HomeMy WebLinkAboutRLC - RLC Application - 11/9/1993 Date Received: I I
MASON COUNTY
DEPARTMENT OF COMMUNITY DEVELOPMENT am
RESOURCE LANDS AND CRITICAL AREAS CHECKLIST
The following checklist is designed to assist an applicant for a Building Permit, On-Site Sewage System Site
Evaluation and Disposal Permit, Access Permit, Land Modification Permit, Boundary Line Adjustments, Land
Segregations, Hazardous Waste Permit, or Shoreline Permit in determining whether their property is affected by
regulations under the Mason County Interim Resource Ordinance (77-93)'. This checklist is an important
opportunity for identifying early in the permit process whether there will be any environmental regulations affecting
the proposed development.
Owner 1ROEY= T f -;�HARpIv B04 CC Phone ttb^ )o^1�fS $�15D
Site Address fJt• In oymu 6611- city JiNli L311 A —zi-p-q-G-1599,_
Owner Address_ _20.50)( (659 City Ih' ELFft))2 State\NrAZip_99526
Tax Parcel No. (Confirm with Assessors Office) 22329 0001 O Legal Description_
29-23-2. 1Z. I of S-31I5O Eh of SWA W1z of SEA
Project Description_6INCTLE FAMILY t7WCLUNCr
Directions to site (Please attach map) p- Af jrlc x'�A_M Q
Please provide or attach a vicinity map which includes cross streets, major roads, creeks, etc.
Answer the following to the best of your knowledge. County-wide maps showing general locations of critical areas
ofr.wr and resource lands are available for review at Mason County Department of Community Development, Planning
u..oti,. Department.
Do any of the following exist on this property or within 200 feet of this property)
r.. N.
❑ [� 1. Saltwater shoreline or a lake 20 acres or larger) LA—''
H ❑ 2. Rivers,streams, or creeks with year-round flow)
LW
❑ Z 3. Rivers,streams or creeks with intermittent flow but are within a clearlf defined channel)
❑ EJ 4. Lakes or ponds less than 20 acres in size) "
❑ [Z 5. Wetlands: Areas that are inundated or saturated by surface water that under normal circumstances
support vegetation adapted for life in such conditions;such as marshes,bogs,and swamps.(See County
J Maps for guidance.) 1� ,\
❑ ["7 ❑ 6. Slopes greater than 15% (8.5 degrees)) (See the County Landslide and Erosion Hazard Maps for
guidance.) tv% pzv, i , /al�{7t,/7Y1 tv �[
❑ [0 7. Floodplainss? (See County,Federal Emergency Management Maps and /County Seismic Hazard Map
for guidance.) "
Q— ❑ d B. Seismic Hazard Areas? (See County Federal Emergency Management Maps and County Seismic
Hazard Map for guidance.) "
You may be provided nuisance protections by the County for certain resource activities. If you are enrolled in any
of the following programs:
Co Ye. N.
❑ M 1. Agricultural Open Space Taxation Program,RCW 84.33
j ❑ VCJ 2. Open Space Timber Taxation Program,RCW 84.33,or Designated Forest or Classified Forest,
RCW 84.34
Copies are available at Mason County Department of Community Development for$5.00 each.
Show following on the site plan
Lot Dimensions Flood Zones
Existing Structures En Fences
Structure Setbacks Driveways
Water Lines • Shorelines
Drainage Plan —-) — Topography
Septic Systems O•C Wells
Proposed Improvements Easements
Name of FlankingStreet EtEC-Mr- ■—•—• Indicate Directional by (N, S, E, W)
Name of Fronting Street FUTOF.E in in relation to plot plan
APPLICANT TO DRAW SITE PLAN BELOW
30
n+s mE�wM
g��f� I PRDDOCK. �
D11 CuLVeET CAU-% 1
SAS)?a
SKIVE WAY
J
R7cH`R BIssiN
c —
LANs I�RRKI hIb 1 WELL.
M ( ARENA NdjFICE
?ADDOCK ?n-foP-E t
0 C
�T
)MA '
arr
h BUttDIPt(r i �
'fCA fE (�tND - G.8-1 SYATIr L-ANV
APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW
�LAI
v
45°° 5rro� t° cuur�xT _ f^ 1
�r:aTcE �----� GuLVEI�T �
*_ _ � S t,o t�E
foica Off �-LKT '� j .
t GJ 612T
hk&Z f I ,I GENTLE i ?
AMW tf69T OF
AaluX w�NG FLAT 15 t 3"5 , /
lY Lew j
� C
�j i Tir LA K D
RESOURCE LANDS & CRITICAL AREAS
SITE PLAN
PLEASE SHOW THE FOLLOWING INFORMATION OR PROVIDE SURVEY MAP IF POSSIBLE:
• Location&dimensions of existing&proposed property boundaries. .Approtdmate slope of land(grade&direction),topography.
"Identify legal accent including,width of all road right-of-ways&easements. . Location of significant natural features(water bodies,rivers).
. Locate all existing&proposed structures,drainfields,wells&driveways. . Project description
Scale t"= NEW C4N5T2UCTI6N: I] North Arrow
WEU/M/^TER.:6
WATEP FLOW: —i——i Fu1fOzE REMOVAL:
C ft'PC(-X0JFbT(JRE DEVELOPMENT:
ZJ'�65 ELEGTI21 119 (MgMntle IN sAME vvT,*i)
r 001 —�— I -
fIENCIUD
T o 1 �AKt.I r o 2° \ y 11
17RJHWAY CUL
� 1, N
_ _ 6tEcrRu s
Yi+RKI NEr WELL,
i=LAT t 1
J
I RI�InIcr , 30 !1
tT�Qi►tsro � —1 p ? p� RR�p ) 1 , C�NT1.�`/ �� �t r
? 0 SwPE
/rkr>urac FRa►tT 1 5
oF-rle/tILiFf- FLP T si l 3 t
WI PVC PI Pe
1 LOW
5(087 0 � '
1 statueNo,,have answered e�a�bno�Ive trtruthfully to the best of my knowledge.
Applicant/Owner I-T�1J Date
FOR OFFICIAL USE ONLY
Adjacent property.
Aea Al��- ;'o t6e'�I�
fix w6c,,ld`n [I'sinq Gotny llg4yrt:6 4arlr Map>f;this}7lAperty fs d®57+ nated
rz#.7.'ai � '�"'` £��yc
r ��� �,� r�g�oC Cor>irsrcSat forest x a 4, Shoreline Master'Program
ol�ding
., Q'"r?§� �9 .a+> ,z � mac' ,.+ c ♦ �
There is a $40.00 application fee for the Resource Land& Critical Areas Checklist. Make checks payable to the Mason
County Treasurer.
When completed,this form becomes part of the permit application.