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Home My WebLink AboutSPH95-0094 - SPL Application - 8/24/1995 MASON COUNTY DEPARTMENT' OF I1EALTH SERVICES POST OFFICE BOX 1666 3Z13`I - liG - Goo9 I SHELTON, WA 98584 (206) 427-9670' APPLICA FAX 42 7-7798 IjTION FOR LAND USE EVALUATION 1�1�� Receipt No: a28 ( Date o£ Payment: `� a INSTRUCTIONS e—,- Ft4q5 _ 4 1. An application is considered complete when the fee is paid and the following elements have been addressed: • Parts 1 and 2 of the application form sust be completed. • one properly excavated backhoe pit per proposed parcel must be ready for inspection. - Property excavated pits are 6 It deep with a 4 It deep shelf on one end of the pit. The 4 ft deep shelf must slope up to the ground surface for easy ingress and egress. • A scaled plot plan must be attached to the application. The scaled plot plan aunt show the precise location of the test holes, dimensions of the property, and location of any existing or proposed wells, roads, or buildings within 100 It of the property boundaries. 2. After a completed application is received, staff will inspect the property and provide the applicant with a written report. i I IMPORTANT: IN ORDER TO AVOID ADDITIONAL COSTS, BE SURE TEST HOLES AND PARCELS ARE ALL FLAGGED AND CLEARLY DELINEATED AS TO LOT AND TEST HOLE NUMBER. THE IDENTIFIED TEST HOLES MUST MATCH THE LOCATIONS SHOIM ON THE PROPOSED PLAT MAP. i PART 1: APPLICANT/PARCEL IDENTIFICATION L Large Lot Subdivision 1�1 Short Plat Ei Subdivision Ei BLA (Office Review) $100 + $10/parcel L-' $85 $400 + $20/lot $10 • NAME OF APPLICANT MAJ�10IA46 `/D. fOVJU& TELEPHONE (X0 ) 537-2.76L • MAILING ADDRESS IDI S 130t!I #L3 g66-71 gcog3 Li! ) ,�_ 9009A 9ov9q • ASSESSOR'S PARCEL NUMBER � 4 - 7 5 - LEGAL PROPERTY DESCRIPTION NWV4, S'Gy#, 56C. 34jTZ/A1jk30,Wj1• • LOT SIZES (ACRES OR SQ FT) 1 he, I•A t. 1.13 Af 9 oC � DIRECTIONS FOR LOCATING SITE _ A TJ•AL/IBG PART 2: INTENDED USE OF PARCEL AGATE LAND SURVEYING E. 2680 Agate Road •�I7INTENDED USE OF PROPERTY (Check One) : f—I Shelton WA 98u$4 lL` Single family residence u Multi-family residence Other, specify: WATER SOURCE FOR PARCELS (Check One) : J� Individual wells U Community well H:\ON-SITE\LNDUSE.N Revised 12/05/94 Land Uae Sbaluaticn PART 3: HEALTH DEPARTMENT REVIEW (OFFICIAL USE ONLY) SOIL LOGS AND SITE CHARACTERISTICS 1 LOT # I LOT # /3 I LOT # -?C I LOT # _� I Test Pit A I Test Pit A I Test Pit A I Test Pit A b-.del 5-AA 1/-c )4 I 0 -"1- 0-j S'AA,m I 0-2(31Au&TLdar. I o-I-T SAA,u7 .Z.Ca ..(-N SA N•�l46hlv-(— I� ~_f•? 5ANd1�ra�L I 2a'6o SR.W /�j ro L I /7 w4iw 'Ti4b/r T- iW I rrr //9 I rrr./a I 'o4 "7wt� d}/Z� I r"� I I I I I I I T�s y �-Y 1��•-e � 1 I I I 4 -nz-s,— 1 1 2� I i a� I I Depth of root pen.: I Depth of root pen.: 3 I Depth of root pen.: — I Depth of root pm.: )-7 I Depth of mottling: I Depth of mottling: I Depth of mottling: I Depth of nettling: ) 7 Depth to rest. layer: 2u I Depth to rest. layer: 3 9 I Depth to rest. layer: EO I Depth to rest. layer: 1-7 Soil type (USDA): N I Soil type (USDA): 14 I Soil type (USDA): y I Soft type (USDA): Test Pit B I Test Pit B I Test Pit B I Test Pit B I I I I I 1 1 I I I I I I I 1 I I I I I Depth of root pen.: — I Depth of root pen.: — I Depth of root pen.: — I Depth of root pen.: — I Depth of mottling: — I Depth of mottling: — I Depth of mottling: — I Depth of mottling: — Depth to rest. layer: — I Depth to rest. layer: _ I Depth to rest. layer: — I Depth to rest. layer: — 1 Soft type (USDA): — I Soft type (USDA): _ I Soft type (USDA): Soft — I type (USDA): I Curtain drain needed? ,� I Curtain drain needed) I Curtain drain needed? I Curtain drain needed? I Slope <x): I l� i slope M- i slope (%): C� i Slope (x): Shoreline? (YIN): N I Shoreline? (Y/N): _J= I Shoreline? (Y/N): `I I Shoreline? (Y/N): I Minimum lot size:A I Minimum lot stze:A i Minimum lot size A r i Minimum lot size:A I I I 1 A Minimum lot size applies to new subdivisions and is defined as the miniaum allowable land area per residence or residen- tial equivalent (450 gallons.per day). CO? IEWS n T v w 71. 5- N:\014-.STPF\LN0(ISF..W Fevlsed 12105194 Land Use Evaluation PART 4: REVIEW SUMMARY (COMMUNITY DEVELOPMENT USE) 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. F9 6=4 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: n u Condition(a) required prior to approval have been met by the applicant. Health Official Date PART 5: REVIEWER SIGNATURE a th Official Date if:ION-.S1TE\6 nrlsr.W Rrvi,<rd 12/05/94 Marjorie D. Young Short Subdivision Assessor's Parcel No, 32134-75-00090 1. From Shelton NE on Highway 3 approximately 4 miles to Mason Lake Road on the left. 2. Turn left on Mason Lake Road and go approximately 0.75 miles(to top of Batstone Hill)to Catfish Lake Road on the right. 3. Turn right and go approximately 0.37 miles on Catfish Lake Road (gravel) to first intersection. 4. Turn left at intersection and go northerly on gravel road approximately 747 feet (0.14 miles)to new access road on the left(unfinished but driveable). 5. This access road runs down the property line between lots 9 and 10. 6. Test holes for Lot 9 are to the left of the road as shown on the accompanying short plat.