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HomeMy WebLinkAboutBLD2020-00023 SFR - BLD Application - 1/10/2020 MASON COUNTY COMMUNITY SERVICES Permit No: 20—coo-z' PERMIT ASSISTANCE CENTER: ,� _ •BUILDING•PLANNING•PUBLIC HEALTH•FIRE MARSHAL 615 W.Alder Street,Shelton,WA 98584 RECEIVED 'IPhone Shelton:(360)427-9670 ext. 352•Fax:(360)427-7798 Phone ,AN 13 2020 Belfair:(360)275-4467•Phone Elma:(360)482-5269 A 515 VV® Alder• �t���� BUILDING PERMIT APPLICATION PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION: NAME: --FC>d� Ti l NAME: Sv & (J o(lr'Zln. Lt) a��✓?w,f �eJ MAILING ADDRESS: 21 pVG" N �✓;ad►, 5'f MAILING ADDRESS:P.0, f3�,X 1'jS6 CITY: Pd-(S6 d STATE: LV^ ZIP: d CITY:141(!r , STATE:�ZIP: TKF � PHONE#1: PHONE: t CELL: PHONE#2: EMAIL : i �-.S. ,� o w�lovK• EMAIL: L&I REG# C z, N EXP. 7-/[J7 PRIMARY CONTACT: O NER CONTRACTOR[ OTHER❑ NAME_ 't'So.1 (,+ LN1CSrvl.S CdtlPri9 ,SQe0. EMAIL Lom st It-S&. e L)e I qp e_- ow Oak MAILING ADDRESS k ). K I zrr. CITY —STATE L0W ZIP ?PY ' PHONE CELL C,(oG� ro`f`I— 2 b�I— PARCEL INFORMATION: PARCEL NUMBER(12 Digit Number) 'Z Z(U` '7 ^ ,S'^O ^ O C)©6(� ZONING < LEGAL DESCRIPTION(Abbreviated) FIRE DISTRICT x SITE ADDRESS Z-7 Q o 1.. 1��{S � �,(� r^ .� CITY _ Gv�qy� l9 i e� DIRECTIONS TO SITE ADDRESS E � IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES❑ NO IS PROPERTY WITHIN 20 T OF THE FOLLOWING: (Check all that apply): SALTWATER❑ LAKE Nr RIVE CREEK ❑ POND ❑ WETLAND ❑ SEASONAL RUNOFF ❑ STREAM TYPE OF WORD: NEW d ADDITION ❑ ALTERATION ❑ REPAIR❑ OTHER ❑ USE OF STRUCTURE(Residence,Garage,Commercial Bldg,Etc)_ �e S/ Q�C� C.,'t q 4-_ IS USE: PRIMARY ❑ SEASONAL [yi NUMBER OF BEDROOMS_ NUMBER OF BATHROOMS_ HEATED STRUCTURE? YES(Whole Bldg) [� YES (Partis]of Bldg) ❑ NO ❑ DESCRIBE WORK IU P�.,� CS.�� �f� c'{ u0� �?� `1 ( ✓��e��i ��`�P SQUARE FOOTAGE: (proposed) 1 ST FLOOR I�j 2sq, ft. 2ND FLOOR sq.ft.' 3RD FLOOR sq.ft. r BASIjMENT 3 C sq.ft. DECKS sq. ft. COVERED DECK ,q.ft. STORAGE sq. ft. ..�.: _sq,ft. GARAGE 72, O sq.ft. Attached li�/Detached❑ CARPORT sq. ft. Attached❑ Detached❑ MANUFACTURED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED* MAKE MODEL YEAR LENGTH WIDTH BEDROOMS BATHS SERIAL NUMBER ENVIRONMENTAL HEALTH: SEWAGE/SEWER SOURCE: SEPTIC M// SEWER❑ / NEW❑ EXISTING PLUMBING IN STRUCTURE? YES NO ❑ Ifyes, attach completed Water Adequacy Form PERIMETER/FOUNDATION DRAINS PROPOSED? YES NO[] EXISTING SQ.FT. EXISTING BEDROOMS PROPOSED BEDROOMS TOTAL BEDROOMS OWNER acknowledges that submission of inaccurate information may result In a stop work order or permit revocation.Acknowledgement of such is by signature below.1 declare that I am the owner and I further declare that I am entitled to receive this permit and to do the work as proposed. I have obtained permission from all the necessary parties,including any easement holder or parties of interest regarding this project. The owner or legal representative, represents that the information provided is accurate and grants employees of Mason County access to the above described property and structure(s)for review and inspection. This permit/application becomes null&void if work or authorized construction is not commenced within 180 days or if construction work is suspended for a period of 180 days.. PROOF OF CONTINUATION OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS PERMIT APPLICATION OF 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED. (MASON COUNTY CODE 14.08.42) x �- 1 l t o( 2-- Signatur OWNER(Must be signed by the OWNER) Date DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS BUILDING DEPARTMENT PLANNING DEPARTMENT FIRE MARSHAL PUB LIC HEALTH a WATER WELL REPORT CURRENT oErEa7YeN7 of Nam&1acDPY—""logy.2mCopy—owner,3"copy—drllkr Notice of Intent No.