2014102069 14507 Yelm Hwy SE COUNTY COl�IlVIISSIONERS
� Cathy Wolfe
District One
Sandra Romero
�""'` District Two
THURSTON COUNTY Kaxen Valenzuela
District Tluee
SINCE 1552
RESOURCE STEWARDSHIP DEPARTMENT
Creating Solutions for Our Future Cliff Moore
TRANSMITTAL MEMORANDUM Director
, Date Submitted � �� f��
PROJECT NAME: _ j
PROJECTNO.: 20�� I Q,���
FOLDER SEQUENCE NO.: �L-I � ' O��o �p ��
_ _ . _ _. . _
RELATED CASES LISTED BY SEQ UENCE NO.:
❑ SUBAREA# ❑FIRE DISTRICT#
❑ SCHOOL DISTRICT�LIST> ADJACENT JURISDICTION�,isT� ��i �
❑PHONE COMPANY ❑ TC PUBLIC WORKS—UTILITES - 7.King
❑AGRICULTURE COMM ❑ WATER RESOURCES—R.Langan
�TCOMM 911 ❑ ORCCA
�TC ENVIRONMENTAL HEALTH ❑ WILLIAMS GAS PIPELINE—wEST
�TC PUBLIC WORKS -DEVELOPMENT REVIEW ❑ PUGET SOUND ENERGY
`QTC PUBLIC WORKS—Real Estate services/Suivey ❑ WA DEPT OF FISH &WILDLIFE
❑WA DEPT OF TRANSPORTATION-D.Severson L)T.NATION []L.MACHUT []D.WIEDEMEIER
❑TC FIRE MARSHAL ❑ WA DEPT OF ECOLOGY
❑TC FLOOD REVIEW [] SHORELINE REVIEW []ENVIRONMENTAL REVIEW
0 TC BUILDING PLAN REVIEW ❑US ARMY CORPS OF ENGINEERS
[]C.Edmark-Commercial []Dock Review ❑ WA DEPT OF NAT RES -Pacific Cascade Region
❑TC NOXIOUS WEEDS �TC ADDRESSING
❑TRIBE-[]NISQUALLY[]SQUAXIN[]CHEHALIS �.TC ASSESSOR'S OFFICE-PROPERTY CONTROL
❑HENDERSON INLET ❑ TC SHERIFF'S OFFICE
❑NISQUALLY REACH ❑AT&T BROADBAND
❑VEENA TABBUTT—T.R.P.C. ❑THURSTON P.U.D.—J.wEmErrFELr,ER
�THCJRSTON CONSERVATION DISTRICT ❑ INTERCITY TRANSIT-D.BLOOM
❑WATER RESOURCES—M.Biever(Geotech Review) ❑ OTHER
PLEASE SEE REVERSE SIDE FOR LIST OF REPORTS SUBMITTED WITH APPLICATION.
Please review the enclosed project information and notify our office in writing of any comments or
recommendations on or before the date noted below. Your comments will become part of the record and
utilized in the decision-making process by staff or the Hearing Examiner. "No comment"by the due date
will be considered an indicatioii that the application is complete.
Department: Complete❑ Incomplete❑ Not Applicable❑
Signature• Date•
Please return comments to: by S:OOpm on• Iv��Q I ��
2000 Lakeridge Drive SW,Olympia,Washington 98502(360)786-5490/FAX(360)754-2939
TDD(360)754-2933 Website: www.co.thurston.wa.us/perniitting
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O:�admin\TRANSMIT"TAL MEMORANDUM.doc
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`� Thurston County Pemut Assistance Center
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MASTER APPLICATION
STAFF USE ONLY DA'I'E STAMP
THURSTON COUNTY
RECEIVED
�iA�' 1 � 2Q��
2014102069 DEVELOPMENT SERVICES
14 110866 ZA
Site Address: 14507 YELM HWY SE OLYMPIA WA 98503
Parcel#: 21714430100
Intake by: ` _
The Master Application is required for all projects and shall accompany a project-specific supplemental
application(s).The Master Application may not be submitted alone.
Property Taa Parcel Number(s}: 21714430100 2171333030(}
Subdivision Name(if applicable): Boundary Line Adjustment Lot#•
Property Address: 14507 Yelm Hwy SE City:Yelm State: WA Zip Code:98597
Directions to the Property:
Property Access Issues(locked gate,code required,dogs or other animals}: QNo ❑X Yes
If yes,Describe: Gate at main entrance
OWNER IS RESPONSIBLE FOR SECURING ANIMALS BEFORE SITE VISIT.
DESCRIPTION OF PROJECT PRQPQSAL
Boundary line adjustrnent between two parcel to place residential on 1 lat and commerical on the other
Revised8-13 FOririNO. MA�al
Thwston County Pernut Assistance Center
Master Application �
Page 2 of 2
Type or Print: Additional property oweter sheet can be obtained online at Ye�� ,� :�<�f� ';�°�or copy obtained
from the Permit Assistant Center.
Property Owner(s): J Z Knight
Mailing Address: 14507 Yelm Hwy SE
City: Yelm State: WA Zip Code: 98547
Phone#: Ext. F�#:
Cell#: E-mail:
Signature:* ���Ltcr-� ���'��.�c'�y��;� �,S.S�tS�C��� � ��Z ��n�G�h�� Date: � �5 /
AppliCant(if different than owner):
Mailing Address:
City: State: Zip Code:
Phone#: Ext. Fax#:
Cell#: E-mail:
Signature:* Date:
Point of ContaCt: Bruce Studeman (Bracy&Thomas}
Mailing Address: 1520 Irvin Street SW,Suite B
City: Tumwater State: WA Zip Code: 98512
Phone#: (360)357-5593 Ext. F�#: (360)357-5594
Cell#: E-mail: bruce@bracythornas_eom
Signature:* `��!�u�-�- �- Date: 04125f 14
BILLING INVOICES
The base application fee charged at the time of application covers base houss listed on the fee schedule. When the base
hours by a Department are used, a monttily billing invoice wiIl be generated fQr aciditionai hours at the hourly rate listed
on the fee schedule. Should review of the project exceed the base hours allotted,billing invoices shall be mailed to:
�x Owner ❑Applicant ❑Point of Contact
*Application is hereby made for a permit or permits to authorize the activities described herein. I certify that I am familiar
with the information contained in the application and that to the best of my knowledge and belief,such information is true,
complete,and accurate. I further certify that I possess the authority to undertake the proposed activities. I hereby grant to the
agencies to which this application is made or forwarded,the right to enter the above-described location to inspect the proposed,
in-progress or completed work. I agree to start work only after atl necessary permits/agprovals have been received.
Revised 8-13 Form No. MA001
�f � � Thurston County Resource Stewardship
�� ���:��
2000 Lakeridge Dr. S.W. ,Olympia,WA 98502
(36(f}786-5490!(360)754-2939(Fax)
�ry, �i � TDD Lme(360}754-2933
-.� ��__�3 �
Email
.�..i-�� .°�i�,��'; t'i3�.'�.i�� �.�� ___ :��:�
Sugplemental Application
BOUNDARY LINE ADJUSTMENT/LOT CONSOLIDATION
STAFF USE ONLY DATE STAMP
14 110866 ZA
Permit Type: Boundary Line Adjustment
SubType: PropertyLineAdjustment TFiURSTON COUNTY
Work Type: Move Property Line RECEIVED
site: 14507 YELM HWY SE OLYMPIA WA 98503 f�7A� � � l�l�
Assessor Property ID: 21714430100
Applicant:J Z KNIGHT DEVELOPMENT SERVICES
Owner:J Z KNIGHT •
�
Intake b : `
This application form eannot be snbmitted alone.In addition to this form,a complete application package includes:
A�US�# SUBMITTAL CHECKLIST StOnl se
❑ Master Application. ❑
� Applicable processing fees.Refer to current fee schedules. Depending on the adopted fee �
structure, additional ees m occur i base hours/ees at intake are exhausted.
� Site plan(site plan checklist attached): One(1)map on 8.5"x 14"sheet(template attached)- �
OR- four full-size map copies no larger than 18"x 24"and one reproducible capy on 11"x
1 T'sheet If submittin full-size ma co ies a M lar wilI be re uested rior to recordin .
❑ Original copy of new legal descriptions. ❑
❑ Original legal descriptions,if applicable.
� Original copy of Completed Declaration of Boundary Line Adjustment and Covenant Form �
with notarized si natures of aII ersons havin ownershi interest in the arcels.
PROJECT TYPE: � Boundary Line Adjustment ❑Lot Consolidation
LOT SIZE BEFORE AND AFTER BOUNDARY LINE ADJUSTMENT:
(Use Sq.Ft.if less than 5 Acres;Use Acres if greater than 5 Acres)
Lot Area Before Lot Area After
PARCEL A 40.00 ac 39.15 ac
PARCEL B 8.96 ac 9.82 ac
PARCEL C
PARCEL D
PARCEL E
Form No. SA023
Thurston County Resource Stewazdship .
Supplemental Application Boundary Line Adjustment
Page 2 of 4
UTILITIES
Water Sunnlv•
Ezisting: ❑ Single Family well ❑Two party well OCrroup B Well ❑Public Utility
Name of water system:
Proposed: ❑Single Family well ❑Two Party wetl ❑Crroup B Well �Pubiic Utility
Name of water system:
Is water system located/proposed on-site? YeS If no,provide t�parcel number of the property the water system is
located or proposed on .A note referencing the off-site water system and parcel
number shall be made on the map.
Are there any off-site water supplies within 200 feet of the property? d Yes �No
How was this verif�ied? field verified
Sewage Disposal•
Egisting: ❑Single Family Septic System �Co�unity Segtic System
❑Public Utifity Naine af Pubtic Utitity:
ACCESS:
❑x Existing ❑New ❑Public Road ❑Private Road
Private or Public Road Name: Z'elm Highway SE
If property is accessed by a private road,how many other parcels have access by this road(include vacant parcels)?
CRITICAL AREAS:
Water on or within 300' of property: ONone ❑Salt ❑River/Creek ❑Lake/Pond ❑Wetland ❑Ditch
Name of body of water:
Has the property ever flooded? ONa ❑Do not lazow ❑Yes,when?
Slopes greater then 30°l0 ❑Yes �x No
Are there any other Critical Areas? (e.g. oak trees,eagle's nest,high ground water,wetlands,etc.} [�1 Yes []x ]No
If yes,describe:
Form No. SA023
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