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Home My WebLink AboutSPH93-0033 SP2267 - SPL Application - 2/1/1993 UNTY DEPARTMENT OF HEALTH SERVICES POST OFFICE BOX 1666 SHELTON, WA 98584 (206) 427-9670 n„Aff FAX 427-8425 �TION FOR SHORT PLAT EVALUATION Receipt No: G/ INSTRu05E®Net 1993 7Y1 Date P ant: "M ClOn is rm,idered complete ..", the fes is paid and the follaslog ,pants have been addramoodz SERVI • part+ i and < of Me qES tion form must Oe completed. • One properly sacavat*d p.cahos pit Par proposed psrcal met be ready for inspectl®. Properly s:iavared Pita I ate 6 ft deep with a a ft deep *half on one and of the pit. The 4 ft deep spelt stet slope up te the ground surface for easy ingress and agrees. -� A 4451ed plot plan s:at be attached to the spplicacion. The scaled plot plan sust show the preales location of the test holes, dimsOliOna Of the proparty, and location of any misting or proposed wells, road+, or buildings within 100 ft Of the property boundaries. 1. After a completed application is raCelved, staff will inspect the property and prwlda the applicant with a written report. :r %be Project requires Mrs aasiscence than the waluatisn of four tot holes and Completion of this rapett, an hourly rate of :37/hour as net forth by the Mason Comty Byrd of Naalth any be dharged to the applicant. Beela" 09/01/22 PART. 1: APPLICANT/PARCEL IDENTIFICATION ..................................... ........... ......::.... ......._...._........................r::::«.!...!..!!.:s«ssr.::az::::: .. ....... ....... • ..... ::•..:.. ............. ..... .. :::::::::::::::................... ..:::::.................................................................•• :::::«:::::::::::.-..«::«s:::::z:�•..�•::••.=r::::«:z::iiiiiiiieiiz«:: 1 • NAME OF APPLICANT AJA a KC(ITELEPHONE ( h) Q Vo-Z-ggo • NAILING ADDRESS -7 I � I U' l Q 14�V I �/� I )Mini jaiI�)� QPSrJ q _�1011y 1 • ASSESSOR'S PARCEL NUMBER 3 Z I 3 7- - 3 z - — — — — — • LEGAL PROPERTY DESCRIPTION U A, Yl I � 4 n l P)�,d ,(��1 ) G U, fL 1 ( • LOT SIZES (ACRES OR SQ FT) J ,y_q � p2•/.&xg - t'J � sae r ran a r.•s a ! • DXRXCTIONS FOR LOCATING SITE PART 2: INTENDED USE OF PARCEL l7 et car ::::::::Unii•..::::.................... .................. ......::::,.....:: ........... « : • INTENDED USE OF PROPERTY (Check One) : 01 Single family residence Multi-family residence Other, specify: • WATER SOURCE FOR PARCELS (Check One) : r^ Individual wells community well PART 3: HEALTH DEPARTMENT REVIEW (OFFICIAL USE ONLY) ............................................................................ ..................................... ................................................... SOIL LOGS AND SITE CHARACTERISTICS rPe11. WT 0 LOr a we. Test it A Test Pit A Pit A Test Pit A C "kk �4 IS. 4 W`J J/VhAD 5.4W Awrt L Depth of root pan.: DOPth Of root pan.: U.Pth of roor Pon.: Depth of root Pau.t Depth of settling: Depth of mottling: Depth of mottling: Depth of mottling: Depth to "at. layer: 3w Depth torest. 1.y.,; �..P"�. to rest. layer: Depth to rest. layer: Soil type (USDA): Soil type (USDA): 1 1;.1, type (USDA): I Soil type (USDA)[ Test Pit B Test Pit 8 i 7.9t Pit 3 Test Pit a Depth of ract Pon.: Depth of CWC Pon.: D.Ptn of root pan.: Depth of root pen.[ Depth of mottling: — Depth Of mottling: Depti, of mottling: Depth of mottling: Depth w "St. layer: — Depth to rest. layer: Deptn to net. layer; Depth to rest. lwjw: Sail type (USDA): — soil type (USDA).