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HomeMy WebLinkAboutSWG2024-00250 - SWG Application / Design - 6/5/2024 ON, MASON COUNTY 415NB SHELTON: ,SMELT967 ,EXT 404 SHELTON:360-27 - 70,EXT 400 BELFAIR:360-2]5446],EXT 400 Public Health & Human Services ELMA:360482-5269,EXT 400 FAX 360-427-7787 On-Site Sewage System Tank Only Permit: SWG2024-00250 APPLICANT JOHNSON ET UX TROY Phone: 206-391-6546 Address: 200 E MIRACLE HEIGHTS DR SHELTON,WA 98584 OWNER JOHNSON ET UX TROY Phone: 206-391-6546 Address: 200 E MIRACLE HEIGHTS DR SHELTON,WA 98584 SEPTIC DESIGNER ADAM HUNTER' Phone: 360-753-1226 Address: PO Box 162 OLYMPIA, WA 98507 Site Address: 200 E MIRACLE HEIGHTS DR Primary Parcel Number: 421233300000 Permit Description: Add lift station for proposed shop BLD2024-00331 Permit Submitted Date: 06/05/2024 Permit Issued Date: 06/05/2024 Issued By: Rhonda Thompson Current Permit Fees Paid: $265.00 (addidaal lees may W Wuirad uFn mstalmw m syslm). Permit Expiration Date: 06/05/2027 roared on dale of Inv.a n) Type of Work OSS New Construction Components being Replaced: Other Surfacing Sewage? No Existing Failure? No Shoreline? No Horizontal Setbacks Met? Yes Number of Bedrooms: 5 Drinking Water Source: Private Well/Spring Additional Details: Add lift station Permit Conditions: 2 Permit must be installed by a Mason County Certified Installer unless prior written authorization from Mason County is obtained. 4 Proposed development subject to zoning requirements and approval by the planning department staff per Mason County Title 17. 1 Horizontal setbacks per WAC246-272A-0210 must be maintained, unless prior approval is obtained 3 Mason County Asbuilt Form, Record Drawing, and Installation fee must be submitted for final installation approval. THIS PERMIT MUST BE ONSITE DURING INSTALLATION OF OSS. PROPERTY OWNERS ARE RESPONSIBLE FOR DETERMINING AND MARKING ALL PROPERTY LINE AND EASEMENT LOCATIONS. THIS PERMIT MAY BE REVOKED IF THE SITE CONDITIONS HAVE CHANGED SINCE THE SITE WAS INSPECTED AND/OR DESIGN APPROVED. FINAL INSTALLATION APPROVAL IS REQUIRED PRIOR TO TEMPORARY OR FINAL OCCUPANCY OF ANY RELATED STRUCTURES. For Final Inspection visit: masonmunty".gov/health/environmental/onsiteloss-Inspection-requ"t.php or call: 360-427-9670, extension 400. OFFICIAL USE ONLY DATENGDYFD: ® MASON COUNTY G 115 1 o'I O COMMUNITY SERVICES AM°°'^ �" MLLNEDBY m w i PI XWM(CPmmun"HeAflTvImKmM lHelm) 3 y swG ao��- c)oasr� p A 2 Di ON-SITE SEWAGE TANK ONLY APPLICATION 3 A m n APPuuwT PHOME m r TROY JOHNSON 2063916546 c NAIUNGADDRE95STPEET CRY,STAI E.LP LODE 3 200 E MIRACLE HEIGHTS OR,SHELTON,WA 98584 a MTEPOMF3SSTREETCT'.IIPCODE 200 E MIRACLE HEIGHTS DR,SHELTON,WA 98584 I"'F NAMEOFOESIGNER P360 I(�. ADAM HUNTER 3607531226 �lyJ NAMEOFINSTA FR PHCNE I� TBD Ipt TYPEOFWORKNY (—) DRINKING WATER SOURCE 25 N ENEWCONSTRUCTIONIUPGRADES OREPAIRIREPLACEMENT EPRIVATEINOIVIUUALWEl1 OPRIVATETWOFRTYWELL 2 Iw COMPONENT(S)TOBEREPUCEDIINSTULED O PUBLIC WATERSYSTEM OSEPTCTMIK OPUMPTANK OWHOWINGTANK BEDROOMS LOTSWE Lko I1 L1 ®DTHER SEPTICIPUMPTANK S W I ul OTHERDETAILS(v M Me K TANK(S)SETBACK CHECKLST 0 O SURFACING SEWAGE CI XISTINGFAILURE 13SHORELINE E 1D0FT•PUBUCICOMMUNT WELLS A 511• PLO SOFT.PRIVATE WELLS,SURFACE WATERS,STREAMS,RIVERS ® PLOT PLAN(REQUIRED) ETANKCROSS SECTION(FNEDUIREO) � tOFT•ORINKING WATER SUPPLY LINE3 Ie O PUMP DETAILS(IFAPPUCABLE) O WAIVER(S)(IFAPPLICABLE) ® 5FT•PROPERTY/EASEMENT LINES,FOUNDATIONS,FOOTINGS PLOT PLW CHECKLIST Q E PROPERTY LINES AND EASEMENTS E EXISTING/PROPOSED STRUCTURES EEXISTING/PROPOSED OSS COMPONENTS AND LINES ~ EWMLSWITHINIODFT EWATERSUPPLYUNES EDRIVEWAYSIPARKING ESURFACE WATERS.STREAMS,RIVERS,ETC._ I rl O DIRECTION OF SLOPE/CONTOURS EPERIMETER/CURTAINDRAINS ENORTHARROW ESCALEBAR 1^ DIRECTIONSTOSIIEANOSRECONDITIONS.(eR,WWe ) FF^! HWY 101 TO A RIGHT ON MIRACLE HEIGHTS DR, FOLLOW SIGNS FOR 200 E MIRACLE HEIGHTS DR. OFFICIAL USE ONLY BELOW THIS LINE UPG WNE I FN W RE 9 W RCE(b mpPN,g wmwee) OVOLUNTARY OMNNTEMANCEIPUMPING BUY.DINGPERMIT OMOMESALE [3COMPLAINT 130 HER: COMMENTSICONDRIONS SEWAGETANKS MUST BE LISTED UNDER DOH'DSTOF REGISTERED SEWAGE TANKS,TANKS MUST MEET CURRENT MINIMUM/SUE REQUIREMENTS.EQUIPPED WTTX RISERS AND UDSMSURFACEAHOINMUDEMEFFLUENTMMRBFAPFLK:ABI RECORD ORAWINGANDINSTALLATION REPORT REQUIRED FOR FINOLA,PROVAL INSPECTORSIGNATURE MTE PPFLILPTgN E%PIMTON MTE APPLICATION APPROVED ISSUED BY DATE THIS FORM MAYBESCANNEDANDAVAILABLE FORPUBLIC AMON THE MASON COUNTYWEII REVISEDIMQ015 § § \ § § � o o m ! ! 0m \ � | ® ; ( cn _ §| % § 5 � © | a . ! , • I| \ ` - ! § \ k \ ; a \ \d § !, ; k \/ } / 3a@@@G@e _ = ® ■ 00 {d §/ ' / f ® K � ! - > ; 0 | � $ m � l , 22ZA \ i � ) » E` ) ; �