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HomeMy WebLinkAboutWAI2023-00060 - WAI Health Waiver - 6/21/2023 415 N 6TH STREET,SHELTON,WA 98584 MASON COUNTY SHELTON:360-427-9670, EXT 400 BELFAIR:360-275-4467,EXT 400 r Public Health & Human Services ELMA:360-482-5269, EXT 400 FAX:360-427-7787 VANIER JON & CARMEN 831 E Trails End Drive BELFAIR, WA 98528 Applicant: VANIER JON & CARMEN Parcel Owner: VANIER JON & CARMEN Site Address: 831 E Trails End Dr Primary Parcel Number: 222235001028 Waiver Request Number: WAI2023-00060 Waiver Description: Onsite: Location, WAC246-272A-0210 Waiver Submitted Date: 06/21/2023 Waiver Review Date: 6/Z3/70 Z3 Waiver Status: App4 If you have questions or concerns let us know. Sincerely, Davi Anderson APPROVED Danderson@masoncountywa.gov JUN 2 3 2023 MASON COUNTY ENVIRONMENTAL HEALTH DJA t**11116.2A w d ? it, §g,;;T MASON COUNTY 3Uti z z 1013 COMMUNITY SERVI i S RECEIVED Building,Planning,Environmental Health,Community Health •HJ:l\ 415 N 6'h Street, Bldg 8, Shelton WA 98584, Shelton: (360)427-9670 ext 400 •: Belfair: (360)275-4467 ext 400 s• Elma: (360)482-5269 ext 400 FAX (360)427-7787 Application for Waiver/Appeal Amount Paid: * , ' ° L JUN 21 2023 Receipt Number: )..3 — `J Instructions By 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/,P�arrc/el Identification Name of Applicant Telephone %?S-�o1 —-5 70© Mailing Address of Applicant 8 City Z-Fro{ State LOA. Zip re5-2--83 12-digit Tax Parcel No. Z Z Z z -- Oz- Site Address 3 t 1- Subdivision Name and Lot PART 2: Nature of Waiver/Appeal ❑ Contractor Certification Requirements 0 Class B Reduction in Vertical (Installer, Pumper, O&M Specialists) Separation 0 Food Sanitation Requirements 0 Building Permit Review Policies 0 Group B Water System Regulations O Location, WAC 246-272A-0210 ❑ Water Adequacy Requirements ❑ Holding Tank WAC 246-272A-0240 0 Enforcement Timelines ❑ Mason County Onsite Standards 0 Departmental Determinations ❑ Other Description of Waiver/Appeal (include justification, additional material may be attached.): h274,(•Iq• =2-- . 77.7 t 1)l LFlair 01 k3 E J r-4Q Applicant Signatur J��QZ Date: -- 7--/)'I c /)ZC2-3 J:\EH Forms\Waiver-Appeal Mason County Local Revised 1/20/2017 Page 1 of 2 t PART 3: Public Health Evaluation (Staff Use Only) taaf, 1. Type of Determination Required: Type of Onsite Waiver(if applicable) Appeal ,Waiver p. None required �. Class A __, Class B Class C 2. Identification of Specific Code/Standard/Determination (include date of determination or latest Code/ Standard revision) 3. Nat,yre,of Appeal: gidUce hvr:'zorlial Serial,On behvan Carp°li f�lmyS ?yam 0 S.` 4. Hearing Official: ❑ Board of Health ❑ Health Officer ❑ Pollution Control hearing Board ❑ Public Health Director ❑ Certified Contractor Review Board IV Environmental Health Manager 5. Mitigating Factors,:, f ¢a01'455 aie, cip yradi'eril ali dram17'e(d 6. I have received this waiver/appeal request. It is complete and mitigation required by the state and local policy has been submitted. Staff Signature: Date: (Yl zJ(?4"Z.3 PART 4: Determination of the Hearing Official Al.. 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: 0 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: V/ AI J:\EH Forms\Waiver-Appeal Mason County Local Revised 1/20/2017 Page 2 of 2 - - .. • Za • O. >-; • • • • ' •a�� Zr"o 0wp ¢ O Ov w ()ye co I C �� w / W 'r S, cn , , ...„ /•--.....,- ,......" : ket 0-et Zw F'W �/ •F-Q -> N, , • It ' w(9 M(1)0 . • / K I Q • dWX• /• z ' ? " Iu) a / + FD • �. el (LOC• ED2014:360SF) Ow 0 n< ZV _ X= XW / 13 `w O / � I- -e • W LL wa Wo � • I •XW r.- • 0. (?Q W I z � ^• -d XWi -i m wQ Y �. L • w ~ zN p a• )-D Xw ♦` • XX N W� 1 W cT • O T� • f hid ` ; ha f o LL ♦ zc Ow T d'N CO) //•2LL - yQ LL O F - U_ O en- • ' Q Zp - w Om -w 00 9y-ts 46,/ +XUN z 5o O J,T•v�k'�yyo ` �� a vain A 0 0 9ps/y • ¢ I-w W W o¢ �vb1J0 i U po c4 > a fo ♦ ° • z No W P: O RN • U 3j w ° W Z / I Zb ?a ZW0N op 0 litii C4 ,--I X ¢ a o F. V w V E. (w . 0 aouWNzI z --' aWN O000CAN0 � ag cc L ' Ji 1 0 < H w W wzcA 0 C '4 3Q ¢ xytjp� O ¢ awa wo