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Home My WebLink AboutBLD1997-00816 * JEFFERSON COUNTY MOBILE HOME INSTALLATION PERMIT Jefferson County Permit Center Castle Hill Mall 621 Sheridan St. Port Townsend, WA 98368 360-379-4450 PERMIT # •BLD97-0816 DATE ISSUED. : 02/13/98 SITE ADDRESS: 112 CHURCH RD :BRINNON, WA 98320 APPLICANT. . . :KATHRYN NELSON PHONE: (206) 246-8817 MAILING ADDR: 16638 8T AVE SO : SEATAC WA 98148 PROPERTY OWNER IF DIFFERENT FROM ABOVE PHONE: MAILING ADDR: INSTALLER. . . :DEAN FONTAINE PHONE: INSTAL LIC #:WAINS1150 EXPIRATION DATE: 12/05/99 CONTRACTOR. . : PHONE: MAILING ADDR: CONTR LIC #: EXPIRATION / / PARCEL NO. . . : 602353042 LEGAL DESC. . : STR 35-26-02 WWM, TAX # 44 LOT , BLOCK , DESCRIPTION OF IMPROVEMENT: Manufactured home installation. THIS PERMIT IS VALID FOR ONE YEAR ONLY AND IS NOT RENEWABLE. THE FINAL INSPECTION MUST BE SCHEDULED AND PASSED WITHIN THAT YEAR. THE EXPIRATION DATE IS 02/13/99. :e/c 4//2/Q A ( ) fBlockinq/Setback)/Plumbing: ( ) Final/Skirting/Vents/Porches/Steps: g fe,L jf fl-9� CALL 379-4455 24 HOURS IN ADVANCE TO SCHEDULE INSPECTIONS. Office Hours 9 a.m. to 4 : 30 p.m. Inspector's Hours 8 - 9 a.m. 24 Hour Recorder for Inspections 1110 ' • •f 3 MOBILE HOME INSTALLATION APPLICATION Jefferson County Permit Center Castle Hill Mall 621 Sheridan St. Port Townsend, WA 98368 360-379-4450 PERMIT # •BLD97-0816 DATE RECEIVED. : 12/31/97 SITE ADDRESS: 112 CHURCH RD :BRINNON, WA 98320 APPLICANT. . . :KATHRYN NELSON PHONE: (206) 246-8817 MAILING ADDR: 16638 8T AVE SO : SEATAC WA 98148 INSTALLER. . . :DEAN FONTAINE PHONE: LICENSE #:WAINS1150 EXPIRATION DATE: 12/05/99 bO ' 43z _ c ,' CONTRACTOR. . : 1�� PHONE: ft aN- \ 6 c� Cm l ,1 MAILING ADDR: • CONTR. LIC #: EXPIRATION DATE: t( /(fir-/?g PARCEL NO. : 602353042 landslide _ plat cond _ wetland _ flooding _ LEGAL DESC:STR35-26-02 W WM seismic _ streams erosion f & w LOT , BLOCK , TAX #440 — — — DESCRIPTION OF IMPROVEMENT: Manufactured home installation. BUILDING TYPE *MOB BEDROOMS--- BATHROOMS-- CRPT/GAR. . : 0 sf TYPE OF IMPROVEMENT:NEW EXIST. : 0 EXIST. : 0 DECKS • 0 sf GARAGE/CARPORT • PROP. . : 3 PROP. . : 2 COMMERCIAL: 0 sf UBC OCCUPANCY GROUP: TOTAL. : 3 TOTAL. : 2 INDUSTRIAL: 0 sf EST COST. $: 80000 SEWAGE DISP. . :CON BANK HT. . . : 0 ft PROJ GRP. . : 10149 WATER SUPPLY. :PWELL SH SETBACK: 0 ft MOBILE HOME MAKE:GUERDOR YR: 98 SIZE: 56 X 40 Owner/agent FEES Signature: type amount by date recpt m PRMT $ 133 . 00 EMH 12/31/97 1142398 Date: -- ��G `L PRMT $ 27 . 00 EMH 12/31/97 1142398 �' °� B.C. $ 4 . 50 EMH 12/31/97 1142398 Issued By: Date: 41(TBu�irt�aq Er;: S{ts�a; $ 164 . 50 TOTAL l�� , JEFFERSON COUNTY PERMIT CENTER, 621 SHERIDAN ST, PORT TOWNSEND WA :98368, MANUFACTURED HOME INSTALLATION PERMIT APPLICATION lat a \ 1IINEW BUILDING ❑ REPLACEMENT SIZE :_546X9(, EAR /V7� 1 g ,� l AKE L �/c/e,(i/' COST >&/ Oda' (1)t'A BEDROOMS: BATHROOMS: EXISTING EXISTING PROPOSED PROPOSED TOTAL TOTAL TYPE OF SEWAGE DISPOSAL: WATER SUPPLY: 0 SEWER 0 COMMUNITY SYSTEM ❑ PRIVATE WELL 0 TWO PARY WELL isi INDIVIDUAL SYSTEM 0 Conventional 0 PUBLIC PERMIT # SEP7q-ee,Ft51❑ Alternative Name of water system: IF WATERFRONT PROPERTY, DISTANCE TO BANK OR HIGH WATER LINE ft BANK HEIGHT ft ---Z SIGNATURE (, " ',,i '�� DATE /a/4/ 7 NAME (PLEASE PRINT) FOR OFFICE USE ONLY BASE FEE 13 ! 