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HomeMy WebLinkAboutBLD2024-00189 - BLD CD Environmental Health Review - 3/5/2025 MASON COUNTY Permit ND: IJ l d a[ AY7-0015 q COMMUNITY DEVELOPMENT Permit Assistance Centel BUHd1n&Planning BUILDING PERMIT APPLICATION PROPERTY OWNER @IFORMATION: CONTRACTOR ME IVFORMATION: NA :F DD I"k &I NAME: MAILING ADDRES9: to i4L , dg,4 F/ MAILING ADDRESS: CITY:_4JI..A. STATE:y[g,ZIP:47su1 CITY: STATE:_ZIP: PHONENI: T/PI PHONE: CELL: PRONE M2: EMAIL: g EMAIL' L&1 REGN CO ESP._/_I PRRMARYCONTACT: OWNER NTRACTOR[ oriviaD (DO NAME EMAIL MAILING ADDRESS -CITY-STATE-MP PHONE CELL PARCEL INFORMATION: ////qq PARCELNUMHER(12Mgit Nwvber) Lo ZOMNG RJC LEGAL DESCR[PTION(Abbrzvi+ted)1,M - ot"AA4 OOy FDtEDISIRICP IZ SORADDRESs lel LJ !}0 'R1'}OMC. QA CITY fIidid DISEC110NS TO SITE ADDRESS ISTR MWECFWITRE'130PFTOFSLOPE(S)GREATERTRMI14%: YESO NOIT SNOWLOAD» M PROPERTY WI'I'HD02 FT OP TIE:FOL WONG: !c/dmAvppy): SALTWATEII❑ LAKE[I RIVEP✓CREEK POND[ WETLAND❑ SEASSONAL RUNOFF❑ STREAM❑ TYPEOFWORR: HEw* ADDIDONO ALTERATIOND REPAm[ oTEERn USE OF STRUCTURE(xvuva cwS..c�aae Fz) � BOMf��/-IDS TSUSE: PRIINARY[ SEASONAL❑ NUMBER OF BEDROOMS_NUMBER OF BATHROOMS_ HEATEDSTRUCTURE? YFS/xweedy❑ YES( 11 91,00 NO� DESCRIBE WORK - SQUARE FOOTAGE:Laa ISTFLOOR p.R 2NDFLCOR sq.& 3RDFLO3R N. RASEMENT eq.R DECK N.R COVERED DECK N.R STORAGE __N.@ OTHER N.iL GE � q.H. Allached[] T Wm it CARPORT N.R A 13 Def Wll MANUFACTURED HOME INFORMATION: F TIIE FLOOR Un". YEAR LENGTH WBYCH BATHS SERW.NIJMBER ENVIRONMENTAL HEALTH: SEWAGE/SEWER SOURCE: SEPTIC SEWER / NEWD MMNQT ( PLUMBMG Dq STRUCTURE? YES[ NOX 1f v.aaoch ro.,i.,d.A&e Forty PERBAETERROUNDATIO SPROPOSEM YPS❑ OD MWING%FT EKISTDJG BEDROOMS PROPOSEDBEDROOMS TOTALBEDROOMS OWXER eri.naMetleee tlBl9u bn tlinxvuNalNaniyb�nby AMtl lnasWpxvk adera penntl revcmCm.POnmNeEgameN MSUMbq' BpMNre[eIw.I EOWRtliBtlan Ne wmef BMl NMIrEYLRtlIB11 Yn M1itlalb MlW Nc pe�mrtend la CO Ne x-uk%pcFwN.ItbM ' dpeb�4ermistim flan aII1M acwwry VaRm.6rJ�W9�1'ennnw�l M.baCardmaf vMecl rega,Ni9 We GNau llie camera Ipal i�neMa�we.reP'e%�M%bwi Neiitanatim poA]NeaauOe stl Oan6a�tlpantlM nCantY aaasc to Ne a4xet 0eunCaL q^D�Y wtl ahurlure(s)lwmiew aM W W�1Nm. Ms Fe^^NeVW'r2tlm Cavnvc nW 6 wil ilwcrk a aNM rtW mm0ucti�n b mfminiertu]MNn I!0 Eys a!anehucWn wk k wspxtlM Me pncd tl 16]gays. PROOF OF CONTINUATION OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS PERMIT APPLICATION OF IN DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EKPIREO.(MASON K 4 A,� COUNTYCODE16.08.42) �� Sgnewre ofDWNE t DaM DEPARTMENTAL REVIEW APPROVED DATE I DENIED I DATE TAGS NOTESrCONDITIONS BUDDING DEPARTMENT PLANNING DEPARTMENT FEtE MARSHAL e PUBLIC HEALTHAlaA F� Z mzm _- 2` © , a q, t 9 m!« _ ; § ug • '� , jig Ell : ° . wRp § B / { � , � , � !■!� ° z , § \\ !), { \{ CL a _,