`"359579 i ECOLOGYCOnstructiOn/Decpmmission('x"in circle) Unique Ecology Well ID Tag No.�N998 ® Construction Water Right Permit No. ❑ Decommission ORIGINAL INSTALLATION Owner Name Todd Tidball Notice of Intent Number property PROPOSED USE: ® Domestic ❑ Industrial ❑ Municipal Well Street Address E Mason Lake DR S. ❑ Dewaar ❑ Irrigation ❑ Test well ❑ Other County Mason TYPE OF WORK: Owner's number of well(if more than one) City Grapeview 0or N ❑ Reconditioned MetMd:❑ Dug ❑ Boned ❑ Driven Location SWI/4-1/4 NW Sec 8 Twn 21 R?iW twar Deepened ® Cable ❑ Rotary ❑ Jetted (s,t,r Still REQUIRED) wwm DIMENSIONS: Diameter of well t1' inches,drOW80 ft. DVtb ofoompletod wall80R. CONSTRUCTION DETAILS Lat/Long Lat Deg Lat Min/Sec Casing ® Welded 6^ Diem.from +1 fl.to Z§& Long Deg Long N in/Sec huttaaed: ❑ Liner installed Diam.from R to ft Tax Parcel No.(Required) 00048 ❑ Threaded Diam_From ft.to ft. Perierawnns: C1 Yes 0 No Type of ponfotator used CONSTRUCTION OR DECOMMISSION PROCEDURE Formation:Describe by color,character.am of material and structure,and the Itind and SIZE of m. m.and no.of nature of the material in each stratum penetrated with at least one entry for each change t by_ parts_from_ft.to ft. of information. (USE ADDITIONAL SHEETS IF NECESSARY.) Screens: ® Yea ❑ No ® K-Pre; LN;d m 73ft MATERIAL FROM TO Menufacnser'sNun Johnson brown sift bound Sd,G 00 09 Type Stanless steel wire wrap Mods No. 18 09 27 br till Diam.5 Sloe size tram L 8 m SQ f br sand&gravels 27 51 Diam. Slot size from R to ft. br s/g water bearing 51 80 Gravd?bVer packed: ❑ Yes ® No Size of gravel/sand Materials placed from ft.to a. Surface Seal: ® Yes ❑ No To what depth?18tt. Material used in seal Bentonite Chios Did any strats oonum unusable water? ❑ Yes ®No Type of water? Depth of strata Method of sealing strain off PUMP: Mmufacturees Name Franklin Electric Type:Submersible E.P. 112 WATER LEVEL&- Land-sorfix elevation above mean sea level ft. Static level 4_?A below top of wall Date 11/08/2017 Arteaien pressure lbs.par square inch Date Artesian water is wonolled by (cep,valve.etc.) WELL TESTS: Drawdown is amount water level is lowered below static level Wu a pump rest mode?❑ Yes ®No if vas.by whom? Yell___jaUmio.with_ft.drawdown after hrs. Yield:_galJmin.with—I drawdown after brs. Yell: IgaUmin.with_ft-drawdown after hrs. Rem►ery dam(rhnezAmaszem when pantoturnedof(materkwineawuadf-01 well rep to r aA7 kwi) R1 Vs Time Water Level rime Water Lave) Time Water Level Dam oftest Bailer test n gWAsun.with.Ift.drawdown afar Ohm. A~­pUmmn with strm aft at R for hrs ,artesian flow_g.p-m Date Start Date 11/02/Z017 Completed Date 11/09/2017 Tenperamro of water was a chemicsr amhsis made? ❑ Ycs ® No WELL CONSTRUCTION CERTIFICATION: I constructed and/or accept responsibility for construction of this well,and its compliance with all Washington well coashucaon stand,&. Meta ab used and the information reported above are true to my best lmowled le and belief. Driller Engineer L1 Trainee Name(Fdo)Dwane Knapp Drilling Company KNAPP DRELLIN4 INC DrWer/Enginm/Tramee Signature Address E 50 Lesscx Dr Driller or trainee License No. 1706 City,State,Zip Shelton Wa.98584 IF TRAINEE:Driller's Lioeose No� Contractor's Dri➢er's signaRtre';� — fa,aia Registratio nNo. I(2VAPPDI9S D] Date 