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Home My WebLink AboutBLD2004-00670 • • MANUFACTURED/MOBILE HOME INSTALLATION PERMIT Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 360 379-4450 FAX 360 379-4451 PERMIT#: BLD04-00670 SITE ADDRESS: 91 COREY LN Received Date: 10/21/2004 BRINNON, 98320 Issue Date: 5/25/2005 APPLICANT: LINDA EYRE PO BOX 335 BRINNON WA 98320-0335 SUBDIVISION: COREY SHORT PLAT Block: Lot: 2 PARCEL#: 941700325 Section: 2 Township: 25 N Range: 02 W CONTRACTOR/ OWNER/BUILDER DEALER PHONE: PROJECT DESCRIPTION: NEW MFH MAKE: MARLETTE YEAR: 1972 SIZE: 60 X 24 THIS PERMIT IS VALID FOR ONE YEAR. THE FINAL INSPECTION MUST BE SCHEDULED AND PASSED WITHIN THAT YEAR. THE EXPIRATION DATE IS 5/25/2006. CALL IN FOR THE REQUIRED INSPECTIONS THAT APPLY TO YOUR PROJECT. Setbacks/Footing (CONTINUOUS FOOTING, SLAB or PADS USED): Stormwater FINAL Approval: Blocking/Plumbing: Propane Tank/Lines • Zofling Final Approval: Septic System Final Approval (If not on sewer): Road Approach Final Approval: Final/Skirting/Vents/Porches/Steps: .5-" 30 66 HEA•LTH DEPARTMENT AND PUBLIC WORKS APPROVAL REQUIRED PRIOR TO FINAL INSPECTION THIS PERMIT IS VALID FOR ONE YEAR OR IT MUST BE PROPERLY RENEWED BUILDING INSPECTION HOT-LINE 379-4455. CALL 24 HOURS IN ADVANCE TO SCHEDULE INSPECTIONS. Office Hours 9:00 a.m. -4:30 p.m. HOT-LINE AVAILABLE 24 HOURS A DAY SPECIAL CONDITIONS APPLY- SEE REVERSE • • MLA04-00609 Review Type: MANUFACTURED/ MOBILE HOME INSTALLATION APPLICATION Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 RADMITDRE#:SS: BLD04-00670 91 COREY LN Received Date: 10/21/2004 E BRINNON, 98320 PLICANT: LINDA EYRE PHONE: (360) 796-4558 PO BOX 335 BRINNON WA 98320-0335 IBDIVISION: COREY SHORT PLAT Block: Lot: 2 ,RCEL NUMBER: 941700325 Section: 2 Township: 25 N Range: 02 W )NTRACTOR/ OWNER/BUILDER PHONE: EALER: .EPRESENTATIVE: PHONE: 'ROJECT DESCRIPTION: NEW MFH -YPE OF WORK MOB MANUFACTURED HOME: SHORELINE: TYPE OF IMP NEW MAKE: MARLETTE SETBACK: ✓ALUATION YEAR: 1972 LABOR & INDUSTRIES APPROVAL? SIZE: 60 X 24 BANK HEIGHT: SEWAGE DISPOSAL: CON WATER SYSTEM: PWELL BEDROOMS: BATHROOMS: PARCEL TAGS: YES NO Exist: Exist: STORMWATER: YES NO Prop: 1 Prop: 2 AREA Plat Conditions Total: 1 Total: 2 Welland Erosion Seismic Streams Flood Way Floodplain Routing Date: /O f a ce 6lt' V F&W Landslide Shoreline Aquifer Type Amount Paid Bv: Date: Receipt: `,E V Manufactured Homes $154.00 KAS 10/21/04 67885 AP V Potable Water Application $52.00 KAS 10/21/04 67885 MAY 2 5 2005 Total: $206.00 4Jtt ers n ounty Planning lea, s JE RSON COUNTY ASSESSOR JACK WESTERMia III II !,. ) cRSONCOUNTYCOURTHOUSE ASSESSOR I PO BOX 1220, PORT TOWNSEND WA 98368 (360) 385-9105 MOBILE HOME INFORMATION FORM ER'S NAME / MAILING ADDRESS: _ . �. .- -_. ._ y/S IS NOTA TAX STATEMENT E: I'` I ,? GiG` Ey r c- The purpose of this questionnaire is to obtain information Rox. regarding either the current location of a mobile home or the tESS: / Po LIS' previous ownership and location of a mobile home. This will Q help our office determine whether the mobile home is already ,L.�R-1 M,ro il, (Pa 1 Z�aD on the tax rolls in Jefferson County or if it has been moved to �/ this county from another area. Please see reverse side for PHONE NO: �6d - 79 - 7�5 e additional information. IOBILE HOME DATA: Q (A) MAKE P l *l` L E T-t 1-r�# (B) MODEL (C) YEAR /% 7 Z c(D) LENGTH 4' i (E) WIDTH 2 7 ' (F)SERIAL NUMBER �p 75 'GL_ (G) YOUR PURCHASE PRICE(DO NOT INCLUDE SALES TAX) JI 0 (H) PURCHASE DATE /40r1- y 'REVIOUS OWNER/ LOCATION OF MOBILE HOME: A) FROM WHOM DID YOU PURCHASE MOBILE Rh aR Gea..- "4 0-1�Z A. R a-/1 k ADDRESS S 7� Rh A c en r0 , J-/1, f L I2 RDf, Wa_ ggJx) B) WAS MOBILE HOME ASSESSED IN JEFFERSON COUNTY LAST YEAR? do NO� �(IF NO,WHAT COUNTY? ) IF YES,WHAT WAS PREVIOUS ADDRESS OF MOBILE? � fJ AI ed-6-v-..