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Home My WebLink AboutGRD2020-00011 - GRD Application - 7/13/2021 Name� lJf W Parcel# Mason County BUILDING Department of Community Development Small Parcel Stormwater Management Application/Worksheet (page 1 of 2) Per Mason County Code, Title 14,Chapter 14.48 a stormwater site plan is required whenever a building application is made for residential development,or redevelopment', with more than 2,000 square feet of impervious surface 2. 'Redevelopment means,on an already developed site,the creation or addition of impervious surfaces,structural development including construction, installation or expansion of a building or other structure,and/or replacement of impervious surface that is not part of a routine maintenance activity,and land disturbing activities associated with structural or impervious redevelopment. 2Common impervious surfaces include,but are not limited to,rooftops,walkways,patios,driveways,parking lots or storage areas, concrete or asphalt paving,gravel roads,packed earthen materials,and oiled,macadam or other surfaces which similarly impede the natural infiltration of stormwater.Open,uncovered retention/detention facilities shall not be considered as impervious surfaces. To Calculate Impervious Surfaces Please Complete This Table Surface Type Length X Width = Area *All dimensions in feet Buildings X House X = 31024 Measurements for buildings are taken at the Covered Porches(House) X = 2,016 perimeter of the farthest projections (example: eaves/gutters) Shed w/2'Overh ngs X = 448 Driveways 1,200 X 12 = 14,400 X = Length of drive begins at the right of way X = Parking Areas X X = Any paved, gravel or packed area per definition above table X = Patios/V1lalks X = X = Any paved, gravel or packed area per definition above table X = Others X X = If the total impervious area of the proposed site X = development is greater than 2000 square feet a Small Parcel Stormwater Site Plan is Required Total Impervious Surface Area(sum of all areas) 19,888 If the Total Impervious Surface Area is LESS THAN 2000 Square Feet,please read,acknowledge and sign below. Based Upon the information you have provided a Stormwater Site Plan IS NOT required for this development activity. Owner/Builder/Agent Acknowledges that 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,owner's legal representative,or the contractor.I further acknowledge that the information provided is accurate and employees of Mason County are granted access to the above- described property for review and inspection as may be required. X Owner/Agent/Contractor(circle one)Date If the Total Impervious Surface Area is GREATER THAN 2000 Square Feet,please ie ZZ vJIVIIV sign the information provided on page 2 of 2. Page 1 of 2 NOV 18 20Z0 615 reef Name Parcel# BLD# Mason County Department of Community Development Small Parcel Stormwater Management Application/Worksheet (page 2 of 2) Based Upon the information you have provided a Stormwater Site Plan IS Required for this development activity. Title 14,Chapter 14.48 of the Mason County Code(MCC)regulates compliance requirements for Stormwater Management in this jurisdiction.A complete copy of the ordinance can be found on the Mason County website: http//www.co.mason.wa—us/code/commissioners/index.htm Please follow the links to "Title 14, Chapter 14.48 Stormwater Management". Regulated activities shall be conducted only after Mason County Public Works approves a stormwater site plan (Mason County Code Title 14 Chapter 14.48 section 14.48.70). You will receive a copy of the Public Works document entitled"Managing Storm Drainage on Small Lots, The Small Parcel Stormwater Site Plan". This document will assist you in preparing the necessary information and plans for Public Works to review and approve. Per Department of Public Works this document will constitute an approved plan if all of the relevant details* are to be installed in their entirety AND no part of the stormwater system adversely affects any septic system (see Environmental Health information below). If an alternative system is to be used a plan will need to be submitted to Public Works for approval. A design by a registered professional may be required for more complex sites. *These details are found in the document Managing Storm Drainage on Small Lots, The Small Parcel Stormwater Site Plan on the pages that begin with"Handout" PLEASE INITIAL BELOW TO INDICATE THE STORMWATER MANAGEMENT PLAN FOR THIS SITE A) The relevant details from Managing Storm Drainage on Small Lots, The Small Parcel Stormwater Site Plan will be installed in their entirety AND the system will be located as not to adversely affect any septic systems on this,or any other,parcel. B) X An alternative plan and/or professional design will be submitted to the Department of Public Works for approval AND the system will be located as not to adversely affect any septic systems on this,or any other,parcel. If you have further questions pertaining to parcel drainage and stormwater management Mason County's Public Works Department can provide additional instructions,guidance and examples.