HomeMy WebLinkAboutWAT Application - 5/18/2023 WATiplae.binaki-Avi<1 uK-
1 MASON COUNTY Shelton,WA 98584
: 415 N.6`6 Street
a Shelton:360-427-9670,Ext 400
' Il �i COMMUNITY SERVICES Belfair:360-275-4467,Ext 400
0.)," Building,Planning,Environmental Health,Community Health Elma:360.482-5269,Ext 400 rg_
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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: 6I,B Y1Pf i +.0)_&• Date: \5 I8 - 2-3
Mailing Address: ^1dAk,N04
6-i- IQLe Phone: OW) • 3130 .4C(`( 3
Parcel Number: (3ici(fi • 11'O(X)IL)
Type of Water System Reason for Application QO • �
•
❑ Public/Community Water System(2 or more >4 Building permit l.-Om ZD�3 _0
connections) 0 Division of land:
• Individual water source(one connection), #of Parcels? SPL
O Well 0 Boundary line adjustment
O Spring/surface water 0 Other(explain
❑ Other(explain)
0 Replaceme t or Remodel( lease indicate name
If you have more than one residence connected of water syste ow-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:
• Public Water System
Name of Water System:
Water Facility Inventory(WFI) Number. (write"none"for two-party)
❑ I 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.
Print Name of Water System Manager Phone
f
Signature of Water System Manager Date
This form may be scanned and available for public view at www.co.mason.wa.us.
J:\EH Forms\Drinking water Revised 4/27/2021
Page 1 of 1
PERMIT
Report Run On: Tuesday, 28 March
NOTES2023 07:22
Permit# PAR2022-00080 Parcel # : 319091300010
Site Address: 130 SE BRENNER OYSTER RD
Note Type Note Code Text Created By Begin Date End Date
REPORT Customer issued original permit from portal Ceguzek@mac.c 01/20/23
om
REPORT Customer issued original permit from portal Ceguzek@mac.c 01/20/23
om
DETAILS Public Works comments attached. KSCHNEIDMILL 01/20/23
ER@masoncount
ywa.gov
CORRESPONDE DOCUMENTS FM Conditions Memo RCOLLINS@MA 01/17/23
NCE SONCOUNTYWA
.GOV
CORRESPONDE DOCUMENTS Document(s)/Letter(s) TCUNNINGHAM 01/12/23 1/12/23
NCE PAR Comments 1-12-23 @masoncountyw
a.gov
DETAILS Septic: As-built and O+M OK JWILMOTH@ma 01/12/23
soncountywa.gov
Drinking water: Submit water adequacy form
with recent coliform testing results. No public
water system is required.
DETAILS Non-Conforming Use of the Property SRUEDY@maso 01/12/23
(Commercial without an SFR or meets the ncountywa.gov
standards of a cottage industry)
Expansion is permitted by the following:
17.05.014-Alterations and enlargements.
Nonconforming nonresidential uses and
structures located outside urban growth areas
may be permitted to expand, subject to the
following conditions:(1)The floor area of the
existing building(s)shall not increase by more
than twenty percent or ten thousand square feet,
whichever is greater. The original building is 792
square feet.
Must meet building setbacks for the RR5 zoning
district.
GENERAL UPPER SHOP=130 SE BRENNER OYSTER MIGRATION 12/28/18
RD
LOWER SHED NEAR THE WATER=300 SE
BRENNER OYSTER RD
LAND RECORDS Link to Laserfiche Folder sboldman 01/01/90
LINK
JJ Brenner Oyster Co.
#16 1-1 WATER QUALITY
REPORT
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