HomeMy WebLinkAboutSPI2015-00002 - SPI Application - 1/2/2015 300 RECEIVED
JAN 12 2015 sPr zo t5 - aw
42fi �IID�EgAR�ST ACCEPTED BY 1U,-
PLANNING DEPT. PIVRIAE-INSPECTION APPLICATIO
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PLEASE PRINT $255.00 Fee Required
1. Site Address:Zo 81''\ 'f_A µuyt4 4 W/4, 96558
Owner: Applicant: f2EN7 WU LtA e
Owner Address: lele16/�IJ Lois P9IV6- Applicant Address:
City:'5'IwE12D19tC Sty* Zip q SUSS - Ya. City: St Zip
Phone: (3&0 )434'�. o 3 day . 4 - Phone: ( ) day
Phone: (U0 ) 1n92 -[0928 evening— Phone: ( ) evening
Email Address: 5ka1i6ce_cP9 , C 0VA Email Address:
2. Parcel #'s � 330� �'oob-� g - -
Legal Description: Lo T- /S, 14,4 yc-d L_,4Krr✓ VOL4- OF OAS,f�4e5 [31-136
3. Purpose of Pre-Inspection: To 15C 15uiL-T owl
C-X'ST7 Nc, Lo r
4. Use of building: 6A+eA('r AtL010&57-DjeA6,1f_-
5. Do any of the following exist on or adjacent to property?: slope (So saltwater ( lake ( river( )
pond ( ) wetland ( ) seasonal runoff( ) other ( ) stream O seasonal creek ( )
Directions to Site: 5 ys,-r 457T(fCs Ti4NuVfF Rive 2 >wK,5-Ig-1et6HT oAl
#AycAll WAV, --T,4y pQ 144V" WAX 148ouT2,Mi earAIM4 -1-D 1-h4VE,J 1-/4 sr4X /1,Ghlr
p rJ 144 vetj N)a y NC R. ABou-s ,Slut t om, 20 8 I /Vc-- / VEIN w taq W IL_L Bps o IJ T%e-ZirT'
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If the information is incomplete, then Mason County must disclaim any errors resulting from deficiencies in the original
application. Pre-inspection reports remain valid only until development changes occur in the vicinity, which affect the lot
evaluated in this inspection, or the laws regulating development of the site change after the time of inspection.
Applicant Signatures && Date:
if you would like to be on site during inspection,please check here: (✓l
Return application to: Department of Community Development, Planning Division
P.O. Box 279
Shelton, WA 98584
Please include a $255.00 check or money order payable to Mason County Treasurer.
MORE ON BACK SIDE
C:\Users\BLR-I.MAS\AppData\Local\Temp\XPgrpwise\2012 Planning Pre-Inspection.doc
Please illustrate below the proposed building site in relation to critical areas (slopes, streams, lakes, wetlands, etc.)
existing improvements, as well as property lines. APPLICATIONS SUBMITTED WITHOUT ADEQUATE
ILLUSTRATIONS WILL NOT BE ACCEPTED AND WILL BE RETURNED TO THE APPLICANT.
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Lo-r 9s83sq/ 97/ Departmental Review
(For Office Use Only) RECEIVED
JAN 12 2015
Planning Department Fi ding :
A26 W CEDAR . '.
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C:\Users\BLR—I.MAS\AppData\Local\Temp\XPgrpwise\2012 Planning Pre-Inspection.doc
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