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HomeMy WebLinkAboutSWG2023-00487 - SWG Application / Design - 11/16/2023 MASONCOUNTY N6SHSTREET SHELTON, ,EXT 404 • SHELTON: ,SHE T967Q WA 98584 L BELFAIR:360-275-4467,EXT 400 Public Health & Human Services ELMA:360-482-5269,EXT 400 FAX:360-427-778r On-Site Sewage System Tank Only Permit: SWG2023-00487 OWNER BROWNAWELL ALLAN Phone: Address: 561 E WILLCHAR SHELTON, WA 98584 APPLICANT BROWNAWELL ALLAN Phone: Address: 561 E WILLCHAR SHELTON, WA 98584 SEPTIC INSTALLER Allan Kirk-MASON COUNTY Phone: 360-426-0574 EXCAVATING INC Address: 30 E WILCHAR BLVD SHELTON, WA 98584 SEPTIC DESIGNER Adam Hunter-Jim Hunter and Phone: 360-753-1226 Associates Address: PO Box 162 OLYMPIA, WA 98507 Site Address: 561 E WILLCHAR BLVD Primary Parcel Number: 220047590113 Permit Description: Add pump tank for new office with bathroom Permit Submitted Date: 11/16/2023 Permit Issued Date: 11/17/2023 Issued By: Rhonda Thompson Current Permit Fees Paid: $255.00 (additional tees may be required upon installation of system). Permit Expiration Date: 11/17/2026 (based on date of nspection) Type of Work OSS New Construction Components being Replaced: Septic Tank Only Surfacing Sewage? No Existing Failure? No Shoreline? No Horizontal Setbacks Met? Yes Number of Bedrooms. 3 Drinking Water Source: Private Well/Spring Additional Details: add 500g pump tank Permit Conditions: 3 Mason County Asbuilt Form, Record Drawing, and Installation fee must be submitted for final installation approval. 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 4 Proposed development subject to zoning requirements and approval by the planning department staff per Mason County Title 17, 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/onsite/oss-inspection-request.php or call: 360-427-9670, extension 400. OFFICIAL USE ONLY DATE RECEIVED. MASON COUNTY l t - alp E�3 y a COMMUNITY SERVICES ADD RECEIVEDar RECEIVED ` " 0 W Ca Public Health(Community Health/Environmental Health) SWG aC�3 -00481 Z N A 45 ON-SITE SEWAGE TANK ONLY APPLICATION 3 z APPLICANT PHONE m Ri r ALLAN BROWNAWELL 3604329706 z c MAILING ADDRESS-STREET,CITY,STATE,ZIP CODE 3 561 E WILLCHAR BLVD, SHELTON,WA 98584 co ----- 73 SITE ADDRESS-STREET,CITY.ZIP CODE SAME AS MAILING ADDRESS _ .l .) NAME OF DESIGNER PHONE p ADAM HUNTER 3607531226 \lU NAME OF INSTALLER PHONE a I ALAN KIRK I-. TYPE OF WORK(se/act one) DRINKING WATER SOURCE y r a NEW CONSTRUCTION I UPGRADES 0 REPAIR/REPLACEMENT El PRIVATE INDIVIDUAL WELL 0 PRIVATE TWO-PARTY WELL Z I� COMPONENT(S)TO BE REPLACED/INSTALLED 0 PUBLIC WATER SYSTEM �7s O SEPTIC TANK El PUMP TANK ❑RV HOLDING TANK BEDROOMS LOT SIZE D OTHER_ _ 3 1.25 ACRES ��`J� OTHER DETAILS(Select all that apply) TANK(S)SETBACK CHECKLIST Q 1 D SURFACING SEWAGE 0 EXISTING FAILURE 0 SHORELINE El 100FT+PUBLIC/COMMUNITY WELLS O I ^ SUBMITTALS IN SOFT+PRIVATE WELLS.SURFACE WATERS,STREAMS,RIVERS V El PLOT PLAN(REQUIRED) O TANK CROSS SECTION(REQUIRED) 0 1OFT+DRINKING WATER SUPPLY LINES 0 PUMP DETAILS OF APPLICABLE) 0 WAIVER(S)(IF APPLICABLE) El SFT+PROPERTY/EASEMENT LINES,FOUNDATIONS,FOOTINGS PLOT PLAN CHECKLIST O r I— E1 PROPERTY LINES AND EASEMENTS 0 EXISTING/PROPOSED STRUCTURES El EXISTING/PROPOSED O55 COMPONENTS AND LINES —I I O WELLS WITHIN IDDFT O WATER SUPPLY LINES © DRIVEWAYS/PARKING O SURFACE WATERS.STREAMS,RIVERS,ETC._ r O DIRECTION OF SLOPE/CONTOURS El PERIMETER!CURTAIN DRAINS El NORTH ARROW EI SCALE BAR DIRECTIONS TO SITE AND SITE CONDITIONS.(ex locked gale) I\/A_ PICKERING TO A RIGHT ON E PHILLIPS LAKE RD TO A LEFT ON WILLCHAR TO SITE ON THE LEFT. a CS r- -- --- OFFICIAL USE ONLY BELOWTHIS LINE— ' "— II' UPGRADECCC I FAILURE SOURCE 0or repoNne purposes) —/ ��Lk OLUNTARY 0 MAINTENANCE/PUMPING L�BOLDING PERMIT [HOME SALE OCOMPLAINT DOTHER' C. G_ COMMENTS CONDITIONS I I RAOV, vie 1 °" SEWAGE TANKS MUG'BE LISTED UNDER DOH'LIST OF REGISTERED SEWAGE TANKS'. TANKS MUST MEET CURRENT MINIMUM SIZE REQUIREMENTS,EQUIPPED WITH RISERS AND LIDS TO SURFACE,AND INCLUDE AN EFFLUENT FILTER IIF APPLICABLE). RECORD DRAWING AND INSTALLATION REPORT REQUIRED FOR FINAL APPROVAL. INSPECTOR SIGNATURE DATE APPLICATION EXPIRATION DATE APPLICATION APPROVED/ISSUED BY DATE I I 1 fz—(0 � 4yvl I I I n ft 3 THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE 1 REVISED 12:702015 111111160 } «�wme D « ue« : ; « . . . ..UTILITY �,E ? « \ ^ / co \ , > y : �x �^ e \ \ \ § cm / \\ \ \ --------- � J : > # \ ° ` \ ' \ r. � } \ \ \ II \ c Pi \ \ \ \ ) / \/ 0 c0o ` ) ) ) ) | [ § - \ b \ ~ w ( \ \ > - ( G - . - 133 rf. es 4 _ -_ / o W \ ( / > >* - 2 2 ! - - y . = m . y9 IiD \- i ! ! � _^ -- I.5H§ 2 � , \„ \ }