11/09/2017 ECY 050-1-20(Rev 02/I O) Ifyou need this docmnenr in an alternate format,Please call the Water Resources Progratr at 360-407-6872. Persons with hearing loss can call 7l1 for Washington Relay Service. Persons with a speech disability can call 877-833-6341. Cascadian Water CASCAD IAN 5301 Airport Rd "`' Cie Elum WA Phone:509-674-4000 Fax:509-674-4002 CascadianWater.com Job Name: Sample#: Date: Tidball 121517-9 12/19/2017 Dealer: Distributor Branch ID: Tested By: 1L Knapp Drilling 3009 Pump GPM: 15 Pressure: 55 *Sample Is Untreated Desired GPM to treat: 10 gpm Customer is OK with Either Automatic or Cartridge Based Soluion Design Flow Max: 11 gpm Minimum BW Flow: 5 gpm(at 35 psig&<60°F) Primary Analysis: Result: MCL or Action Level Turbidity 0 0.3 NTU Cloudiness of water,interferes with treament,can indicate micro-organism problem Tannin/Lignin 0.1 1.0 mg/L (MCL=0.2mg/L for OATRAP®Media Systems)Causes colored water,stains and filter plugging. pH 6.65 <6.8 or>8.5 7.0 is neutral,over 7.0 is alkaline,under 6.8 is acidic and corrosive. ORP 214 None Indicates available oxidants in sample or overall cleanliness,ability of water to dissolve Total Hardness 3 gpg 3.6 to 7.0=moderately hard water.Over 3.5 wastes soap,forms scale&deposits in heaters and fixtures. Total Iron,Fe 0.05 0.3 mg/L Over 0.3 mg/L stains plumbing fixtures and clothes.Organic or Colloidal Iron Not Tested* Manganese,Mn 0.002 0.05 mg/L Over 0.05 mg/L stains plumbing fixtures and clothes TDS 101 500 mg/L Total dissolved solids,500 mg/L is EPA suggested maximum contaminant level. Other Info/Notes: KNOWN PROBLEMS AND OTHER INFORMATION:Water Source=New private well,Well Age=3 months,Water Quality is Consistent=Y,Location Sample Drawn From=Hydrant @ well head,Sample Drawn Clear=Y,New well,conditions unknown,no smell-No other information provided or considered. Recommendations: The following recommendations are based on the submitted water sample and information furnished.Should water characteristics change in the future,a new analysis will be needed and different treatment may be recommended.03WS is not responsible for recommendations based on upon inaccurate information.Tests performed by O,WS are for informational purposes only.O,WS does not have a certified lab and Performs water tests and makes recommendations as a courtesy only.Please submit anv lab test results to O�WS for consideration.*Treatment recommendation based on separating irrigation and treating domestic only,call for options if required to treat irrigation water.*No determination made as to form of iron,additional treatment may be required. Quantity: Recommended Automatic Treatment Max.Flow Min.BW Recommended ICS Treatment 1 AcidFIX-10 11 5 ICS-P,For hardness, iron,staining, low pH and 1 ICS-S5,Sediment depth filter sys. 15 0 silica 1 Pinnacle-10 11 2.4 Automatic Treatment Remarks: ICS Treatment Remarks: AcidFIXTM to raise pH (will increase hardness),stop blue stains and protect appliances. ICS-P, For hardness, iron,staining, low pH and ICS-SS,True depth filtration down to 5 micron silica Pinnacle TM to reduce hardness and iron/manganese in solution. Max. ICS Flow is 15 gpm. 12/19/2017 121517-9,Tidball,Knapp Drilling,3009.xism Contact Name-Charles Houghan ---\ WAT 26N - oc?l MASON COUNTY COMMUNITY SERVICES RECEIVED Building,Planning,Environmental Health,Community Health 415 N 6t"Street, Bldg 8, Shelton WA 98584, JAN 13 2020 Shelton: (360)427-9670 ext 400 •3 Belfair: (360)275-4467 ext 400 Elma: (360)482-5269 ext 400 FAX(360)427-7787 615 W. AIder StrE;e4 Application for Determination of Water Adequacy Instructions 1. Complete Part 1. No determination can be made until Part 1 is fully completed. 