- WHERE MOBILE HOME IS TO BE LOCATED: (A) WILL THE MOBILE HOME BE IN A MOBILE HOME PARK? YES gi (B) IF LOCATED IN A MOBILE HOME PARK: NAME a ADDRESS OF PARK SPACE NO. (C) IF NOT LOCATED IN A MOBILE HOME PARK: NAME OF LAND OWNER: ,, Rd._ Eyre LOCATION(ADDRESS) ! G e r eg L'� L ii '.Q / 8/'I IVIVD N I. , Oa 9� � a REAL PROPERTY PARCEL NUMBER/DESCRIPTION cli �- 7Uc - 3 -7 a cl �5-A.1 RQ,14 .2tr cAe-tvrittaA ad d Y. d1/20_,VL 11661± Pie& k,rjj f RYOURHELP! Ala �4-„,_TANK YOU FO . SIGNATURE All LARSON, roperty Technician THIS FORM CONFORMS TO THE STANDARDS OF THE STATE DEPARTMENT OF REVENUE AND IS SUBJECT TO AUDIT VERIFICATION. r rn al yro -i co r 'IUD . -- 0 n i 0 m T1: yy • r oTa - 4C > )11 0 V .-, btil � F \-7\; ,2 1.=: 22'. I 90 8 Q Pt m z r Cy & (...)•/ p'4 Q. roaA r (03 ;1,! 1\—:\—\-i — •--. Asa "' \ ® ,.,1t € H to ft) .....1 y 1---- 4-' 7 �� ÷ ,-, ei $ :, ,' ":\ It- m SI u " ` a114 APO /ilea c. 1% �- o r 1 \ r g!. ------------: "-- _c" ri'l 1 i h' k 10 MZT:2 gi. \ '., 4v,,, ____/. , , 1 r 1. O S N1 ! 1[ s"1 : I'I " r IA ;5' / - Z w - "8'"-- 0 00 = .L m 1. ," � Z S � 4. Q. . 7 S-1 ! \- : ------ q vs_ , L Poor _ -Ai 1 44 • I i`�JIr m _ A T D Q T ,x C C 5 '7 r Q f rl w3- Q Q C w N i f r __1 3 x ' (1v .1). 1 3^ rn tyn it Y s i1 11 tA hZ .M- c` 0` # s to 1 o y, N , • MANUFACTURED/MOBILE HOME INSTALLATION PERMIT Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT#: BLD04-00670 Received Date: 10/21/2004 SITE ADDRESS: 91 COREY LN Issue Date: 5/25/2005 BRINNON, 98320 APPLICANT: LINDA EYRE PO BOX 335 BRINNON WA 98320-0335 SUBDIVISION: COREY SHORT PLAT Block: Lot: 2 PARCEL#: 941700325 • Section: 2 Township: 25 N Range: 02 W CONTRACTOR/ OWNER/BUILDER PHONE: DEALER • PROJECT DESCRIPTION: NEW MFH MAKE: MARLETTE YEAR: 1972 SIZE: 60 X 24 THIS PERMIT IS VAUD FOR ONE YEAR. THE FINAL INSPECTION MUST BE SCHEDULED AND PASSED WITHIN THAT YEAR. THE EXPIRATION DATE IS 5/25/2006. CALL IN FOR THE REQUIRED INSPECTIONS THAT APPLY TO YOUR PROJECT. Setbacks/Footing (CONTINUOUS FOOTING, SLAB or PADS USED): Stormwater FINAL Approval: Blocking/Plumbing: Propane Tank/Lines • Zoning Final Approval: Septic System Final Approval (If not on sewer): Road Approach Final Approval: Final/SkirtingNents/Porches/Steps: HEALTH DEPARTMENT AND PUBLIC WORKS APPROVAL REQUIRED PRIOR TO FINAL INSPECTION • THIS PERMIT IS VALID FOR ONE YEAR OR IT MUST BE PROPERLY RENEWED BUILDING INSPECTION HOT-LINE 379-4455. CALL 24 HOURS IN ADVANCE TO SCHEDULE INSPECTIONS. Office Hours 9:00 a.m. -4:30 p.m. HOT-LINE AVAILABLE 24 HOURS A DAY SPECIAL CONDITIONS APPLY-SEE REVERSE • SPECIAL CONDITIONS CASE # BLD04-00670 1.) APPROVED CONDITIONED UPON THE RESIDENCE RECEIVING FINAL APPROVAL FROM L&I THAT THE RESIDENCE HAS BEEN CONVERTED TO A ONE BEDROOM 2.) The application was reviewed by the Jefferson County Department of Community Development staff on October 27, 2004 for the potential presence of Environmentally Sensitive Areas (ESAs) under the provisions of the Unified Development Code (UDC). After an initial Geographic Information Systems mapping review and an investigative site inspection, the following ESAs were confirmed to be present on the subject property: seismic; flood; SUSC aquifer recharge; coastal SIPZ; fish and wildlife habitat. 3.) Aquifer Recharge Areas in Jefferson County are characterized by porous geological formations that allow percolation of the surface water into the soils and the underlying zone of saturation. Aquifers are geologic formations that contain sufficient saturated permeable material to yield significant quantities of water to wells and springs. Aquifers serve as the source of drinking water within most of the rural portions of Jefferson County. 