HomeMy WebLinkAboutSWG2023-00152 TANK ONLY - SWG Application / Design - 4/26/2023 • MASON COUNTY 415 N 6TH STREET,SHELTON,WA 98584
SHELTON:360-427-9670,EXT 400
BELFAIR:360-275-4467,EXT 400
6' Public Health & Human Services ELMA:360-482-5269,EXT400
FAX:360-427-7787
On-Site Sewage System Tank Only Permit: SWG2023-00152
APPLICANT JOHN BOWMAN Phone:
Address: 7420 STATE HIGHWAY 3 SW, TRLR 31 BREMERTON, WA 98312
SEPTIC DESIGNER CINDY WAITE- Septic Designer Phone: 3607010205
Address: 80 E PICKERING LANE SHELTON, WA 98584
Site Address: 1170 E TRAILS END DR
Primary Parcel Number: 222235106025
Permit Description: RV holding tank
Permit Submitted Date: 04/26/2023
Permit Issued Date: 05/02/2023
Issued By: Rhonda Thompson
Current Permit Fees Paid: $255.00 (additional fees may be required upon installation of system).
Permit Expiration Date: 04/27/2026 (based on date of inspection)
Type of Work OSS New Construction
Components being Replaced: RV Holding Tank
Surfacing Sewage? No Existing Failure? No
Shoreline? No Horizontal Setbacks Met? Yes
Number of Bedrooms: 0 Drinking Water Source: Public Water System
Additional Details: Holding tank
Permit Conditions:
4 Proposed development subject to zoning requirements and approval by the planning
department staff per Mason County Title 17.
2 Permit must be installed by a Mason County Certified Installer unless prior written
authorization from Mason County is obtained.
1 Horizontal setbacks per WAC246-272A-0210 must be maintained, unless prior approval is
obtained
3 Mason County Asbuilt Form, Record Drawing, and Installation fee must be submitted for
final installation approval.
THIS PERMIT MUST BE ONSITE DURING INSTALLATION OF OSS.
PROPERTY OWNERS ARE RESPONSIBLE FOR DETERMINING AND MARKING ALL PROPERTY LINE AND EASEMENT LOCATIONS.
THIS PERMIT MAY BE REVOKED IF THE SITE CONDITIONS HAVE CHANGED SINCE THE SITE WAS INSPECTED AND/OR DESIGN
APPROVED.
FINAL INSTALLATION APPROVAL IS REQUIRED PRIOR TO TEMPORARY OR FINAL OCCUPANCY OF ANY RELATED STRUCTURES.
For Final Inspection visit: masoncountywa.gov/health/environmental/onsiteloss-inspection-request.php or call:
360-427-9670, extension 400.
r,
•
OFFICIAL USE ONLY
0,, . ._._,
MASON COUNTY [DATE RECEIVED:
COMMUNITY SERVICES ^M�. D: . RECEN Y
CO N
Public Hiakh(Community Health/Environmental Health) c cDn
0
y
300-437•%70..1.400 or 30�275-44670 ,ext.400
47 C
5N.bth Street-Sheih:nl,'A'/NSeq • /-, . `G %�
-
CO Mb O Cn
53
ON-SITE SEWAGE TANK ONLY APPLICATION D a
APPLICANT m n PHONE m
JOHN BOWMAN __ 360-999-7156 '—
MAILING ADDRESS-STREET.CITY.STATE,ZIP CODE
cZ
7420 STATE HIGHWAY 3,'TAL .21, BREMERTON, WA. 98312 CO
SITE ADDRESS-STREET,CITY,ZIP CODE m
ZI
1170 E TRAILS END DR., BELFAIR, WA. 98528 IN
NAME OF DESIGNER
PHONE
CINDY WAITE 360-701-0205 I N
NAME OF INSTALLER
PHONE 0 IN
