HomeMy WebLinkAboutPermit File 3604 Georgia Place 3Laq G- \2j Cam \ `P\
GST — 044,,_• REQUIREMENTS FOR
9 m APPLICATION FOR LAND CLEARING
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1. DESCRIPTION OF WORK: A complete description of the proposed work is required.
Include area to be cleared,drainage control, any fill or grade adjustment and disposal of waste
material.
2. SITE MAPS: Provide a site map showing abutting platted streets, existing grades,
existing drainage,proposed new grades and drainage paths, any wetlands and/or
critical soils. (Steep slopes,unstable soils,etc.)
3. On site burning requires a permit from the Fire Department,Northwest Mr Pollution
Authority and in certain areas,the State Department of Wild Life.
4. The work area boundaries are to be clearly marked at time of application and until
the project is completed.
5. When more than 50 cubic yards of soil is placed,removed or moved a grade and fill
permit is required.
tj OCT J. 6 Z003 J
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0.4'`' CITY OF ANACORTES
o APPLICATION FOR CLEARING PERMIT
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OWNERS INFOORMATION G f.�`�
Name: A, clear, 04,./7 Phone: .r Cc c G o c
Address:
City: State: Zip Code:
CONTRACTORS INFORMATION
Name: - . 'I' lc (cam vu .c Phone: 0 2
Address: ( 2 2.(� C c cQ,t(A. � .t�
City:.:i !/„/a GO Q State:pUjk Zip Code: �J Z2
State Registration No.: &oar tc 4I Del 1,Q- Exp. Date.: y '' VO _
LEGAL DESCRIPTION Cy O y 6ers t ez- 101
Lot: Block: Div.: Addition:.
Assessors Account Number:
DESCRIPTION OF WORK
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Are wetlands included in this site? Yes o If yes show the wetland area(s) on the site map.
If area is less than one acre. How many square feet will be cleared?I-0 C)oS.F. If area is greater than one
acre submit a completed State Environmental Act(SEPA) checklist.
Attach a map showing adjacent streets,section lines, access roads,wetlands and boundary
markers. Drainage control or other information as required by ordinance.
I hereby acknowledge that I have read this application and state that the information I have
provided is correct and agree to comply with all city ordinances and state laws regulating land
clearing and grading.
Consent is hereby given to the City of Anacortes,its officers,agents and employees,to enter
upon the land for the purpose of such inspections,investigations, or corrective action as the
building official of the city deems ne sary.
Signature: GGt Date:
Aldil
orized Agent
Receipt No.:
DNR Permit.:
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ANACORTES PLANNING & COMMUNITY DEVELOPMENT DEPT.
PERMIT CENTER
PH (360)293-1901
P.O.BOX 547, ANACORTES, WA 98221-0547 FAX (360)293-1938
1891 .w IAN MUNCE,DIRECTOR • EDWIN FRANK, BUILDING OFFICIAL • Email:ed@cityofonocortes.org
`9 CORtt •
October 22,2003
Bill Turner
Mt. Erie Construction a spy
13725 Goodman Lane
Anacortes,WA 98221
RE: Partial Clearing
3604 Georgia Place
Dear Mr. Turner,
Your request to partially clear 3604 Georgia Place for the purpose of geo-technical review is
approved,provided the geo-technical expert,engineer is on site during cleating to evaluate
and monitor the clearing. The geo-technical expert will need to make recommendations
for possible re-vegetation requriemetns.
Please let us know the geo-technical expert you have retained to perform this work and
possible re-vegetation requirements.
If you have any questions,please contact me at 293-1901.
Sincerely,
CITY OF ANACORTES
Don Measamer
Plans Examiner
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