4.) A Flood Elevation Certificate was submitted in conjunction with the application to address the base flood elevation. 5.) Susceptible Aquifer Recharge Areas are those with geologic and hydrologic conditions that promote rapid infiltration of recharge waters to groundwater aquifers. 6.) Geologically Hazardous Areas in Jefferson County are characterized by slope, soil type, geologic material, and groundwater that may combine to create problems with slope stability, erosion, and water quality during and after construction or during natural events such as earthquakes or severe rainstorms. 7.) Marine shorelines and islands are susceptible to a condition that is known as seawater intrusion. Seawater intrusion is a condition in which the saltwater/freshwater interface in an aquifer moves inland so that wells drilled on upland areas cannot obtain freshwater suitable for public consumption without significant additional treatment and cost. Maintaining a stable balance in the saltwater/freshwater interface is primarily a function of the rate of aquifer recharge (primarily through rainfall) and the rate of groundwater withdrawals (primarily through wells). The Washington Department of Ecology is the agency with statutory authority to regulate groundwater withdrawal for individual wells in Jefferson County. New development, redevelopment, and land use activities on islands and in close proximity to marine shorelines in particular should be developed in such a manner to maximize aquifer recharge and maintain the saltwater/freshwater balance to the maximum extent possible by infiltrating stormwater runoff so that it recharges the aquifer. 8.) The parcel is located within a coastal SIPZ (seawater intrusion protection zone) according to the County GIS map. There are voluntary and mandatory measures identified in the Jefferson County Seawater Intrusion Policy(Resolution 44-22, effective September 23, 2002) that apply to well drilling proposals and building permit applications on existing lots of record. A Coastal SIPZ is defined as: all islands and area within one-quarter mile of marine shoreline, but no history of chloride concentration above 100 mg/L in groundwater sources within 1000 feet. 9.) Critical Aquifer Recharge Areas may require special protection measures to mitigate water quality degradation. The submitted proposal does not require additional aquifer protection measures. However, during construction the project shall follow the Best Management Practices (BMPs) and facility design standards as identified and defined in the Stormwater Management Manual for the Puget Sound Basin. 10.) To help prevent seawater from intruding landward into underground aquifers, all new development activity on Marrowstone Island, Indian Island and within 1/4 mile of any marine shoreline shall be required to infiltrate all stormwater runoff onsite. • 11.) VOLUNTARY MEASURES OF,ASTAL &AT RISK SIPZ: Water conservation measures: 1. Roof and other intercepted precipitation shall be routed to on-site detention ponds and/or other approved means and allowed to be released to the soil slowly. 2. Water collected from Storm water and roof catchments may be used for watering lawns and gardens. Unless catchment water has been treated to meet drinking water standards, there shall be no cross connections allowed between the potable supply and impounded water. 3. Water withdrawn from wells on each property shall not be used for watering of lawns and/or gardens. 4. Ground water withdrawn from each property shall be restricted to a rate of three (3) gallons per minute. 5. Installation of water conserving fixtures such as low flow toilets, faucets and shower restrictors and other water saving plumbing fixtures. 