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HomeMy WebLinkAboutSPH94-0146 - SPL Plot / Site Plans 1 x 2 i O A � "• �� � � T� r Ul D m w O �r a -rya G Z cn \ Z 2 O CJl o r~I Ippn r. C m -i y A O 2 C') f D Zl �i CC) N �/ -rc O - i Z m D - o �u �l O -i W m a -j a < a m y � v \ Rl ( LEWIS ) cn m -i Cn y z y 1. 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An application is considered complete when the fee is paid and the foll7siaments have been addressed: ' Parts 1 and 2 of the application form must be completed. • one properly excavated backhoe pit per proposed parcel must be ready Properly excavated pits are 6 ft deep with a 4 ft deep shelf on one end of the pit. The 4 ft psef must elope up to the ground surface for easy ingress and egress. A scaled plot plan must be attached to the application. The scaled plot plan must 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 ft of the property boundaries. 2. After a completed application is received, staff will inspect the property and provide the applicant with a written report. If the project requires more assistance than the evaluation of four test holes and completion of this report, an hourly rate of S37/hour as net forth by the Mason County Board of Health may be charged to the applicant. Revised 09/01/92 PART 1: APPLICANT/PARCEL IDENTIFICATION ..................................................................... .......................... :`:................... • NAME OF APPLICANT CarNY WAiK�R.. :..•............................... • TELEPHONE (206 ) $S7-']$82 • MAILING ADDRESS 7515 )42Np ST. Or. AJO _G�G N.ea oz. ula 983 City s t•t Sip • ASSESSOR'S PARCEL NUMBER 2 � _7 -7 - • LEGAL PROPERTY DESCRIPTION LOT 0 F L hR wr L o r 5V6 )J VI5't 0Aj A o 1) • LOT SIZES (ACRES OR SQ FT) 00 JAL, 2S C• 0 Lot 3v �] 1 � '• 3C 3C '.� • P � Lot Loa 3p • DIRECTIONS FOR LOCATING SITE A,.5r ELTON-> AfE'nNNwr3 to &goeview G� R,� IN,gRfeC,,o„� Sw�-,�ueao cK. E TN 61J Da r R VOWS�a. (oD 9D D•7 I 1216KT LR7AAS yo Su Br �0 &,CyrKOY VAIDBR ,0C(NOG% CAB,9" Gars Avet R oA r AT DocJBtL OOtLrdT 6RTSIOQ OF PART 2: INTENDED USE OF PARCEL Ei: .......................................................... .iE ............. ... ............. .................. • INTENDED USE OF PROPERTY (Check One) : NA LON Single family residence ❑ Multi-family residence Other, specify: • WATER SOURCE FOR PARCELS (Check One) : ❑ Individual wells Community well short Plat Evaluation rA11T,j- HEALTH DEPARTMENT REvir..w (OFFICIAL USE ONLY) .. ....................................... .% .. ... ............................... ..... .. ... ................ ..... .................... SOIL LOGS AND SITE CHARACTERISTICS *1 A -1 L40T I LOT Lar 0 MA-4f wa 9w Test Pit A Test Pit A Test Pit A Test Pit A est wT LM "OT Test P Test P 1% Test I 71a YL 1, (T 11C-�l �o A /y MAY 4-19-3 0-11 Depth of root pen.: 119, 1.90)1 As vp Depth of root pens Depth of rob pen.! Dep pen th of root .: 17 Depth of mottling: Depth Of mottling: Depth Of mottlings tj At Depth of mottlin:y.r, Depth to rest. layer: Depth to rest. layer! Depth to rest. layers A 8011 type (USDA): SOIl type (USDA)! Depth to rest. I Test pit B soil type (USDA)f 8011 type (USDA): Test pit a Test PI 0- W N 6 t3 Test Pit B3 *teA 6- 107, m /61`7 7717 .6-2 n s 137 %if t .5(7-d Alljl - Depth of root pen.: Depth of root pen.t Depth of root pent Depth of mottling- Depth Of mottling: Depth Of mottlings Depth of root pens Depth of t n Depth to Depth Of mottling: rest. Jay-It' Depth to rest. layer .2p - soil type (USDA)! Soil type (USDA)f Depth to rest. layers Depth to at. layers soil type (USDA)l soil ------- 3011 type (USDA)! Yp Curtain drain needed? Curtain drain needed? Curtain drain needed? Curtain drain needd? V Slope (%)I slope (s) slope (%)I Slope (11)1 Shoreline? Shoreline? (Y/m): AL Shoreline? (y/m)l Shoreline? (Y/m)s Minimum lot 9120!