HomeMy WebLinkAboutBLD2020-00615 - 01 PERMIT APPLICATIONUp Front Parcel
Review Parcel
Date Completed:
Owner Name:
Add. Name:
Mailing Address:
Site Address(es):
Parcel Number: S-T-R: --Total Acreage
Legal Description Land Use:
Flood District:Fire District:Planning Area:
Flood Map (FIRM) Panel No: School District Zoning:
[ ] Zoning ________________________________________________________________________________
[ ]Setbacks:Front:_______Left Side:__________Right Side: __________ Rear:_______________
Informed by JCC 18.30 or Title 17 for Master Planned Resorts:
Shoreline Setback:____________Critical Area Buffer__________________________________________
Building Setback: ______________________________________________________________________
Adjoining Forest Lands: Commercial/ ____________ Rural/______________Inholding_______________
[ ] Lots/Require Declaration of Restrictive Covenant YES NO, submitted: YES NO __________________
[ ] Legal Access to Property YES NO _____________________________________________________
[ ] Parcel Tags or Scanned Documents YES NO List:_________________________________________
[ ] Sepcial Reports Nearby YES NO List:____________________________________________________
[ ] Shoreline Designation: YES NO _______________________________________________________
[ ] Critical Areas
Geologically Hazardous Areas YES NO
Shoreline Slope Stability:____________Landslide____________Erosion_____Seismic___________
CMZ: none High Risk Moderate Risk Disconnected CMZ__________________________
Report Submitted________________________________________________________________________
FWHCA: YES NO Stream type: __________________________ Pond or Lake < 20 acres________
Marbled murrelet/Spotted owl_____________ marine nearshore______________
Wetlands:YES NO ___________________________________________________________________
Flood:YES NO List FIRM map:_______________________________________________________
Flood Certificate: ______________________________________________________
Aquifer Recharge Area:YES NO___________________________________________________________
SIPZ: none At Risk High Risk Coastal ________________________________________[
] Site Visit conducted YES NO _____________________________________________________
[ ]Notice Provisions/Disclosure Forest Lands:YES NO Airport YES NO MRL YES NO
Agricultural Lands: YES NO No Shooting Zone:YES NO
[ ] Archaeology:YES NO _____________________________________________________________
RF-40
No
No
No
None
Yes
None
geotechnical report
Slight
S15 T27N R2W
None
n/a
No
Yes
Yes
250 (CF)5
No
No
150' for Type F; 75' for Type N - proposal is outside of buffer
Brent and Peggy Bierbaum
100 (RF)100 (RF)
Wildwood Road
No
702151001
702151001
No
NONE
No
n/a
No
P.O. Box 100
Quilcene, WA 98376
No
No
None
No
No
RF-40
RF-40
Yes
No
S15 T27 R2W NE NE
none
CF-80
Land Use Requirements
[ ] SEPA Required:YES EXEMPT _________________________________________________
[ ] Landscaping Required: Yes No_______________________________________________________
[ ] Parking Spaces Required NO 2 Other_______________________________________________
[ ] Building Height: 35' UBC Standard __________________________________________________
[ ]Stormwater: New Impervious Surface_____________Land Disturbing Activity ________________
Min Req #1 thru #5Stormwater Req's: Min Req #2 Min Req #1 thru #9
Engineering ________________ Drainage District Review Required___________
[ ] Stormwater Pollution Prevention Plan Submitted: Yes No __________________________________
[ ] Impervious Surface coverage percentage: __________________________________________
Resource Lands & Public: 10%Rural Residential: 25%Rural Industrial: Per UDC Sec 6.7
Rural Commercial: 60%Area of Building Coverage: 60% in Rural Industrial Lands only
[ ] ADMIN: Setbacks entered in Permit Plan case N/A YES ________________________________
New Parcel Tags entered in Permit Plan N/A YES ____________________________________
Special Reports Scanned N/A YES _________________________________________________
[ ] ADU Proposed YES NO Square Footage: ______________________
[ ] Total Building (s) Size:____________________________________________________________
RVC: 20,000 SF CC: 5,000 SF NC: 7,500 SF GC: 10,000 SF All others: subject to septic & water constraints/None specified
[ ] Road Classification:_______________________________________________________________
Road Approach:EXISTING NOT REQ'D RAP__________________________________________
[ ] Require Final Zoning Approval/inspection YES NO __________________________________________
[ ] UGA No Protest Agreement YES NO, submitted: YES NO _____________
[ ] Recorded Date of Subdivision:_______________AFN____________________________Over 5yrs=UDC
Plat Conditions:_____________________________________<5yrs=Plat Conditions on plat or Old Ordinance
Reviewed By:
Additional Notes:
No
No
Geotechnical report submitted as part of the SEP application was reviewed.
197-11-800(1)(b)(i)
N/A
N/A
C340409
25%
Donna
N/A
No No
No
4800 sf
N/A
2
2,313 sf
No
No
Exempt
4
No