6. Landscaping plan (xeriscaping, native vegetation with minimal amounts of irrigation). Please NOTE that the above listed measures are not intended to be exhaustive, but rather is intended to be illustrative of the types of water conservation measures. 12.) VOLUNTARY MEASURES OF COASTAL &AT RISK SIPZ: 1. Installation of a flow meter. 2. On-going well monitoring for chloride concentration. 3. Submittal of monitoring data to County. 13.) MANDATORY MEASURES FOR COASTAL SIPZ: 1. For proof of potable water on a building permit application, applicant must utilize DOH'-approved public water system if available. 2. If public water is unavailable, a qualifying alternative system may be used as proof of potable water or an individual well may be used as proof of potable water subject to the following requirement: a. Chloride concentration of a laboratory-certified well water sample submitted with building permit application. 3. If public water is unavailable, a qualifying alternative system may be used as proof of potable water. 14.) The property owner shall comply with Water Conservation Measures (per list maintained by the UDC Administrator). 15.) A flow meter shall be installed prior to final sign off of the building permit. 16.) The applicant is proposing to create or add 1440 square feet of impervious surface and 1440 square feet of land disturbing activities. 17.) The project shall adhere to the Best Management Practices (BMPs) to control stormwater, erosion and sediment during construction. BMPs shall address permanent measures to stabilize soil exposed during construction, and in the design and operation of stormwater and drainage control systems. 18.) Jefferson County determined that this proposal is categorically exempt from review under the State Environmental Policy Act (SEPA) pursuant to WAC 197-11-800(1)(b)(i). 19.) The site plan as submitted with the building application has been reviewed for consistency under the UDC, and has been approved by Jefferson County Department of Community Development. Any modifications, changes, and/or additions to the stamped, approved site plan dated May 23, 2005 shall be resubmitted for review and approval by Jefferson County Department of Community Development. 20.) This approval is for installation of a manufactured home only. Any future permits on this site are subject to review for consistency with applicable codes and ordinances and does not preclude review and conditions which may be placed on future permits. 21.) Outdoor residential storage shall be maintained in an orderly manner and shall create no fire, safety, health or sanitary hazard. • 22.) Not more than two (2) unlicense or inoperable vehicles shall be stored on any lot less than one-half acre unless totally screened from view of neighboring dwellings and rights-of-way. Such screening shall meet all applicable performance and development standards specific to the district in which the storage is kept, and shall be in keeping with the character of the area. Screening shall meet the requirements of Unified Development Code (UDC) Section 6. Outdoor storage of thirteen (13) or more unlicensed or inoperable vehicles is prohibited except in those districts where specified as an automobile wrecking yard or junk (or salvage) yard and allowed as a Permitted Use in Table 3-1 of the UDC, and such storage shall meet the requirements of UDC Section 4.10. In no case, shall any such unlicensed or inoperable vehiclesbe stored in an Environmentally Sensitive Area (ESA). 