^ Minimum lot sizes' Minimum lot sizes Minima lot size:^ Minimum lot 0120 applies to now subdivisions and Is defined an the minimum allowable land area till equivalent (450 gallons per day). per residence or residen- .ennui�. rLa�. G V d1LLG1.lUl1 PART A: HEALTH DEPARTMENT REVIEW (OFFICIAL USE ONLY) SOIL LAGS 1l1M SITE C ARACTERISTICS ror # -. LCT , a war un # pew Test Pit A Test Pit A Test Pit A Test Pit A gn .f I e•1�r� � ., �z � ,� 'vd S3?d u rIFY 11 PS -ZDepth of-root pen.: Depth of root pen.: Depth of root pen.: Depth of root pen.: Depth of mottling: Depth of mottling: Depth of mottling: Depth of mottling: Depth to rest. layer: ) Depth to rest. layer: Depth to rest. layer: Depth to rest. layer: Soil type (USDA): Tyr— Soil type (USDA): Soil type (USDA): Soil type (USDA): C Test Pit B��� Test Pit B r(,(%�� Test Pit 0A � Test Pit B 4 1079 0 67777 0136714-, n#) 5 ,r, 1 1-5 Lit 107 Depth of root pen.: J Dep��rootpen.: (p Depth of root pen.: Depth of root pen.: Depth of mottling: Depth of mottling: Depth of mottling: Depth of mottling: Depth to rest. layer: Depth to rest. layer: Depth to rest. layer: Depth to rest. layer: Soil type (USDA): Soil type (USDA): Soil type (USDA): Soil type (USDA): Curtain drain needed? Curtain drain needed? curtain drain needed? Curtain drain needed? ` Slope (i): �/I© slope (t): AWL slope (i): Slope (i): Shoreline? (Y/U): Shoreline? (Y/N): shoreline? (YIN): Shoreline? (Y/P): AL Minimum lot ' ittnimua lot .ize:_ Ministnq lot .ize:'� L ![inimum lot size:' 4 '� Minimum lot size applies to new subdivisions and is defined as the min+*-•�� allowable land area per residence or residen- tial equivalent (450 gpllons per day). �MRliTB Short Plat Evaluation PART 3: HEALTH DEPARTMENT REVIEW (OFFICIAL USE ONLY) SOIL LOGS AVD SITE CHARACTERISTICS LOT ` �c Lr LOT I LOT N LOT # Id �l Test Pit A Test Pit A Test Pit A Test Pit A } 1a7MQ� �t � alai rn MAO ,� 4t Depth of root pen.: Depth of root pen. sr Depth of ro6type Depth of root pen.: Depth of mottling: Depth of mottlin W — Depth of mottli Depth of mottling: Depth to rest. layer: //1�i Depth to res lay Depth to rest. Dyer: Depth to rest. layer: Soil type (USDA): Soil type ( .SD `' � Soil ty �SDA): Soil ty pe (USDA): a � Test Pit B�1 O�� � Test Pit ~ Test Pl Test Pit B 7 w r� Depth of root pen.: Depth of root pen.: Depth of root p pen.: Depth of root pen.: Depth of mottling: Depth of mottling: Depth of mottling: Depth of mottling: Depth to rest. layer: - Depth to rest. layer: Depth to rest. layer:Y Depth to rest. layer: Soil type (USDA): Soil type (USDA): Soil ty pe (USDA): Soil type (USDA): Curtain drain needed? Curtain drain needed? Curtain drain needed? Curtain drain needed? Slope (%): Slope (B): Slope (%): Slope (8): Shoreline? (YIN): Shoreline? (YIN): Shoreline? (YIN): Shoreline? (YIN): Minimum lot size:' Minimum lot size:' / Minimum lot size:' Minimum lot size:' ' Minimum lot size applies to new subdivisions and is defined as the minimum allowable land area per residence or residen- tial equivalent (450 gallons per day). COMMENTS • Short Plat :evaluation PART 4:' IIEALTII DEPARTMENT REVIEW SUMMARY (COMMUNITY DEVELOPMENT USE) .................................................................. .... . ... . .. . .......... ...... ........... .... ............ .......... 0 A /OV3 C7-\ 20M 9- A!17_S P071— 1)ppgrjP_s -F34A-r HERTS HEALTH CODE F`0 4s;b& I'- fo'S W i C l G, 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 pa cel cannot support an on-site sewage disposal system meeting the require- a Wta local g latigna untl the following conditions are met: "A ^ A—TV1171L AM AM> 17 U) AAe- r:J'7,d XWOJ%..9711 1 P7 (s) r* p for to approval hav an mot y the applicant. Health Of i&l Data Co V Health Co40f( W PART 5: REVIEWER SIGNATURE ......................... ................... ......... ..... ........................ ..................... ........ .......... ... Health offifal Date