1 V a .��7.? RECEIPT # / ADDITIONAL SECTIONS I r CAS /CK # / STATE SURCHARGE ' DATE �c.! %,1/ g� 4 SUBTOTAL GNj �U POTABLE WATER gl � or 911/ROAD APPROACH ,dji,` TOTAL (ir H:\HOME\PLNCNTR\FORMS1MOBILEAP,5/97 MOBILE HOME INSTALLATION APPLICATION Jefferson County Permit Center Castle Hill Mall 621 Sheridan St. Port Townsend, WA 98368 360-379-4450 PERMIT # •BLD97-0816 DATE RECEIVED. : 12/31/97 SITE ADDRESS: 112 CHURCH RD :BRINNON, WA 98320 APPLICANT. . . :KATHRYN NELSON PHONE: (206) 246-8817 MAILING ADDR: 16638 8T AVE SO :SEATAC WA 98148 INSTALLER. . . :DEAN FONTAINE PHONE: LICENSE #:WAINS1150 EXPIRATION DATE: 12/05/99 CONTRACTOR. . : PHONE: MAILING ADDR: CONTR. LIC #: EXPIRATION DATE: / / PARCEL NO. : 602353042 landslidef\ plat cond _ wetland fit flooding LEGAL DESC: STR35-26-02 W WM seismic (No streams erosion f & wo LOT , BLOCK , TAX #4*9 — — DESCRIPTION OF IMPROVEMENT: Manufactured home installation. BUILDING TYPE *MOB BEDROOMS--- BATHROOMS-- CRPT/GAR. . : 0 sf TYPE OF IMPROVEMENT:NEW EXIST. : 0 EXIST. : 0 DECKS • 0 sf GARAGE/CARPORT • PROP. . : 3 PROP. . : 2 COMMERCIAL: 0 sf UBC OCCUPANCY GROUP: TOTAL. : 3 TOTAL. : 2 INDUSTRIAL: 0 sf EST COST. $: 80000 SEWAGE DISP. . :CON BANK HT. . . : 0 ft PROJ GRP. . : 10149 WATER SUPPLY. :PWELL SH SETBACK: 0 ft MOBILE HOME MAKE:GUERDOR YR: 98 SIZE:56 X 40 Owner/agent FEES Signature: type amount by date recpt PRMT $ 133 . 00 EMH 12/31/97 1142398 Date: PRMT $ 27. 00 EMH 12/31/97 1142398 B.C. $ 4 . 50 EMH 12/31/97 1142398 Issued By: Date: $ 164 .50 TOTAL Owner/Applicant: ,77, STORMWATER CALCULATIONS �_ / ❑ PROPOSED LAND DISTURBING ACTIVITY Site Address: /X2, e1/2(t/,{0 f�t 4/C l - • Drainfield area cleared i.a47 sq.ft. Driveway Length=;_ _ ft. X Width j e` ft. 9 Digit Parcel Identification No.:�l/ �!�5, [✓ /� Permit Number: = Total Driveway sq.ft. Clearing and Grading for Site Development (Well/Structures/Utilities/etc.) sq.ft. Total Land Disturbance sq.ft. PLOT PLAN INDICATE the following information. 0 IMPERVIOUS SURFACE Draw entire parcel to scale. Indicate scale of plot plan: Proposed Structures (all roof area) 2C QO sq.ft. One inch equals Existing Structures (all roof area) C sq.ft. Sidewalks 12o sq.ft. O 1. North arrow Concrete Patios sq.ft. ❑ 2. All property boundaries and dimensions Proposed ❑ 3. Names of adjacent streets Driveway Length ft. ❑ 4. Driveway/s & parking spaces X Width ft. ❑ 5. Major features such as ravines, = Total Driveway sq.ft. seasonal creeks, bodies of water, etc. Total Impervious Surface sq.ft. O 6. Septic tank and drainfield location, existing or proposed, and distance to The Stormwater Manual sets forth the following Small Parcel Minimum Requirements: closest structure • Construction Access Route Stabilization: 0 7. Sewer lines Construction vehicle access shall be, whenever feasible, limited to one route. Access points shall be stabilized with ❑ 8. Wells and/or water lines quarry spalls or crushed rock to minimize the tracking of ❑ 9. Neighboring wells within 150 feet sediment onto public roads. If sediment is inadvertently transported onto public roads, roads shall be cleaned ❑ 10. Paved surfaces (patios) thoroughly at the end of the day by shoveling or sweeping. ❑ 11. Structures, existing