2. Complete only the portion of Part 2 applying to the type of water connection utilized. 3. Submit completed application, with any required attachments for review. 4. An approved building site plan must accompany this application. Part 1: Applicant/ Parcel Identification Name on Applicant: 'T� ..E r�t�.. Date: 1/101 Z O w Mailing Address: .d �jo, (`7 Phone: G'O —G W Parcel Number: +-i- Z2 S'o L Type of Water System Reason for Application ❑ Public/Community Water System (2 or more Building permit /connections) ❑ Division of land: ® Individual ter source(one connection), #of Parcels? SPL fY Well ❑ Boundary line adjustment ❑ Spring/surface water ❑ Other(explain} ❑ Other(explain) ❑ Replacement or Remodel (please indicate name If you have more than one residence connected of water system below if applicable—no to this well, check the Public/Community Water signature required) System box. Part 2: Water Connection Information Complete the section appropriate for the type of water connection being evaluated: HEALTH Public Water System Name of Water System: Water Facility Inventory (WFI) Number: (write"none' for two-party) ❑ 1 am the manager of this water system. The water system has been approved for services. There are presently connection(s) in use. This will be the connection. ❑ I am the manager of this system.This connection will be to upgrade or change the use of an existing connection on this system (i.e.: recreational to full time). Please indicate on the following line the nature of this change: This water system is able and willing to provide water to this (these) connection(s)without exceeding the limits of the water system or any limits set by state and local regulation. Signature of Water System Manager Date This form may be scanned and available for public view at www.co.mason.wa.us. JAEH Forms\Drinking Water Revised 1/252018 Individual Water Well ❑ Water well report (attached to application). Depth ft. ❑ Well capacity Test(attached to application) qpm gpd. The well driller often performs well capacity tests at the time the well is constructed. Results from these tests are noted on the water well report. Results from these tests will be accepted. If the water well report cannot be located by the applicant or if the water well report does not have a capacity test, a well capacity test, which provides stabilization of draw-down and recovery data, must be performed by a licensed contractor. ❑ Satisfactory bacteriological test(attach to application). Water Resource Inventory Area (WRIA) Development within which WRIA http://gis.co.mason.wa.us/planninq 10� 15_ 16_22_ Water use or limitation recorded................................... N/Ak Yes Well Drilled ............................................................... Date Individual Spring/Surface Water ❑ WDOE permit(attach to application) ❑ Method of disinfection ❑ 1 have reason to believe that this water source can provide at least 300 gallons per day; and/or provides water at a rate of 2 gallons per minute based on the following observations. Author of Statement Date Relationship to Applicant Part 3: Mason County Community Services Evaluation (staff use only) D Satisfactory Determination: This determination does not address adequacy of the distribution system, guarantee an adequate supply of water indefinitely in the