HomeMy WebLinkAboutCOM2011-00061 - BLD CD Environmental Health Review - 7/25/2011 COMMUNITY DEVELOPMENT ENVIRONMENTAL HEALTH R VIEW
Mason County Public Health Official use only
415 N. 6th Street Permit Number: C,6 I I —mfl'o
PO Box 1666
Shelton, WA 98584 Date Received: 7 2S-2l0/ (
Shelton: (360)427-9670, Ext. 400 Amount RQceiverd� tQ
Belfair: (360)275-4467 Ext.400 ,JAAZ-
g Elma: (360)482-5269 Ext. 400 Receipt NLViDer
Fax (360)427-7787
Applicant Information (h CAI(AA� Type of Review
Applicant t nr�Olt . 4 _ Datet-Z5_ 0 Building Permit
Mailing Ad ress�i .O o New o Re�Jae� �
I I(MA I_i IA �-tBSZ Commercial Building Pe mlt
O New O Replacement
Ci
yy�� � 3tpo-a" State Zip 0 Building/Commercial Permit Revision
aytl'mehone�tnb Other Phone O Tenant Review
s Fne -' � 4
M "' \� >�ri1 c_4:5 0 Pre-Application
Parcel Information
12-Digit Parcel Number I - I -Lg QnLl
Site Address 4xD E 6V LP.j - WA Z 85
Street Number Street Mamel City
Typp of Job ��c,¢, xl Please submit a scaled lot plan
DeGGstrcllrl e ork _TMIL n�Kcom ll - -+X r showing all existing and proposed
building, on-site sewagesystem,
Number of Bedrooms and well.
On-Site Sewage Information Water System Information
On-Site Septic System O New Existing Plumbing in structure? XYes O No
O Sewer Name of Sewer System If yes:
Using an existing on-site septic system will require a current Please submit a comple ed Water
maintenance report and a Record Drawing (Asbuilt). Documents Adequacy Form.
for both of these requirements may be on file with Mason
County Public Health. Other requirements may apply.
Applicant Signature
Date
Official use only
Departmental Review Approved Denied Notes
Water Adequacy
On-site Sewage System
Tenant Review
Revision
Revised 2117109
Pioneer Digging Inc.
3083 E. Mason Benson Rd.
Grapeview, WA. 98546
360-426-1803 office
8/17/2011
To: Mason Co. Health Department
Re: 12108-21-90043 - Mason Co. Fire Dist. #3
In regard to the above mentioned parcel, I have reviewed the design and
the proposed facility addition and feel that there will be no significant impact
on the existing septic system. In addition, Pioneer Digging Inc. has done a
complete Operation and Maintenance inspection and found the system to The in
satisfactory working condition.
Best Regar
,r
� Stejwaler
Ro
Pro a System Designer