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Home My WebLink AboutSPH94-0201 - SPL Application - 12/27/1994 MAeON COUNTY DEPARTMENT OF HEALTH SERVICES �; p� r . POST OFFICE BOX 1666 �WJ ilf�'� BE �t.11 11 SHELTON, WA 98584 (206) 427-9670 FAX 427-8425 DEC 2 704 APPLICATION FOR PLAT EVALUATION N9F_ V R` `ICES Receipt N�7 Date of Payment: 9i 1. An application is considered complete when the fee is paid and the following elements have be7add- edd: • parts 1 and 2 of the application form must be completed. • One properly excavated backhoe pit per proposed parcel must he ready for inspection. Propeted pit.are 6 ft deep with a 4 ft deep shelf on one end of the pit. The 4 ft deep shelf moat slop groundsurface for easy ingress and egress. • A scaled plot plan must be attached to the application. The scaled plot plan most show thocationof the test holes, dimensions of the property, and location of any existing or proposed we orbuildings within 100 ft of the property boundaries. 2. After a completed application is received, staff will inspect the property and provide the apth a written report. If the project requires more assistance than the evaluation of four teat holes and cosupleticm of this report, an hourly rate of $37/hour as set forth by the Mason County Board of Health may be charged to the applicant. Revised 03/04/93 PART 1: APPLICANT/PARCEL IDENTIFICATION i • NAME OF APPLICANT J ,qtj 13,, 7Mes • TELEPHONE ( ) S�zG-wf663 • MAILING ADDRESS /00 BOX 3/9 'E ou) (qO i8 I 6ext) Wa Y$SL(R gp02. CYty 6tata Lip elo183 • ASSESSOR'S PARCEL NUMBER 3 Z I 3 - 7 S - _ • LEGAL PROPERTY DESCRIPTION Se C_ 39 T L/ /J 1E ,3 • LOT SIZES (ACRES OR SQ FT) Z,LO /9L /,06/9G LOt 1 LOG 2 LOt 9 Let 4 • DIRECTIONS FOR LOCATING SITE '4;a d,J Cg.7Fi3/1 LoKt ZoO A 1re/Z. 5 Ta it 0"64A/- i; - B 7ILt3 T/g, PART 2: INTENDED USE OF PARCEL • INTENDED USE OF PROPERTY (Check One) : rul Single family residence El Multi-family residence Other, specify: • (WATER SOURCE FOR PARCELS (Check One) : El 4 �J Individual wells Community well _ Revised 03/04/93 Plat Evaluation PART 3: HEALTH DEPARTMENT REVIEW (OFFICIAL USE ONLY) ................. ............................................................................................................................................................ SOIL LOGS AM SITE CHARACTERISTICS # 1 lOT # 2, LOT Test Pit A Test Pit A Test Pit A Test Pit A 43-2 4/ -74 kjo LaXLM -Zs- --TA A)o LOAAA dfS- 2 7- Cd ko L A.' Z'el-—rl 41/1 Depth of root pan.: Depth of root pen.: 7,3r Depth of root pan.: 7,L Depth Of root pen.: _ Depth of mottling: Depth of mottling: Depth Of Mottling: - Depth of mottling: Depth to mat. layer; 7 L/ Depth to met. layer: 7,b Depth to met. layer: fr- Depth to rest. layer- _ Soil type (USDA): Soil type (USDA): &j Soil type (USDA): Soil type (USDA): L V Test Pit B Test Pit B Test Pit B Test Pit B ,0 -VA NOL AAA in—ZS gAtJOLLAM 0-2.1. T,(k)D L Q AA4 .33---?q aj ce l ..Q-A W-cww'i in# ZL--Ti/ wgm,,/Ae l Zt 39 uja4 Y- Depth of root pen.: Depth of root pan.' � Depth of root pan.: Depth Of root pen.: Depth of mottling: Depth of NOttliD92 Depth of mottling: Depth of ZkOttliU92 Depth to mat. layer: Depth to met. layer: 'Z F Depth to mat. layer: Z"L Depth to mat. layer: Boil type (USDA): Soil type (USDA): ly Soil type (USDA): Y Soil type (USDA): Curtain drain needed? Al Curtain drain, needed? Al Curtain drain needed? Curtain drain needed? Slope (t): 2 Slope m: Slope (%)t Slope (%): Shoreline? (Y/N): Shoreline? (Y/R): Shoreline? (T/N): tO shmaiva-i (YIK)- Kininus lot ize:a Mini— lot size:' Minimum lot size.' Ki-ijoun lot aim: Minimum lot size applies to new subdivisions and is defined as the -Aftinam allowable land area par "aidencst Or maiden- tial equivalent (450 gallons per day). C014KENTS Revised 03/04/93 Flat Evaluation PART 4: HEALTH DEPARTMENT REVIEW SUMMARY (COMMUNITY DEVELOPMENT USE) ................... ......... ... ............................................. ......................... ...... .................................I............... rN MEETS HEALTH CODE After examining