23.) Maximum lot coverage is not to exceed 60%. Lot coverage is defined as amount of impervious surface which includes roof tops, driveways, concrete, etc. 24.) The building height is not to exceed 35 feet. 25.) Minimum setback from Corey Lane right-of-way is 25 feet. Minimum side and rear setbacks are 5 feet. 26.) Lighting fixtures shall be designed and hooded to prevent the light source from being directly visible from outside the boundaries of the property. The intensity or brightness of all lighting, during construction and after project completion shall not adversely affect the use of surrounding properties or adjoining rights-of-way. 27.) Exterior lighting for residential uses shall not exceed twenty feet(20') in height from the finished grade, excepting when such lighting is an integral part of a building or structure. Ground level lighting is encouraged. 28.) A minimum of two (2) on-site parking spaces shall be provided for the single family residence. 29.) The lot was created through the Corey Short Plat on March 15, 1976 under AFN 233329. 30.) A Flood Elevation Certificate was prepared by Anold Wood, PLS and found that the base flood elevation is 20.70 feet. 31.) PRIOR TO FINAL APPROVAL FOR OCCUPANCY, THE L&I ALTERATION PERMIT MUST BE APPROVED AND FINALIZED BY L&I. NUMBER OF BEDROOMS IN THIS DWELLING WILL BE ONE (1). ALTERATION PERMIT IS TO ADDRESS ALL LIFE & SAFETY AND VERIFTY SECOND BEDROOM HAS BEEN DECOMISSIONED. e°140N. w JEFFERS COUNTY III co inikDEPARTMENT OF COMMUNITY DEVELOPMENT 621 Sheridan Street • Port Townsend •Washington 98368 M 360/379-4450 • 360/379-4451 Fax i1 Vt.c,, G`,0 www.co.jefferson.wa.us/commdevelopment E r , ., 1 Master Permit Application MLA: Project Description(include separate sheets as necessary): a.. • Tax Parcel Number: / .. �_� 5 Property Size: / (acres/square feet) Site Address and/or Directions to Property; n Property Owner(s)of Record: Ore U Q_lrt` RY+i Telephone: Fax: do 1 e_ —Cc41 -1 ��' Mailing Address: email: Applicant/Agent(if different from owner): .S' Telephone: Fax: email: Mailing Address: What kind of Permit?(Check each box that applies) ❑ Building DI Demolition Permit ❑Variance(Minor,Major or Reasonable Economic Use) ❑Single Family ❑ Conditional Use[C(a), C(d),or C]** CI❑Garage Attached/Detached Discretionary"D"or Unnamed Use Classification El anufactAtta Home ❑ Special Use(Essential Public Facilities)** CI Modular 0 Boundary Line Adjustment ❑Commercial* ❑ Short Plat** ❑Change of Use ❑ Binding Site Plan** ❑Address 0 Long Plat** ❑ Propanedd ❑Road Approach ❑ Planned Rural Residential Development(PRRD)/Amendments** ❑Allowed"Yes"Use Consistency Analysis ❑ Plat Vacation/Alteration** ❑Allowed Stormwater Management ❑Shoreline Master Program Exemption/Permit Revisions** ❑Site Plan Approval Advance Determination(SPAAD)* ❑ Shoreline Management Substantial Development** ❑Temporary Use ❑Shoreline Management Variance CI Wireless Telecommunication* 0 Comprehensive Plan/UDC/Land Use District Map Amendment CI Practices Act/Release of Six-Year Moratorium ❑Jefferson County Shoreline Master Program Amendment *Ma r uire a Pre— lication Conference **R Please identify any other local,state or federal permits required for this proposals if known Conference: I hereby designate DESIGNATION OF AGENT to act as my agent in matters relating to this application for permit(s). OWNER SIGNATURE Date: By signing this application form,the owner/agent attests that the information provided herein,and in any attachments,is true and correct to the best of his,her or it's knowledge. Any material falsehood or any omission of a material fact made by the owner/agent with respect to this application packet may result in this permit being null and void. I further agree to save,indemnify and hold harmless Jefferson County against all liabilities,judgments,court costs,reasonable attorneys fees and expenses which may in any way accrue against Jefferson County as a result of or in consequence of the granting of this permit. I