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HomeMy WebLinkAboutVault Toilets - SWG Application­77 .. 77 .S A S E PERMIT NO. SWG MASON COUNTY DEPARTMENT OF HEALTH SERVICES ------- N 426 W. CEDAR/P.O. BOX 1666/SHELTON, WA 98584 Date <. N PHONE (360) 427-9670 Receipt No. I n Amount$ —' Z F P8PPER7y OWN ATE:R: _ P 91 ate, t. a,r-�io,t`S Cp,,,�, ' �i ('Z �O'�j CHECK APPLICABLE ITEMS �/ m MAILING ADDRESS: DAYTIME PHONE: NEW SYSTEM b L{gO'Z S- 1`tF,- S14 72L3 - 7-Gz - 7731 REPAIR SYSTEM CITY: STA E: ZIP: TABLE 6REPAIR v WVA gF?L1o5- 19VZ MAINTENANCE REVIEW m PROPERTY ADDRE S: 1 T i 1 SINGLE FAMILY Z \ '25 6 6 ?_ k^O\oa. W a 1o.�k V Q `� B OTHER: C- w 3 PRIVATE WELL SPECIFIC DIRECTI NS FOR LOCATIN SITE: U 1 m rv\ d�� COMMUNITYWELLIPUBLICSYSTEM ,A \ ,/ SYSTEM WFI# I� �✓ 1'��dt•;L� `-41l�R. • SYSTEM NAME APPLICANT NAME �tS a -_T_ Name of Lot ft.x ft. MAILING ADDRESS Installer r WA '( 1,is vw' Size: acres TELEPHONE 36o 731 361 Name of Number of SIGNAlI�R o Designer Bedrooms X !!�¢// ' O OFFICIAL USE ONLY BELOW THIS LINE DEPARTMENTAL SOIL LOGS DEPARTMENTAL COMMENTS/CONDITIONS I G m Art AOr�1, I I c J 1$� r ' fU 1A10AjkAdQ,l/t t8;Ie�S• Pay., O�,.in,.. ���� A .C7 ON � m c� M my `_' a m a o w SOIL TEXTURE CODES: V=Very G=gravelly S=sand L=loam Si=sift C=day E=Extremety INSPECTOR(print name) INSP ION SIGNATURE GATE PERMIT PI TION DATE Fie yW 0 b •All systems require ongoing Operation and Maintenance(08M)as specified in Mason County On- ' Standards. •All on-site sewage systems must be designed by a Mason County Certified Designer or a Professional Engineer,unless prior approval is granted otherwise •All on-she sewage systems must be Installed by a Mason County Certified Installer,unless prior approval is granted otherwise.In such cases a preliminary on-site meeting between health department staff and the homeowner is required. •On-site sewage system design approval does not imply other building she requirements(i.e.RLC,Water Adequacy)have been met. •Any change from the specified use of the property or any site alteration affecting the system design may invalidate this permit. •This permit expires 3 years from the date of she review.Denial of this permit may be appealed to the Health Officer within 10 da s of denial date. DESIGN REVIEW APPROVAL BY: DATE: INSTALLATION APPROVED BY: DATE: TOP: Health Dept. Copy MIDDLE: Designer's Copy BOTTOM:Applicant's Copy HAHOBAS SCOUT RESERVATION MCILITY 4 SITE LOCATIONS _. To WJCH 'I . S 1U •% UN CHAR . r TWANA conSSMRY -3. Y le �+ �A�nc NVSRBG . - NMCCRArrUWE 501111 �E ��'•''�'''z SMor�unWISE RANGE 1WAtN .w Y GATE TO DWAR - r i a OWACLE _ CAM FM CHAI PU �� .TY.C.��• `J11M11 1 ,CiiiLLo ACCESS ROElINS NEW LATE LAKE StpWERs �,/ l t i TAHOMA tANOnA w IODGE • �STAFI�i �" ,COVFE�/ PARIING _ ' LOT DO PALLS , SLY S1AFF� . FIELD ♦�i DdAKE SUL G MSERVATNMI .—. LW6E RESERVAINNIQ •�� ALDpGN ""' . MAINTENANCE ENiPANCE LACE camssw CATE HAHOBAS SCOUT RESERVATION NEALTN RANGEE9 HNS NE 1365 HAHOBAS WAY LODGE TAHUYA. WASHIN60N 98588 TO SELi < 360.372.2701 - 3`a- 04/17/2003 14:39 3602758531 BEISLEY INC PAGE 02 Beisley Inc. PO Box 2355 Ph.(360)275-5783 Belfair,WA 98529 Fax(360)275-8531 17 April, 2003 Mason County Building Dept. 426 W.Cedar St Shelton. WA. 98584 360-275-4467 ext.352 Re: Boy Scout Camp Hahobas Dear Sir/Madam, After the existing nineteen out- houses have been removed the vaults will be filled with drain rock. Yours Sincerely Bill Beisley/ Presidents APPROVED MC HEALTH OEPT APR 2 3 20W PSD 04/17/2003 14:39 3602758531 BEISLEY INC PAGE 03 Beisley Inc. P.O. Box 23559 Betfair,WA. 98M 360-275-5733 / fax 2754S31 LETTER OF TRANSMITTAL MMa h 27, 2003 FROM: Mark T. Brock TO: Mr. Larry Sorenson Pacific Harbors Counsel Boy Scouts of America 4802 South 19'' Street Tacoma, WA 98405 Phone: 253-752-7731 Fax: 253-752-7819 " PROJECT: Construction of nineteen sanitary facilities at Hahobas Boy Scout Camp SUBJFXF; 'Ilse following items are being uansmitted. Attached you will find a sketch if the proposed changes to holding tank. I can order the fabrication of the holding tanks as soon as I receive approval of the new layout and the signed contract. If you would like I will accept a fax copy of the contract so fabrication can start sooner,the fabrication will take two weeks. APPROVED MC HEA1_TH DEPT APR 2 3 ZUu3 PSD Signed By Mac of ` '04/17/2003 14:39 3602758531 BEISLEY INC PAGE 04 UY ' ! I ir 1 - .. O ' % I I - 1 1 V `SIC 1 . 1 APPROVE MC HEALTH DEpr APR 2 3 2003 PSD I I I I Ns , 04/17/2003 14:39 3602758531 BEISLEY INC PAGE 05 M PPRo eD APR SB9.6O1 2 3 2003 is 0 FAX C10�ggl 19212 VGIUV Amnus Fast • Sumner. WA • P.O. Baas 88 • "390 I000 641 �I GI'r� �oMpAf' I T�K ( i Z�T�I Mob 1 - I 1, ��• is Tor � 04/17/20@3 14:39 3602758531 BEISLEY INC PAGE 06 MAPPRO VEp Pr APR 2 3 �v03 psi) :lk 0�1 cl IFI I