and/or proposed Street washing should only be done after the bulk of the sediment has been removed by sweeping. ❑ 12. Setbacks (distances to property • Stabilization of Exposed Soil: boundaries, structures, banks, All exposed and unworked soil shall be stabilized by sodding, seeding, mulching, plastic covering, application of and shorelines) gravel base on roads and driveways, or other appropriate ❑ 13. Easements for access or utilities means within seven days during the period from May 1 to September 30 and within two days during the period from ❑ 14. Arrows showing direction of slope-- October 1 to April 30. Mulch shall be applied to a minimum assume an elevation of 100 feet at one depth of two inches. • Protection of Adiacent Properties: lot corner and indicate the other lot Adjacent properties shall be protected from sediment corner elevations in relation to it deposition by appropriate use of vegetative buffer strips, sediment barriers or filters, dikes, mulching, or by a combination of these measures and other appropriate Best FOR APPLICATIONS ADJOINING SHORELINES, Management Practices (BMPs). INDICATE: • Maintenance: All erosion and sediment control BMPs shall be regularly ❑ 15. Ordinary high water mark inspected and maintained to ensure continued performance ❑ 16. Top of bank, if over 10 feet high of their intended function. • Other Appropriate BMPs as required by Jefferson ❑ 17. Slope of bank in degrees County to mitigate the effects of increased runoff shall be applied. H:\HOME\PLNCNTR\FORMS\PLOTPLN.FRMS/15/97 Jefferson County Permit Center Date 621 Sheridan Street Fee Port Townsend WA 98368 Rec # CRITICAL AREAS QUESTIONNAIRE Ck # Case # Applicant Name "1r1TVIA) ) /i 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 a' 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 ENO 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 ENO 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) III ,' /' / ,,1-- / ; , / / /' ,' iii / I / / „./ , �..0 Il / I / / / i i i / i / / al% / / / / / / / -•*0 riiii//,/- .' _-fl 111 Y (Questionnaire Continues on Back) 6. Does the site have steep slopes with little to no vegetation? YES kNO 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 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 (77L Date /1/4 A7 FOR OFFICE USE ONLY ❑ Wetlands ❑ Seismic CRITICAL AREAS ON OR ❑ Aquifer Recharge Area (zone ) ❑ Fish & Wildlife Area 1 IMMEDIATELYADJACENTTO SITE: ❑ Frequently Flooded Area ❑ Fish & Wildlife Area 2 ❑ Erosion ❑ Landslide Zone: Parcel Size: Status: Comprehensive Plan Land Use Designation: Reviewed by: Community Plan: Date: , 'a' Syp...,/,q z z aLI. o 3 ...Ci t f t • r` .•/ .Avas,> N j It Ef} 'i-04 .,.... 2_. i 4\ 1 1 °� f IN qu I o 4 sa, P 8 i 1 was , � � ,c i'1r o ,., . .\\:.-A..sr, ��at I r B D. D O m 3 a o r O m 5' N Z "' d r CD a 0 D Cl,• —i C 10 is r o D x- z cn • 49,f.4., 1 A. 0A tiT s,,,, 9). o v.) F,Sl 9` tz z m � z m H . O D n X -O p.- › /711k, r- c- m �yy. tD D -a rm. Y v x _________}., 0 m r � o -0 c� v r O { ` ao v td r o o - z to 0 m c -n CI z �I t7 tb > c } 27 „� ?" 6 f m SETBACKS z ~ v' ),,,, HY o i c� n O D -a aa)) o m co CD o Or D t CD 0 O a) pt 0 41 .O+ v C2 .O _ -O n a Ca CD �. 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