Fillable ACCESSORY DWELLING UNIT PERMIT

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ACCESSORY DWELLING UNIT PERMIT

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Rev. December 2021 Accessory Dwelling Unit Permit Page 1 of 3
Mason County Permit Center Use:
DDR___________-________________
Date Stamp Rcv’d:
Rcv’d By:____________ Planner: ______________
ACCESSORY DWELLING UNIT PERMIT
(Special Use Permit with ADU criteria)
Permit Fees:
☐ Special Use - $240.00
A “Special Use” is one that possesses unique characteristics due to size, nature, intensity of use, technological
processes involved, demands upon public services, relationship to surrounding lands, or other factors. The
purpose of this application is to provide for adequate oversight and review of such development proposals, in
order to assure that such uses are developed in harmony with surrounding land uses, and in a manner consistent
with the intent of the Development Regulations for Mason County; Ordinance No. 82-96. Acceptance of this
application by Mason County does not guarantee approval of request.
Applicant(s) Name:______________________________________________________________________
Mailing Address: _________________________________________________________________________
________________________________________________________________________________________
Phone: __________________________________E-mail: _________________________________________
Property Owners Name: (if different than applicant) _________________________________________________
Site Address: ____________________________________________________________________________
Brief Legal Description: __________________________________________________________________
________________________________________________________________________________________
Tax Parcel #: ______________-_____-________________ Zoning: ___________________________
ProjectDescription:_______________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
_______________________________________________________________________________________
615 W Alder St., Bldg 8, Shelton, WA 98584
Shelton Phone: (360) 427-9670 ext 352 Fax (360) 427-7798
Rev. December 2021 Accessory Dwelling Unit Permit Page 2 of 3
Please provide a site plan that includes the following:
1. Indicate Scale and North Arrow.
2. Property line dimensions, easements, and right-of-ways.
3. The location of all existing and proposed structures. Include square footage of existing and proposed structures.
4. Setback distance, in feet from all property lines and structures.
5. Existing and proposed road access to and from the site.
6. Parking spaces.
7. Location of on-site sewage tanks and drain-fields.
8. Location of drinking water supply. Include location on the proposed site and surrounding parcels.
9. Steep bluffs, wetlands, streams, and bodies of water.
10. Surface and storm water run-off routes.
Mason County Code Title 17.03.029 requires the following criteria to be met for consideration of an
Accessory Dwelling Unit (ADU) Permit:
ACCESSORY DWELLING UNIT (ADU) REQUIREMENTS
YES
NO
INFORMATION
1. Is the ADU in a shoreline jurisdiction?
1(a) Are you in the Flood Plain?
Please inquire with Mason County
Community Services staff, if unsure.
2. Will the owner of the lot reside in either the principal
residence or the ADU?
3. Will the ADU be located within 150 feet of the principal
residence or will the ADU be a conversion of an existing
structure (i.e. garage)?
4. The ADU cannot exceed 80 percent of the habitable area
of the primary residence, or 1000 sq. ft., whichever is
smaller. Will your proposed ADU meet this criteria?
5. Will the ADU meet all setback requirements?
Please inquire with Mason County
Community Services staff, if unsure.
6. Will all applicable health district standards for water and
sewer be met by the ADU?
Water/Well Permit and sewer/septic
approval must be met before
planning/building review.
7. Recreational vehicles are not allowed as ADUs. Please
confirm (with YES) that you are not submitting a
Recreational vehicle for review.
8. Your property will only have one (1) ADU?
9. You have provide an additional off-street parking space
for the ADU?
(Ord. 108-05 Attach B. (part), 2005)
Rev. December 2021 Accessory Dwelling Unit Permit Page 3 of 3
On a separate piece of paper (# of pages: ), state your reasons for requesting an Accessory
Dwelling Permit (Special Use Permit) and be sure to address the following six criteria. Your request will be
evaluated based on these criteria and the Accessory Dwelling Unit Requirements from the previous section.
1. Will the proposed use be detrimental to public health, safety, and welfare?
2. Will the proposed use be consistent and compatible with the intent of the Comprehensive Plan?
3. Will the proposed use introduce hazardous conditions, at the site, that cannot be mitigated through appropriate
measures to protect adjacent properties and the community at large?
4. Is the proposed use served by adequate public facilities, which are in place, planned as a condition of approval
or as an identified item in the County’s Capital Facilities Plan?
5. Will the proposed use have a significant impact upon existing uses on adjacent lands?
6. If located outside of an Urban Growth Area, will the proposal result in the need to extend urban services?
Applicant’s Signature __________________________________ Date _______________________
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ACCESSORY DWELLING UNIT PERMIT

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Completed 22 April 2022

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