future,or guarantee compliance with all applicable WDOE water resource regulations. Recommended approval indicates requirements of Sanitary Code,Title 6, Chapter 6.68.040-Determination of Adequacy for.Building Permits are satisfied. Additional Growth Management requirements may apply. Chapter 36.70A RCW. ❑ Unsatisfactory Determination: Applicant's water supply does not appear adequate to meet the needs of its intended use for the following reason(s). Reviewer's Signatures: Environ. Health: Date CSD Director: Date 2 of 2 ,r Qop03 a MASON COUNTY ' , � COMMUNITY SERVICES Building,Planning,Environmental Health,Community Health I 415 N 6`h Street, Bldg 8, Shelton WA 98584, Shelton: (360)427-9670 ext 400 •3 Belfair: (360)275-4467 ext 400 •: Elma: (360) 482-5269 ext 400 FAX (360)427-7787 Application for Waiver/Appeal Amount Paid: Receipt Number: S�o Instructions 1. Complete Parts 1 and 2. No determination can be made until these parts are fully completed. 2. Fees may be billed for waivers and appeals, based on the Environmental Health Fee Schedule. 3. Submit completed application with attachments to Mason County Public Health for review. PART 1. Applicant/Parc?l Identification W t Name of Applicant J0, W Telephone �t — r2-)—C) 1 Mailing Address of Applicant P, C City 12(( iL, State Cj�+ Zip SZ I p 12-digit Tax Parcel No. Z O -7 -- O -- 0 t O Site Address Z�( y-.SSc, L�, d Subdivision Name and Lot PART 2: Nature of Waiver/Appeal ❑ Contractor Certification Requirements ❑ Class B Reduction in Vertical (Installer, Pumper, O&M Specialists) ❑ Separation ❑ Food Sanitation Requirements Building Permit Review Policies ❑ Group B Water System Regulations Location, WAC 246-272A-0210 ❑ Water Adequacy Requirements ❑ Holding Tank WAC 246-272A-0240 ❑ Enforcement Timelines ❑ Mason County Onsite Standards ❑ Departmental Determinations ❑ Other Description of Waiver/Appeal (include justification, additional material may be attached.): Applicant Signature: , Date: 1//)2 d J:\EH Forms\Waiver-Appeal Mason County Local Revised 1/20/2017 Pagel of 2 '4 ; j PART 3: Public Health Evaluation (Staff Use Only) 1. Type of Determination Required: Type of Onsite Waiver(if applicable) ❑Appeal aiver ❑ None required ❑ Class A ❑ Class B ❑ Class C (�.(5�••-1 [tea-�ts� 2. Identification of Specific Code/Standard/Determination (include date of determination or latest Code/ Standard revision) 3. Nature of Appeal: 4. Hearing Official: ❑ Board of Health ❑ Health Officer ❑ Pollution Control hearing Board KK Public Health Director ❑ Certified Contractor Review Board ❑ Environmental Health Manager 5. Mitigating Factors: l,(n n:8 A < 6. 1 have received this waiver/appeal request. It is complete and mitigation required by the state and local policy has been submitted. Staff Signature: Date: Z.a PART 4: Determination of the Hearing Official ❑ The hearing official has determined that approval of this request will not adversely affect public health and is hereby granted. This decision is based on the following findings and conditions: ❑ The hearing official has determined that approval of this request could potentially adversely effect public health and is hereby denied. This decision is based on the following findings and conditions: Hearing Official Signature: Date: i' E I J:\EH Forms\Waiver-Appeal Mason County Local Revised 1/20/2017 Page 2 of 2 ' I MASON' LAKE SEPTIC TANKS LOCATION MAY CHANGE WITH BUILDING PLANS. KEEP TANKS 50'+ FROM ALL WELLS AND SHORELINE. " 75'TO SHORELINE INSTALLED 2FTSETBACK WIWAIVER