N. 5TH Street/P.O. Box 279, Shelton, WA 98584
ENVIRONMENTAL PERMIT APPLICATION
MASON ENVIRONMENTAL PERMIT)( CONDITIONAL USE ❑
The purpose of the Resource Ordinance is to protect Mason County's natural resource lands and critical
areas and is under the authority of Chapters 36.32, 36.70A, 39.34, 58.17, 76.09,`84.33, 84.34 and 90.58
RCW.
PLEASE PRINT
1 Owner: N Of1 r t l of VUY I U`I`� Owner Mailing Address:
dba HToa Canal IMArma A�5au SE V4'3- Plow Sulu �10
Site Address:
5101 E. Mk E n u� I b U City: I S S a U a h State: W I+_Zip:IM9 I
City: u h l b h State ZiA S4kien/Title Holder
Phone: Daytime( Y lJ
Address:
Fire District#:
%o T�r�, s/Jo� rti C L State: Zip:
r� ,
Signature:
2. Parcel Number: 3�Z3 a - 5O 040�I Legal description: I L40LA P1 �tp LI-1 p
Parcel Size: union Nhod (anal [Ana ` IMP CO Bit * I Lots
1-4 Tail a w Ex� Ta>< l 31DB Cx-8-1 .
3. Directions to site:
Turn I&E er1�b N Imo'' St roud rtarvt,[ ehAVIMJ n NO�YYIc,11F1 Rd , I Un fhavtAct to 9"CrAd LE ed,
turn aff h thttl On RwKdaLt IZd, bear ri40L onli rMt1N4 Ed, morn ri hl {-per on mcUattla,
}urn ItWh (> 10on RILIZ aVu Vd, on riyhi- inFo E. S1Ak QOuk IOU. ►trove e 5101 e. $)-a+c Rou1-cIOU .
State what sections require a permit: In-Holding Lands,Chapter 17.01.062 ❑
4. Long-Term Commercial Forest,Chapter 17.10.060 ❑ Wetlands,Chapter 17.01.070 ❑
Mineral Resource Lands,Chapter 17.01.066 ❑ Frequently Flooded Areas,Chapter 17.01.090 ❑
Aquifer Recharge Areas, Chapter 17.01.080 ❑ Landslide Hazard Areas, Chapter 17.01.100 ❑
Erosion Hazard Areas,Chapter 17.01.104 ❑ Seismic Hazard Areas,Chapter 17.01.102 ❑
Fish and Wildlife Habitat Conservation Areas,Chapter 17.01.1 10 0
5.
Id ntify current use of$$roperty with existing improvements:
ljyvint—LA t Qt �wnt ht�s (dYl �,�Ifl'lYlu MAY111q DLtIWr VIG1 and nrlya�e
1
6.
Identify and describe the proposed project,including the type of materials to be used,construction methods,principle
dimensions and other pertinent information(Att ch additional sheets if 5 d
rtanhilarf
nVIA need d): I � l't 1'1 r
31 V1110A. v ►
4
7. Will there bean alteration of a wetland and/or wetland vegetation area? Yes ❑ No)K
g, Any water on or adjacent to property:
Saltwater A Lake ❑ River ❑ Pond ❑ Wetland ❑ Seasonal Runoff ❑
Other
9. If septic is located on project site,include records.
Connect to septic?A Community Septic? ❑ Public Water Supply? ❑ Well? ❑
10.
Type of Job: New ❑ Add ❑ Alt Re air Demolition ❑ Other
This permit is granted pursuant to the Resource Ordinance (Chapter 17.01 MCC)and nothing in this permit
shall excuse the applicant from compliance with any other federal, state, or local statutes, ordinances, or
regulations applicable to this project, but not inconsistent with the Resource Ordinance. The permit may be
rescinded pursuant to the event the permittee fails to comply with the conditions of this ordinance.
MASON ENVIRONMENTAL PERMIT: $560.00/$335.00(with another permit)
MASON CONDITIONAL USE ENVIR.PERMIT: $1,350.00
HABITAT MANAGEMENT PLAN: $395.00
I:\PLANNING\C&R\ENV IRONMENTAL REVISED 01-16-07
MASON COUNTY RESOURCE ORDINANCE. July 2003
LIST OF ADJACENT PROPERTY OWNERS
WITHIN 300 FEET OF YOUR PROPERTY BOUNDARIES
FOR CONDITIONAL USE AND VARIANCE
Addresses are to be obtained from the Mason County Assessor's Office, Bldg. 1, Second Floor.
S� C 'A [U .
'1�aoo'7 0000 8
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MASON COUNTY RESOURCE ORDINANCE July 2003 '
Publication cost is the responsibility of the applicant. Final permit processing will not occur until
advertising fees have been paid to the newspaper by the applicant. The Shelton-Mason County Journal
will bill the applicant directly.
I /WE understand that I / WE must sign and date the attached acknowledgment indicating and that I /
WE understand that is MY / OUR responsibility. I /WE must submit the signed page as part of
application in order for it to be considered as complete.
DATE �t r
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OWNER
U �r VVIC(r 0
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Show the following on the site plan
Lot Dimensions Flood Zones
Existing Structures Fences
Water Lines Driveways
Drainage Plans Shorelines
Septic System Topography Indicate Directional by(N,S,E,W,etc.)
Proposed Improvements Easements In relation to plot plan
Name if Flanking Street
APPLICANT TO DRAW SITE PLAN BELOW:
APPLICANT TO DRAW TOPOGRAPHY BELOW: