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TC 2013102611 10900 Bald Hills Rd SE SECOND SUBMITTAL 03132015 ,• , y� ; � � � ,�r««s;�aw�, �,,���;:�,cA s�y k _ �r�:�::�`4**�S ;�,� ' �'�'° ���� Thurston County Permit Assistance Center �: r - r 2000 Lakeridge Dr. SW,Olympia,WA 98502 ��'��`�� �� �aj�" � 360 786-5490 / (360)754-2939 Fax �- ,� 022015 c � c � �� �� ���` ��`` � � � � � TDD Line(360)754-2933 �� � �'" �..�����;;;- -�� � �� � � �' �• Email:permitna cathurston.wa.us ��°"���"� ������-��� � �,�� www.co.thurston.wa.us/permitting THLRSTC7N C()UNT� �;��_.__.__. ������s= Creating Solutions for Our Fulure MASTER APPLICATION STAFF USE ONI.Y DATE STAMP 13 107483 BS TNt��STON COUNT`� Permit Type: Site Application R��,�.���� Sub Type: Residential Lot:B M�Y �A �n�� site: 10900 BALD HILL RD SE YELM WA 98597 � I Assessor Property ID: 22729310700 Applicant: BALD HILL ROAD LLC ���{��� �1�5�����'�C� �+��►��� Owner: BALD HILL ROAD LLC '�_:� �. ._`'.� I l'��� � ( � Intake by: '�Z 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. Check the appropriate box for each supplemental application being submitted with this Master Application. T e of Pro�eCt(check all that apply): BUILDING PLANNING ❑Residential(�orm SA001) ❑Administrative Variance(form SA021) ❑Non-Residential(�orm SA002) �Binding Site Plan(�orm SA022) ❑Non-Residential Hood&Duct(�orm SA003) ❑Boundary Line Adjustment/Lot Consolidation (form SA023) ❑Non-Residential Sign(�orm SAOO4) ❑Critical Area Review(�orm SAO24) ❑Manufactured Home Placement(}'orm SA0o5) ❑Design Review(form SAO25) (�I Minor Permit (form S,4006) (�Division of L,and(form SA026) (Mechanical/Plumbing/Fire/Re-roof/Re-siding/Demo) �Division of Land Final Map({orm SAO26a) ❑Adult Family Home Inspection (}'orn�S,4007) ❑Environmental Checklist(SEPA)(�orm SA027) ❑Fire Code Permit(form SA008-SA012) ❑Forest Practice Activities(form 5,9028) �Innocent Purchaser(}'orm SA029) ROADS ❑Joint Aquatic Resources Permit Application(Jt�RPA) 0 Encroachment Permit(jo.m SA013) (�orm SA030) ❑Construction Permit(jorm SAOZa) ❑Legal Lot Detemunation (�orm SAO31) ❑Variance(�orm SAOIS) ❑Other Administrative Actions (�orm SA032) ❑Scoping Review Request(form SAO15a) ❑Presubmission Conference({orra SAO33) ❑Access Permit(�orm sAO156) ❑Reasonable Use Exception(�orm SAO34) ❑Release of Moratorium(�orm SA035) ENVIRONMENTAL HEALTH ❑Rezone, Comp Plan Amendment, Open Space(�ormsAO36) �On-Site Sewage System(�orm SAOI6) ❑Shoreline Administrative Variance(jorm SAO3�) ❑On-Site Sewage System Abandonment(�orra SAO17) ❑Site Plan Review(�orm SAO38) �CEIV ❑On-Site Sewage Evaluation (�orm SAO18) ❑Special Use Permit(�orm SA039) ❑Water System Design(Group B or 2 Party)(�orm �Variance—Hearing Examiner(�orm SAO o) J U N 21 2013 SAOl9) SC A N I V E D �Well Site(form SA020) R����d 3-» JUN 2 4 2013 Form No. MA001 T'hurston County Permit Assistance Center Master Application Page 2 of 3 Property Tax Parcel Number(s): 22729310700 ' Zoning: RR1/5 Acreage: 10.5 Subdivision Name(if applicable): BLA04104565TC Lot#: B Property Address: 10900 BALD HILL RD SE City: YELM State: WA Zip Code: 98597 Directions to the Property: GOING SOUTH ON HWY 507 THROUGH YELM TO RIGHT AT TRAFFIC LIGHT ONTO BALD HILL RD SE TO SITE ON LEFT. Property Access Issues(locked gate,code required,dogs or other animals): �No OX Yes If yes,Describe: LOCKED GATE-LOCK BOX ON LEFT SIDE OF GATE,CODE:3-6-0 OWiti�R 1S t2ESP�i�SI$I.�F`�I'�,�'_,E���l\TS��I1_�LQ�,S BEFORE SITE VISIT. Type or Print: Additional property owner sheet can be obtained onli�ze at www.co.thurston.wa.uslnermittine or copy obtained from the Permit Assistant Center. Property Owner(s): BALD HILL ROAD LLC CHAD HALTERMAN Mailing Address: 15705 92ND CRT SE City: YELM State: WA Zip Code: 98597 Phone#: (253)380-2954 Ext. Fax#: Cell#: E-mail: Signature:* Date: AppliCant(if different than owner): Mailing Address: City: State: Zip Code: Phone#: Ext. Fax#: Cell#: E-mail: Signature:* Date: Point of Contact: JIM HENRY DESIGN SERVICES INC Mailing Address: PO BOX 14531 City: TUMWATER State: WA Zip Code: 98511 Phone#: 956-7242 Ext. Fax#: 956-7242 Cell#: 507-1267 E-mail: HENRYJIM@COMCAST.NET � Signature:* ` � Date: �5 —,Z — Revised 7-71 Form No. MA001 .�`�� Thurston County Environmental Health � _ 2000 Lalceridge Dr. SW�lympia,WA 98502 F_� �� (360)867-2b73/(360)867-2660(Fax) __� � TDD Line(360)754-2933 7�i-I! IZ�`l�t'� t.��i:�,;-t-,- , �. �� �s- <<��-d�_�� �rr��cei�x�.� — - Supplemental Application ONSITE SEWAGE SYSTEM STAFF USE ONLY DATE STAMP 13 107484 HD Permit Type: On Site Sewage Systems ".��""��T�� �,.Q�f[�''��( �������� Sub Type: On Site Sewage 5ystem Lot:B site: �QgpO BALD HILL RD SE YELM WA 98597 MAY 2 9 2013 Assessor PropertylD: 22729310700 Applicant: BALL�HILL ROAD LLC ����E�QSS��j'�l,��� ����.��� Owner: BALD HILL ROAD LLC i5^` ` ' ��"e',�°; �'� C � Io � C� C C c>F �t�e� : `'� This application cannot be submitted alone.In addition to this form,a complete package includes: Ap U C�ant SUBNIITTAL CHECKLIST S Onl se Q Master Application_ ❑ � For new septic systems requiring a design: � a. Site plan(5 copies—11"X 17"maximum size), 1"=20'or 1"=30' scale.(See attached checklist) b. On-site sew e se tic stem desi 3 co ies � For replacement of existing septic systems requiring a design:On-site sewage(septic)system design � 3 co ies . � For submittals not requiring a design: (�amples: sand filter and/or mound rebuild using existing � design,septic tank or pump chamber replacement,septic tank placement):Site plan(3 copies—11"X 17"m�imum size , � For onsite sewage system proj ects within a city jurisdiction,the application must be taken to the city � for review and comment prior to submitting an application with Thurston County. If unable to obtain comments rrom the city,Environmental Heaitii wili route the appucation to the city. The project will be laced on hold unril comments from the ci have been received. � 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. SEPTIC DESIGNER: Name: JIM HENRY Company Name: JIM HENBY DESIGN SERVICES INC Mailing Address: PO BOX 14531 City: TUMWATER State: WA Zip: 98511 Phone#: 956-7242 Ext. Cell Phone# 507-1267 Fax#: 956-7242 E-mail Address: HENRYJIM@COMCAST.NET Revised 5-9-II Form No. SA016 Thurston County Environmentai Health Supplemental Application for Onsite Sewage System Page 2 of 3 JURISDICTION: �����' � � Thurston County ❑City of Select City from List CITY JURISDICTION REVIEW AND COMMENT: ❑Approved ❑Disapproved � � , Comments: � � � �° � � �..��"�C.� t� �' � .��c. �C( � � , " _..� - -Tit1e. �., ` � =z� �r' Signature: % >% ' � ���1:�<<a� ���Cs_r�"t.� ��' Date: > � �i TYPE OF PROJECT: 0 Onsite Sewage System with Residential Site Plan Review (Project includes a new structure or addition/remodel to e�sting structure) �Qnsite Se�xr�.ge System only(I�) (no claange to structure that septic will serve) 0 Residential Single Family ❑ Residential-Multifvnily #Units �Ton-Residential TYPE OF PERMIT: �On Site Sewage System ❑Tank Only ❑Sand Filter and/or Mound Rebuild or Replace ❑Community Drainfield WORK TYPE: ONew ❑Repair of a Failure ❑Modification Upgrade Number of Bedrooms: 6 WATER SUPPLY: ❑E�sting �Proposed 0 Single Family well ❑Two Party well ❑Group A ❑Group B System Name of Communiry system ID# ACCESS: x❑Existing Access ❑Proposed Access ❑X Private Driveway ❑Shared Driveway ❑Private Road (list name of road,if applicable) Ox Public Road BALD HILL RD (list name of road,if applicablel PROPERTY INFO: Water on or within 300' of property: ❑None ❑Salt �River/Creek/Flood Zone ❑Lake/Pond ❑Wetland�Ditch Name of body of water: FLOOD ZONE ACROSS ROAD WITHIN 200 FT OF SW PROP CORNER Has the property ever flooded? ❑No ODo not know ❑Yes,when? /Tl rc'ti. S'Itu�r ur�a t�n �t1�i'i;t�z� Slopes greater than 20%? ❑No ❑Yes APPEAL: Any person aggrieved by a decision,an inspection,or notice made by the Health Officer sball have the right to appeal the matter as specified in Article 1 of the Thurston County Sanitary Code. EXPIRATION• Sewage System applications eapire one year from date of application per Thurston County's Sanitary Cod,Article IV, Section 9. This period may be extended for a single one-year period without charge,if specifically requested by the applicant prior to the eapiration date. Revised 5-9-11 Form No. SA016 Thurston County Permit Assistance Center Master Application Page 3 of 3 BRIEF DESCRIPTION OF PROJECT PROPOSAL NEW CONSTRUCTION FOR PRIMARY MOBILE HOME AND FUTURE FMU BILLING INVOICES The base application fee charged at the time of application covers base hours listed on the fee schedule. When the base hours by a Department are used,a monthly billing invoice will be generated for additional 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 b ant 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 ab ee to start work only after all necessary permits/approvals have been received. Revised 3-11 Form No. MA001 Thurston County Environmental Health Division �"°�-�� 2000 Lakeridge Dr. SW,Olympia,WA 98502 °� � - (360)867-2673/(360)867-2660(Fax) ��g� ,�„ ,: TDD Line(360)867-2603 THL'ItS�t'�.��'�i C;(JUI�TTY http://www.co.thurstou.wa.us/health/ehadm ����a�,� � WATER SYSTEM PRIORITY OF SERVICE ❑ Owner/Applicant '�Applicant Only Date Received -- � � L L� � � �-fi � Phone#� J 3 ���'!� _� % S�� Name ���,a L � -��I l l� r �� . . �� 1L'Tf,P "`'�' \�. Mailing Address � � 7� I ���� � �1 f � �"'� �/} r ��� �' �� Property Address ��� 1 ��� ��'T- � � � � ��"�� �S �_ Parcel#�� �c��� ,� �0 7(� � (attach location map) � Project Description (Plat, short plat, etc) : i1 L �r - - Primary Source Area Utility_ �� I M ��t�� �� _ Priority I-Area Utility Yes,the applicant will be provided with terms of service Yes, via area utility satellite service _No (Go to Priority Level II) Signature of Utility Representative Date Priority II-Neighboring Utility Yes, the applicant will be provided with terms of service Yes,via neighboring utility satellite service _No (Go to Priority Level III) Signature of Utility Representative Date Priority III-Other Approved Satellite Service Company Yes _ No (Go to Priority Level IV) Signature of Utility Representative Date Priority IV-Water Supply Developed by Applicant Date Signature of Thurston County Environmental Health Representative Approval of Service Date Signature of Thurston County Environmental Health Representative To obtain a list of approved utilities, and the name of your primary area utility, contact the Thurston County Environmental Health Representative. 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"—"—_ ����� � � � �. � �� ,�.,.� .�-a. ��� �.- .�� _��;�� �� � c� � � � . � � � � � �..� .�� ..� 4.. � �___ t_ _�� �_. � Exr�iarr A RESOLUTION 541 SIX YEAR TRANSPORTATION IMPROVEMENT PRClGF2AM PROJECT LIST . ._._ ��_.. �...._......__. Proj+�ct Name Prvjecf � � Number '� __ __.......___� Bald Hill to SFt 507 -tUew Connection Y2C � � SR �10 Yeim �oop_� _ Y3 -- --�� Kdlion to Coates - New Connecfiion _ _ ; Y4A ', . �._.........._....�...._� _.........._�.- -r----.................. �Burnett/93� (r�tersection -Realignment and Signal i Y5A ' __......_._ � Longmire lntersection - Siqnal � _ Y56 Central Business District between Culiens and 4 - Y5C Reconstructian _....._..__ ____.....__�.__ Cannect Prairie Line to Tacama Rail Y7A __M. d_ _._..____._.___ , Rail Traif between, o�,._wer canal and Roy Y7B �_..._.. - � Extend Mosrnan from Lt�ngmire to Solberg (New Y8A ; ' connection} ......_.�_� —....._......�._a __. �._._ ____._ _._..---._. _. Soiberg between Yeim Avenue and Masman - ; YSB � ( Reconstructian ' __. __.__........._.,_...,._ Masman between Sofbe�nd SR 507 - Reconstructian Y8C ' Mosrnan/SR 547 intersection - Reali�nment Y8Q Mosman between SF2 507 and��- 4t�-Reconstruction W Y8E - ---...._...�_._..., ----....�_..___ Mosman from 4 ta Clark-�lew Connection Y8F B�Id Hill Road from City limits ta 5 corners - Y9 Reconstruction � x CITY OF YELM RESOLUTION NUMBER 546 AMENQING THE SIX YEAR TRANSPORTATION IMPRQVEMENT PRO�RAM V1�NE�EAS, Section RCW 35.77.010 RCW requires the ad�ption of a six year ' transportation improvement program; and : WHER�s, the adopted six year transpartation improvement program has been updat�d annually by the City Council; and WHER�AS, the Gity Council has determined that recommendations c�f the Yelm ' Transportation Gommifitee ta upc�at�: and amend the adopted six year transportation ' ; improuement program are consistent with the C�mprehensive Plan and Transpartation P{an; and WHE��AS, the current Six Year 7ransportation Improvement Program was adopted by the City Councif on July 9, 2013, by Resolution 561; and WwE��,s, the Counc'sl wishes to clarify that project Y5C includes the constructian of curb, gutter, and sidewalks on the north side of Yelm Avenue (SR 510) between Solberg Street and Cullens Road; NC}W, THEREFORE, BE IT RES�LVED by the City Cauncil af the City of Yelm that the 2013 six year transpc�r�ation improvement program is amended by the addition ofi project Y5C1 as at#ached to this r�solutian as Exhibit A and that a copy of this resalution be fi(ed with the Director of the Washington State Department of , Transportation. APPR4VED this 14t`'day January, 2014. ��-� ` �,��,,.� ----__.�.�'..._........_.._..�.�_.......e........._._�_.._.______ Ron Harding, �� ayor ' � ATTEST: � ��L��i��-%�:�� ...�'��.�,,.�,,... M anine Schnepf, City C! k � �in.x'=�< � � �i � �4'P,�E � � � W � � � �. ; �a � _ }� � i � Q � W3 0 G� Z 1 � II � � �.���ua � � J v � � � , - �� � ��'� � � o� �'` � . �� _, ; �. �_.�.-+---+_-�. �� ��� � `�-�, __ .--... `°'`.- .�, ._______��_�. -. . �.. , , O � � ��� �� w � w ¢ x �- _ o ,j r � ��� � 0 c�E J�R G�� � ; :.,, � 0 'Y�.p�......fY Y 4 7 w,,,,,��S ""id8;;; �r+w�• �} i� F i� °r hV �. \ W w � � � ln Z W = J Q �— _ _ O � ~ O � 3s aa�33a� 3 w 3S t 2iOW � { � 3N 2�4 b'Zt/ld � i ���PJ� � � W j cn W w � U � U � F=-. � J o Z V � � W Y � � m 3S a II�Nb'n c� � � w � i u�i � �� W ;i � U ; Q W �� _ �v C9 � � ii _ ,e' O ' w a ' � � 3s ls wnrvvlwn '� a _ �