(Section 14.48.130)contact Public works at: Phone: (360)-427-9670 EXT. 450 Mail: P 0 Box 1850, Shelton WA 98584 Physical: 415 N 6th St, Shelton WA 98584 If this development has,or will have,a septic/drainfield system you may need to contact Mason County Division of Environmental Health to ensure that the stormwater system will not adversely affect the septic system of this,or any other,parcel. You may also wish to consult with the septic design professional involved with the project. Mason County Division of Environmental Health can be reached at: Phone: (360)-427-9670 EXT. 352 Mail: P 0 Box 1666,Shelton WA 98584 Physical: 426 W Cedar St, Shelton WA 98584 A condition will be added to the building permit that states, in part,that all conditions the stormwater site plan will be met prior to a request for final inspection of the building permit. Owner/Builder/Agent Acknowledges that 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,owner's legal representative,or the contractor. I further acknowledge that the information provided is accurate and employees of Mason County are granted access to the above- described property for review and inspection as may be required. X Owner/Agent/Contractor(circle one)Date: Page 2 of 2 12/24/2020 MC3.jpg GrQlk_ bobfl MASON COUNTY PERMIT NO._ DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING•PLANNING•FIRE MARSHAL WWW.CO.MASON.WA.US (360)427-9670 Shelton ext.352 Mason County Bldg.8, (360)275-4467 Belfair ext.352 ra;r 615 W.Alder Street,Shelton,WA 98584 (360)482-5269 Elma ext.352 1 6' ��/ LAND MODIFICATION PERMIT (Grading Permit) -qj <V �! OWNER INFORMATION: CONTRACTOR INFORMATION: irks ir •pe NAME: 6 ftK '` ei►.M Sb&Vo NAME: el` MAILINGLADDRESS: `f f1 rur_"L.:��i L:-�c MAILING ADDRESS: CITY: Wsk _STATE: Iid-� ZIP: `1O CITY: STATE: ZIP: PHONE: CELL: ;l:c in '22A PHONE: CELL: EMAIL: b;;.,r c r. mu\ . C;,n EMAIL: 1111111111111k a a. ING�% c.n.5. +LFjvt t o t,� . Co r,., L&I REG# E PARCEL INFORMATION: PARCEL NUMBER(12 DIGIT NUMBER) Z�Z-k -Ly -"c cc.� �Cc'' � 'c t+L FIRE DISTRICT LEGAL DESCRIPTION(ABBREVIATED): %.:t L. kc- AL Irl., ZZ 9•1 SITE ADDRESS U R0 CITY Oi„ont wr• DIRECTIONS TO SITE ADDRESS 4 k-L-c IS PROPERTY WITHIN 200 FT: SALTWATER N LAKE❑ RIVER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAMA DOES PROPERTY HAVE SLOPE(S)WITHIN 300 FT OF THE PROTECT-GREATER THAN 14% YES(8 NO❑ WILL TIMBER BE CUT AND SOLD IN PARCEL PREPARATION? YES❑ NO N TYPE OF JOB: EXCAVATION N FILLING ® GRADING 2 CUTTING 2 OTHER ❑ TOTAL SIZE OF PARCEL HL) 5 l ACRES/SQ FT SIZE OF AREA TO BE EFFECTED ACRES/SQ FT ESTIMATED AMOUNTY OF CUBIC YARDS -iW IJ DOES THE SITE HAVE SLOPES/1 4%OR GREATER YESg NO[] DESCRIBE SCOPE OF WORK l'wit.ux -L);,kau Q S It, I'r0 : C� ^ 1}:z,. .. 1( a rT ��2Kn� mXI h..4'•f•+. -sA* oa %'l `,. i.i\'\ I1 rz l" . 5b:..w �c' 4 i WILL FILL BE BROUGHT ON SITE? IF YES,SITE ADDRESS:JIA WILL EXCAVATED MATERIAL BE TAKEN OFF SITE?IF YES,SITE ADDRESS: DOES FILL CONTAIN POTENTIAL HAZARDOUS MATERIALS? YES❑ NO HAS A SOILS REPORT BEEN COMPLETED ON SITE?IF YES,INCLUDE A COPY.(-,:az. YESg NO❑ WILL PROPSAL RESULT IN REDIRECTION OF ANY SURFACE WWATER RUNOFF? YES IR NO❑ WILL WORK ALTER WHERE STORMWATER OF GROUND WATER ENTERS OR EXISTS THE SITE? YES X NO❑ WILL QUALITY,QUANTITY OR VELOCITY OF STORM/GROUND WATER BE ALTERED? YES❑ NOW WILL THE RUNOFF BE COLLETED/CONTROLLED BY INTERCEPTORS,CURTAIN DRAINS OR OTHER DEVICES? YESR NO❑ WILL THE LAND BE REPLANTED UPON COMPLETION? YES N NO❑ WILL THE PROPOSAL RESULT IN SLOPES STEEPER THAN THOSE CURRENTLY ON SITE? YES❑ NO g IS THE SITE WITHIN 200 FT OF A DESIGNATED SHORELINE OR A WETLAND? n0i %i•;,L 5" YES❑ NO 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 1 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-aee te and grants employees of Mason County access to the above described property and structure(s)for review and inaction.This�prmlt/appfication becomes null&void if work or authorized construction is not commenced within 180 days or if struction wo suspended for a period of 180 days.PROOF OF CONTINUATION OF WORK IS BY MEANS OF INSPE TI THIS PERMIT APPLICATION OF 180 DAYS WILL INVALIDATE THE APPLICATION. X / 2�20 Signal f Applicant e X - . a OWNE /REPRESENTATIVE/CONTRACTOR Print Name (CIRCLE TO INDICATE) Zo l Z.o Z 1 1� https://mail.google.com/mail/u/O/#inbox?projector--1 1/1