- Soil type (USDA)[ SOLL type (Umfth)z curtain drain needed? Cxirtain drain needed? CUZteln drain nsded7 Curtain, -rain bo"sd7 slope Slope 31OP. Slope (1k): Shoreline? (YIN): Shoreline? (YIN): I Shoreline? (YIN): Kinlamma lot s1z." N Kill— lot size:- minimum lot size-� MI-1-1- 11Z 2 W. N 2 c, 0 -I L&4 1-00c , K"I-'- 'M size -PP"*' W " -Ohdiv1810-- and illfl-ed n- the .11owbl* law arse par r1middOWN, OV resided- ti&1 Qquivllmt (450 gallons per day). COMIENTS Lnis ) . 0 , i R AN;q -4g; Lq --Lift0m I 140") uaw o4tfu, Revised 09/01/?- 'PART 4: HEALTH DEPARTMENT REVIEW SUMMARY (COMMUNITY DEVELOPMENT USE) ..................... ............................................................... ............................................................................. ::::...... APPROVE After examining lot size, proposed water source, and soil type, it is the do- termination of Mason county Department Of Health Services that each proposed parcel can support an on-site sewage disposal system meeting the requirements of state and local regulations. DENY After examining lot size, proposed water source, and soil type, it is the do- termination of mason county Department of Health Services that each proposed parcel cannot support an on-site sewage disposal system meeting the require- ments of state and local regulations. This determination is based on conuLderation of the following factor(a) ; APPROVAL UN= FURTKKR ACTIONS ARE TXXEN Br APPLICANT After examining lot size, proposed water source, and soil type, it is the do- termination of Mason County Department of Health Services that each proposed parcel cannot support an on-site sewage disposal system meeting the require- ments of state and local regulations until the following conditions are met: Cl CMALU=(.) requIred prior Ppi .a b. by tbe ^ppliZ. 3"ith Orflcw O.C. PART 5: APPROVAL SIGNATURE ..................... ............................................................................................................................................... Health Official Dace (ISLAND WEsr SHORT PLAT ' ASSOC) APPROVED ———S e '4 ' E 309.80—— I D I RECTOR OF COMMUN 1 TY . _ ___ DEVELOPMENT • I i SHORT PLAT LOT 1 DALE &F ANDREA 1 . 00 AC. 1.11 DRE WR Y I� IN ---- 4 --- - SW 1/4, NW 1/4, a I I NW 1/4, SW 1/4, �� / SEC. 32, TWN. 21N. , R. 3W. , W.M. 14 a // LOT 2 i $� I 7401 FAIRVIEW RD. SW 12 �6 — 1 . 00 AC. "' — i �� I g I OLYMPIA, WA. 98502 t3 PARCEL 321323200110 Be3s'4,= E� -_' I m 1 LEGEND: 0=15 IRON BAR & PLASTIC ses a YELLOW CAP SET 3I I I O=IRON BAR WITH PLASTIC CAP FROM PREVIOUS SURVEY $ I I ©POSSIBLE WELL z \LOT 3 ' I ■ =SOIL LOG 2. 10 AC, 15' DRAINAGE I THE PROPOSED LOCATION OF �U(TYPICAL) I I WELLS AND too ' RADIUS ARE �P I I ADVISORY ONLY. WELLS 1 TE e95. P� 5 I I APPLICATION A SEPTIC SITE ro INSPECTION MUST BE APPLIED w O \\ Cl 20 T9'58' I FOR PRIOR TO BUILDING PERMIT. A.V S R-240.00 I 50' EASEMENT FOR 31 i 25' GREEN \ • L=86.57 I INGRESS, EGRESS, CAM � AREA ESM1T. ? 9�• DRAINAGE AND UTILITIES. (PRIVATEjAF/555115 PROP. 32 LOT 4 ' . , I NOTE: / 1 . 90 AC. E` N \\\ I SEE BOUNDARY LINE I 199�T. ADJUSThENT 192-98 I 141CR) AS RECORDED UNDER AF MASON RECORDS MASON OF COUNTY, WA. C2 // LINE TABLE GP 3571'25 No. BEARING DISTANCE / R-240.00 L1 S 5520'25' IV 55.79 F — L-147.40 / L2 N 7558 '51' E 51.37 a L3 N 59*52'09' E 75.09 15 ' UTILITY / / 25 _SEMEN / �0 5t L 4 N 5321 '17 E M 59.J7 (\\iceR rl�,�.l O A \ �5� ti.. ....: ..k ■ NS�N NO � .:��o w , SCALE: 1 =100 0 0 50 100 TSiiii200 WARNING: MASON COUNTY HAS NO 92154SP4 RESPONSIBILITY TO BUILD, IMPROVE, MAINTAIN, OR OTHERWISE SERVICE HOLMAN & ASSOCIATES THE PRIVATE ROADS CONTAINED PROFESSIONAL LAND SURVEYORS WITHIN, OR PROVIDING ACCESS TO 2323 N. ADAMS, SHELTON, WA. THE LAND DESCRIBED IN THIS SHORT (206)426-2990 98584 PLAT.