HomeMy WebLinkAboutBLD1999-00589 Jeffdrsot County Permit Center Date -! Z—9 9
6 eridan Street Fee
Poll Townsend WA 98368 Rec #
CRITICAL AREAS QUESTIONNAIRE Ck #
Case #
Applicant Name 6,4 $ / - 1-I ,, r TE N
x. Building Application _ Land Use Application _ Shoreline Application
On-site Sewage Application _ Subdivision Application _ Other:
1. Is there any standing or running water on the surface of the YES Y. NO
property or on any nearby property at any time during the year?
If YES, please describe:
2. Has any portion of the property or any nearby property ever been YES NO
identified as a wetland or swamp?
If YES, please describe:
3. Are any willows, skunk cabbage, alders, or cottonwoods present YES k NO
on your property or adjacent properties?
If YES, please describe:
4. Are there any indications on any portion of the property or on any YES X. NO
nearby property of rockslides, earthflows, mudflows, or landslides?
If YES, please describe:
5. Please indicate which line best represents the steepest slope found
on your property. (Check appropriate box)
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(Questionnaire Continues on Back)
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6. Does the site have steep slopes with little to no vegetation? YES �
s.
If YES, please describe:
•
7. Does the site contain high percentages of silt and/or very fine YES NO
sand?
If YES, please describe:
8. Does the site contain ground water seepage or springs near the YES NO
surface surface of the ground?
If YES, please describe:
The applicant hereby certifies that all of the above statements and the information contained in any other
transmittals made herewith are true, and the applicant acknowledges that any action taken by Jefferson
County based in whole or in part on this application may be reversed if it develops that any such statement
or other information contained herein is false.
Signature U ' 1 • `
Date S- " / 'Z- e1 9
FOR OFFICE USE ONLY
❑ Wetlands ❑ Seismic
CRITICAL AREAS ON OR 0 Aquifer Recharge Area (zone ) 0 Fish & Wildlife Area 1
IMMEDIATELY ADJACENT TO SITE: 0 Frequently Flooded Area ❑ Fish & Wildlife Area 2
0 Erosion
❑ Landslide
Zone:
Parcel Size: Status:
Comprehensive Plan Land Use Designation: Reviewed by:
Community Plan: Date:
. t/6940
JEFFERSON COUNTY BUILDING APPLICATION
Jefferson County Permit Center
Castle Hill Mall
621 Sheridan St .
Port Townsend, WA 98368
360-379-4450
PERMIT # •BLD99-05&9 DATE RECEIVED. : 09/01/99
SITE ADDRESS : 83 RIDGE DR
:PORT TOWNSEND, WA 98368
APPLICANT. . . :PETER BASICH PHONE: (360) 301-4048
MAILING ADDR:MARIANNE BASICH
:25825 104TH AVE SE
:KENT WA 98031
CONTRACTOR._ . :OWNER � ;
MAILING ADDR:
CONTR. LIC #: EXPIRATION DATE: / / Review 9( 7/99�,
ARCHITECT/ . . :DR STRONG PHONE: (425) 827-3063
DESIGNER • 10604 NE 38TH PLACE
MAILING ADDR:SUITE 101
:KIRKLAND WA 98033 ��pp n n
PARCEL NO. : 940800002 Landslide lat Cond-�yV- Wetland Floodi li
LEGAL DESC:STR 13-30-02 W WM Seismic lV O Streams /Ut Eros n F & W r')
LOT 2, BLOCK , TAX # Shoreline A�o Aquifer / i a
Vv �
CAPE GEORGE VIL4 Area rnru Forest: Adj . N O 3 0 0 '
`fl?S 1 W-5 DESCRIPTION OF IMPROVEMENT: deck
BUILDING TYPE •RES BEDROOMS--- BATHROOMS-- MAIN FL. . . : 0 sf
TYPE OF IMPROVEMENT:ADD EXIST. : 0 EXIST. : 0 ADD' L FL. . : 0 sf
GARAGE/CARPORT • PROP. . : 0 PROP. . : 0 HT W) BSMT. : 0 sf
WOODSTOVE • TOTAL. : 0 TOTAL. : 0 UNHT BSMT. : 0 sf
UBC OCCUPANCY GROUP: SEWAGE DISP. . :ALT OTHER 0 sf
TYPE OF CONST WATER SUPPLY. :CAPE GEO CRPT/GAR. . : 0 sf
UNITS. : 0 STORIES:0 HEAT TYPES. : DECKS. . . . . : 512 sf
DIMENSIONS : COMMERCIAL: 0 sf
FRAME TYPE:WOOD INDUSTRIAL: 0 sf
EST COST. $ : 5120 BANK HT. . . : 0 ft
PROJ GRP. . : 4952 SH SETBACK: 0 ft
Owner/agent FEES
Signature : type amount by date recpt
PRMT $ 125 .25 RAC 09/01/99 18323
Date : PLCK $ 37 .58 RAC 09/01/99 18323
B.C. $ 4 .50 RAC 09/01/99 18323
Issued By:
Date : pot' A`
(bld_appl .txt 4/98)
$ 167 .33 TOTAL