TBD
TYPE OF WORK(select one) DRINKING WATER SOURCE (n I K}
❑ NEW CONSTRUCTION/UPGRADES 0 REPAIR/REPLACEMENT 0 PRIVATE INDIVIDUAL WELL 0 PRIVATE TWO-PARTY WELL z
COMPONENT(S)TO BE REPLACED'INSTALLED PUBLIC WATER SYSTEM "�',p1/S oad
❑ SEPTIC TANK 0 PUMP TANK ® LOT
RV HOLDING TANK BEDROOMS I Z I�
Er I(,SIZ ,
El OTHER U 1
` (i--cif
OTHER DETAILS(select all that apply) CO
TANK(S)SETBACK CHECKLIST I—
❑ SURFACING SEWAGE 0 EXISTING FAILURE 0 SHORELINE 0 100FT+PUBLIC!COMMUNITY WELLS
SUBMITTALS 0 SOFT+PRIVATE WELLS,SURFACE WATERS,STREAMS,RIVERS
❑ PLOT PLAN(REQUIRED) ❑ TANK CROSS SECTION(REQUIRED) 0 10FT+DRINKING WATER SUPPLY LINES I
❑ PUMP DETAILS(IF APPLICABLE) 0 WAIVER(S)(IF APPLICABLE) 0 SFT+PROPERTY!EASEMENT LINES,FOUNDATIONS,FOOTINGS
PLOT PLAN CHECKLIST
1 to
❑ PROPERTY LINES AND EASEMENTS 0 EXISTING/PROPOSED STRUCTURES 0 EXISTING/PROPOSED OSS COMPONENTS AND LINES O❑ WELLS WITHIN 100FT ❑ WATER SUPPLY LINES ❑ DRIVEWAYS/PARKING 0 SURFACE WATERS,STREAMS,RIVERS,ETC... IN)
❑ DIRECTION OF SLOPE/CONTOURS 0 PERIMETER/CURTAIN DRAINS ❑ NORTH ARROW 0 SCALE BAR y
DIRECTIONS TO SITE AND SITE CONDITIONS:(ex.locked gate) M
GO NORTH ON HIGHWAY E, TURN LEFT ONTO MASON BENSON RD, TURN RIGHT
ONTO TRAILS ROAD(AT FIRE STATION), TURN RIGHT ONTO TRAILS END ROAD TO
ADDRESS. PARCEL IS ON RIGHT SIDE OF ROAD, COMPLETELY CLEARED(ACROSS
FROM THE COMMUNITY PARK)
-- -- OFFICIAL USE ONLY BELOW THIS LINE-
-UPGRADE/FAILURE SOURCE(for reporting purposes)
❑VOLUNTARY 0 MAINTENANCE/PUMPING ❑BUILDING PERMIT OHOME SALE OCOMPLAINT ❑OT n 7 n r
COMMENTS,CONDITIONS +
tJ +� 1.+ 5 !
E�
15k t \ �v Kv fAil L APR 2 6 2023 ,�
SEWAGE TANKS MUST BE LISTED UNDER DOH'LIST OF REGISTERED SEWAGE TANKS TANKS MUST MEE1 CURRENT MINIMUM BP>e II,tR"ERT EOWI$.R48ERS
AND LIDS TO SURFACE.AND INCLUDE AN EFFLUENT FILTER(IF APPLICABLE). RECORD DRAWING AND INSTALLATION REPORT REQUIRED FOR FINAL APPROVAL.
INSPECTOR SIGNATURE DATE APPLICATION EXPIRATION DATE
APPLICATION APPROVED/ISSUED BY DATE
ftsINS.4... --?/(75-7-)
THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE
REVISED 07/09/2019
i
I
I .
. i 1
. i
...
.. I
.....1 G .
WWI i
kll .k
C I
Dr:. •
,C1)
1 CD
.......\
g I
! CI
C,
13
I _
I) i 1
(v
0<M
,S1:1
r ,
. --4
);••
= 0
k "...---........ ..-...
--T-
,1017/tre
I ,
0
.-P 1
C i
t i
(8. \:-..).
, V i A ----
• l'..)
c,
t.----- czt
I.•••
"...0..... '''Z'i
--__
X k
,...-. .„t
lt v • k.;,
..
I t4,
k ....t.,...
...L. . ...,
1 ,t
1 ... 4
t i
L.
1i ,
Li we,....
i
i
,
_..
—l-- -:. , .
„ h '; 1500P & 1500P—HW
aif �T.:S
ai
T v
'r:E-2 ,,,.. 1585 GAL. FL.00D CAP.
i
('-1 TOP VIEW 24 18" 72
66„
4 6" APPROVED
j MAY 0 2 2023
MASON COUNTY ENV1RONMENTAI.HEALTH
t
3"
1
6. PV PORT 24- ORENCO TANK ADAPTER MASTIC
4' CAST A SEAL GASKET
1/7 .
b-- 4"
27.8 GALS. PER/INCH 64
52- 1 /2"
4"
___ 7 iii ► 1
APPROX. WEIGHT 12,000 LBS.