further agree to provide access and right of entry to Jefferson County and its employees,representatives or agents for the solepurpose review and any r wired later inspections.Access and right of en to this ro hours• " t►Y P perty shall be requested and shall occur only during relar burin applicationo Signatur . Date: Q The action or actions Applicant will undertake as a result of the issuance of this permit mayendangered species and could lead to a potential"take"of an endangered species astho a terms are defined pon one or more threatened or in the federal law known as the Y impact "Endangered Species Act"or"ESA?Jefferson County makes no assurances to the applicant that the actions that will be undertaken because this permit has been issued will not violate the ESA Any individual,group or agency can file a lawsuit on behalf of an endangered species regarding action(s)even if yo are in complia with the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual and non-transfe e resp,nsibility adhering to and complying with the ESA. The Applicant has read this disclaimer and si ns and dates itbelow.your Signature: + Date: �� / n Y G:\PeanitCenter\FORMS\DRD FORMS\Master Permit Application 7-8-04,doc DOWNER BUILDER STATEMENT0 ,•,. dot of this statement does hereby certify that they are the Owners of the parcel referenced herein,that they ari: licensed contractors and that i. e assu the-es.• v lity of the General Contractor for the proposed project. i i t° G` I,l/ -C Date: /O//A/D V A FNc- .CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: LL ( ) f,to t�',.i ),,,._. EMAIL: ADDRESS: WAINS CTOR'S LICENSE NUMBER . PHONE ( ) FAX:( ) :CT/ENGINEER: ADDRESS: EMAIL Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: fT ❑ Wood Existing: 0 Bank ❑ �emmunity System wer ition ❑ Steel Proposed: Total: Height: It Individual System ration/Remodel 0 Concrete SEp permit# Lair 0 Oason ther: Bedrooms: W er Supply: nolition 0 Other: Existing: Sete: Private well ❑ Two Party Proposed: _- ❑ Public A Heat: Total: Name of System: 7( -/'.b is a Commercial Project you must answer the following: Number of ADA Parking Spaces: er of Parking Spaces: Current Proposed: Proposed er of occupants(includes owners,tenants,employees,etc) Current Will you have Food Service? Yes / No occupancy: IBC Type of construction: is a Propane Tank and/or Appliance Installation permit,mark all Proems below ane Tank: that apply: derground Tank ❑ Above ground Tank Size:at Stove ❑ Cook Stove ❑ Woodstove ❑ Fireplace Insert ❑ Hot Water Tank ❑ Pellet Stove ❑ Other s appliance being installed in a Manufactured/Mobile Home? Yes / No ,all property n applying for a permitdt install c a propane tank Y tank to all property liu must also submit a nte es,es,lan showing all of the buildings and septic system components, ,,tank location and size,distances from the propane ,din• the reserve area. i �q x x ` 1 b" r;: �'P� �my {`# f� 2 ts"v4 ,, y,/ F ,,h ,• S•uare Foota•e .,i „�l t r4 hKn�^`1 '4.': ^-14 i _, -' .' Current Pro•osed # '_ir r 1� • Wer!-AAAM. I Floor 1.,�II i"' . ` *3 Consistency Review: 4, ,, I . y X ;a, , base fee: : . ' Floor n Additional Section � a oft; ; O'� '. .' a T .1 1 =k)or Plan'Check fee: < ¢amine: _- 4 ; fit ��3 '� State Surcharge fee: -r 3 ii�x , ated Basement F u� _,� .�.• y �k , heated Basement • Pot Water Review fees ,- "�` p ,1� , Vi y.. = Al � ,� ler Unheated 911/Rd Approach - x� N.� .. Y - TOTA f 4rrz t ., ,z � i', ei ® Y F sy irage/Carpo r .* { .+,,t ;cks M Receipt Number t, .r h(Check Number—:'"- „ x - they STIMATED COST(REQUIRED) Date: 'ca rs * . k p ( 0 lair market value of all labor and materials foundation to finish Initials: .-t.. , t ;5 t ��¢., q \permitCenter\FORMS\DRD FORMS\Master Permit Application 7-8-04.doe