lot size, proposed water source, and soil type, it is the de- 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. DOES NOT MEET HEALTH CODE After examining lot size, proposed water source, and soil type, it is the de- 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 consideration of the following factor(s) : HOLD APPROVAL UNTIL FURTHER ACTIONS ARE TAKEN BY APPLICANT After examining lot size, proposed water source, and soil type, it is the de- 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: Elcoodition(s) required prior to approval have been met by the applicant. Health Official Date PART 5: REVIEWER SIGNATURE ................. ............................................................................................................................................................. h Official Date Revised 03/04/93 Plat Evaluation MASON COUNTY DEPARTMENT OF HEALTH SERVICES POST OFFICE BOX 1666 SHELTON, WA 98584 (206) 427-9670 FAX 427-8425 SHORT PLAT EVALUATION What is a short plat evaluation? short plat evaluations are written determinations by the health department whether on-Bite sewage disposal systems for general categories of developmen- tal land use on specific parcels of land meet current requirements of state and local health regulations. Short plat evaluations also identify factors that could limit the parcels' ability to accommodate on-site sewage disposal systems. -- Why do people request short plat evaluations? Property owners request short plat evaluations as part of county requirements for subdividing their land. The county needs to know whether the parcels will be buildable before approving land divisions. Do short plat evaluations guarantee parcell are buildable? No. Short plat evaluations take into consideration the health codes and po- licies in effect at the time of evaluation. These items periodically change. Short plat evaluations are not considered legally binding for the health de- partment, though a moral commitment is recognized and site evaluations are honored whenever possible. Legal issues surrounding pre-evaluations have caused some health departments to stop offering the service altogether. Do short plat evaluations allow property owners to begin preparing parcels for building? No. During the short plat evaluation, the health department usually has minimal information concerning building size, building placement, road place- ment, and well placement. These are critical design elements and might need to be altered in order to allow for approval of on-site sewage disposal sys- tems. Excavation associated with site preparation could make it difficult to alter these design elements and could damage the only useable drainfield areas on the parcels. Caution: It is possible that building site preparations made prior to design of septic drainfield systems could render sites unsuitable for on-site sewage disposal. How can I obtain a guarantee that a parcel is buildable? Obtain an approved On-Site Sewage Disposal Permit. Permits specify septic drainfield designs and locations to serve the sewage disposal needs of spe- cific developmental proposals. Permits are valid for three years from the date of approval. Revised 03/04/93 "o i 0o zz •2s MCP, 5t -U:zt o F O <oo ffpp O m\ p z a s Hil�II�TY nnv m Om• o mm = N� 0.Zi Z A ��L,s7 cz) Llg G zto im00 N m o Tr m�ri OV Oo mIJ OO n� M OO m o N m c �tid O N 0 O, •[ tt Ln v z n n n n ? (A N-` \ N Oy Z m D O n QNt r. m add ( w QW Of n O LAII o zz� Op�O. �m a O O o m ro 6� m � o O �-0:•P O m� Ol M> rrr 0 m F4 N NOO �/ r ti FN -1 D O f0 O t0 �4 . .�`0 y m co� O (A CA m 0 O wcn�, y� to ytn��a m �. �ob V m D W N4. v C O 00� Q A� M zzz 0NAo �r o1'- zc j� OZ m0 NNgZ DO O DI-i �O N Z 1m0 0 OIII.WWW... mW _ -i O1_ 0W OO � r- N m N Eny • m D N Z GI w -pl 245.00' 159.45' 150.55" 1404.12' y w 310.00' m Cn N 00'37'47" W �o00 oc zz -a � C a � a �4* o � 0^l (-.6 m0 O O � NOY`� Z °a �A � k � tu � � ;. ; RICHARD B. NORRIS P.L.S. Re +• n +• P.O. Box 397 0 1� (206) 427-5530 r V +o a SHELTON, WASHINGTON 98584 7 a a n n n a JOB # 34(21,3)10 ti