DRAINFIELD DECK FOOTING PER PLANS OECD NoME s' 0 t GP�p,GE� � 6' 6'.2 Q � o 0 CUSTOMER: TODD TIDBALL SCALE 1"=30' PIONEER DIGGING, INC. PARCEL#-22107-50-00048 TEST HOLE 1: TEST HOLE 2: SEPTIC DESIGNS ADDRESS: 1270 MASON LK DR S 0-24 GLS 0-60 GLS • 2+43 LS ROOTS-60 3083 E.MASON BENSON RD. GRAPEV17 WA 88546 DESIGNER: ROBERT PAYSSE 43+MOTTLED NO R/L FOUND 1� OFFICE-360-426-1803 FAX-360-427-2353 DESIGN PAGE: OF ROOTS-43 MASO/V L 4XE SEPTIC TANKS LOCATION MAY CHANGE WITH BUILDING PLANS. ' KEEP TANKS 50'+ FROM ALL WELLS AND SHORELINE. � oF VAS,,, c x • �T Q"• H pAV65E r 75'TO SHORELINE INSTALLED 2FTSETBACKTOTANKS �r DRAINFIELD ► �' +� DECK FOOTING PER PLANS 7FT SETBACK oEr✓ 1 TO DRAINFIELD 1 No I.nE B' 2ND STORY DECK ° 6 GP POST(S) 25 -,3 t 2% SLOPE l � - POST 2 FOOTING w APPROX. 1� TANKIoo CUSTOMER: TODD TIDBALL SCALE:1"=30' PIONEER DIGGING, INC. PARCEL#:22107-50-00048 TEST HOLE l: TEST HOLE 2: SEPTIC DESIGNS ADDRESS: 1270 MASON LK DR S 0-24 GLS 0-60 GLS • 24-43 LS ROOTS-60 3083 E.MASON BENSON RD. GRAPEVIEW,WA 98546 DESIGNER: KOBERT PAYSSE 43+MOTTLED NO RA-FOUND l� OFFICE-360-426-1803 FAX-360-427-2353 DESIGN PAGE: OF ROOTS-43 MASON LAKE SEPTIC TANKS LOCATION MAY CHANGE WITH BUILDING PLANS. KEEP TANKS 50'+ FROM ALL WELLS AND SHORELINE, ENVIRONMENTAL HEALTH 75'TO }, SHORELINE - INSTALLED 2FTSETBACK W/WAIVER DRAINFIELD - ° DECK FOOTING PER PLANS Al ep 1 1 RECEIVED JAN 13 2020 615 W. Ader$tree � c� ° CUSPIONEER DIGGING, INC. PARCEL MB R2 077--55 00048�L STES THOLE 1: TEST HOLE 2: SEPTIC DESIGNS ADDRESS: 1270 MASON LK DR S 0-24 GLS 0-60 GLS 2+43 LS ROOTS-60 3083 E.MASON BENSON RD. GRAPEVIEW,WA 98546 DESIGNER: ROBERT PAYSSE 43+MOTTLED NO R/L FOUND 1� OFFICE-360-426-1803 FAX-360-427-2353 DESIGN PAGE: OF ROOTS-43 MASON LAKE SEPTIC TANKS LOCATION MAY CHANGE WITH BUILDING PLANS, KEEP TANI<S 50'+ FROM ALL WELLS AND SHORELINE. ENVI r�F'AENTAL HEALTH 75'TO SHORELINE INSTALLED 2FTSETBACK W/WAIVER DRAINFIELID) DECK FOOTING PER PLANS 4 t ° Sao Lo 6b,op RECEIVED JAN 13 2020 615 W. Alder street O PIONEER DICCINC INC. CUSTOMER: TODD TIDBALL SCALE F--30° I PARCEL#:22107-50-00048 TEST HOLE 1: TEST HOLE 2: SEPTIC DESIGNS ADDRESS: 1270 MASON LK DR S 0-24 GLS 0-60 GLS 2+43 LS ROOTS-60 3083 E.MASON BENSON RD. GRAPEVIEW,WA 98546 DESIGNER: ROBERT PAYSSE 43+MOTTLED NO RA,FOUND 1� OFFICE-360-426-1803 FAX-360-427-2353 DESIGN PAGE: OF ROOTS-43 415 N 6TH STREET,SHELTON,WA 98584 MASON COUNTY SHELTON:360-427-9670,EXT 400 / �+ BELFAIR:360-275-4467,EXT 400 1t COMMUNITY j "SERVICES ELMA:360-482-5269,EXT 400 Building,Planning,Environmental Health,Conttnanity190a1Ch FAX:360-427-7787 ENVIRONMENTAL HEALTH REVIEW OF BUILDING PERMIT TODD ENDICOTT& SUSAN RENAE TIDBALL 02/12/2020 621 NE HARRISON ST POULSBO, WA 98370 Applicant: TODD ENDICOTT&SUSAN RENAE TIDBALL Parcel Owner: TODD ENDICOTT&SUSAN RENAE TIDBALL Site Address: 1270 E MASON LAKE DR SOUTH Primary Parcel Number: 221075000048 Permit Number: BLD2020=00023 Permit Description: NEw SFR w/attached garage Permit Submitted Date: 01/13/2020 Permit Review Date: 02/12/2020 The above mentioned building pe t has been reviewed by Environmental Health and found more information is required. �-- Missing all well documents-well to , atisfactory bacteriology test, " If you have any questions or concern Sincerely, [ ] Rhonda Elliott, EH Specialist 360-427-9670, Extension 581 relliott@co.mason.wa.us [ ] Jeff Wilmoth, EH Specialist 360-427-9670, Extension 543 jwilmoth@co.mason.wa.us [ ] Luke Cencula, EH Specialist 360-427-9670, Extension 584 Icencula@co.mason.wa.us