HomeMy WebLinkAboutSWG2023-00515 TANK ONLY - SWG Application / Design - 12/7/2023 MASON COUNTY 415 N 6TH STREET,SHELTON, , E 98584
SHELTON: ,SHEL ON, EXT 400
J BELFAIR:360-275-4467,EXT 400
Public Health & Human Services ELMA:360-482-5269,EXT 400
FAX:360-427-7787
On-Site Sewage System Tank Only Permit: SWG2023-00515
APPLICANT BAUER RONALD WAYNE & MICHELLE Phone:
EVELYN
Address: 50 E VUECREST DR UNION, WA 98592
OWNER BAUER RONALD WAYNE & MICHELLE Phone:
EVELYN
Address: 50 E VUECREST DR UNION, WA 98592
SEPTIC INSTALLER DARED HANSON- Hanson Excavation Phone: 360-239-6792
LLC
Address: 86 SE BANJO LANE SHELTON, WA 98584
Site Address: 50 E VUECREST DR
Primary Parcel Number: 321057690153
Permit Description: Replace septic tank
Permit Submitted Date: 12/07/2023
Permit Issued Date: 12/15/2023
Issued By: Rhonda Thompson
Current Permit Fees Paid: $255.00 (additional fees may be required upon installation of system).
Permit Expiration Date: 12/15/2024 (based on date of inspection)
Type of Work OSS Repair
Components being Replaced: Septic Tank Only
Surfacing Sewage? No Existing Failure? No
Shoreline? No Horizontal Setbacks Met? Yes
Number of Bedrooms: 3 Drinking Water Source: Public Water System
Additional Details: 1200 g septic tank
Permit Conditions:
4 Proposed development subject to zoning requirements and approval by the planning
department staff per Mason County Title 17.
3 Mason County Asbuilt Form, Record Drawing, and Installation fee must be submitted for
final installation approval.
1 Horizontal setbacks per WAC246-272A-0210 must be maintained, unless prior approval is
obtained
2 Permit must be installed by a Mason County Certified Installer unless prior written
authorization from Mason County is obtained.
THIS PERMIT MUST BE ONSITE DURING INSTALLATION OF OSS.
PROPERTY OWNERS ARE RESPONSIBLE FOR DETERMINING AND MARKING ALL PROPERTY LINE AND EASEMENT LOCATIONS.
THIS PERMIT MAY BE REVOKED IF THE SITE CONDITIONS HAVE CHANGED SINCE THE SITE WAS INSPECTED AND/OR DESIGN
APPROVED.
FINAL INSTALLATION APPROVAL IS REQUIRED PRIOR TO TEMPORARY OR FINAL OCCUPANCY OF ANY RELATED STRUCTURES.
For Final Inspection visit: masoncountywa.gov/health/environmental/onsiteloss-inspection-request.php or call:
360-427-9670, extension 400.
7 1 •
!I ;: OFFICIAL USE ONLY- -
`." ! ' DATE RECEIVED:
MASON COUNTY Z ---1 ' Z3 c
COMMUNITY SERVICES AmolcEit v m
Public Health(Community Health/Environmental Health) (A
. 27S-467 rat 400 ( O
315N.6th 70.etR-400a0,87 SWG 1 u) '1. -0 0S t c Z x
415 N.6tA$trot�S�dtoiLWA 98584 SWG �JV�,V)
ON-SITE SEWAGE TANK ONLY APPLICATION D
3
m n
m
APPLICANT PHONE r
Ronald Bauer 707-322-2764 z
MAILING ADDRESS-STREET.CITY.STATE,ZIP CODE g
CO
50 E Vuecrest DR m
z
SITE ADDRESS-STREET.CITY,ZIP CODE
50 E Vuecrest DR —
NAME OF DESIGNER PHONE 1 1
NAME OF INSTALLER PHONE 0 I
Hanson Excavation LLC 360-239-6792
• TYPE OF WORK(select one) DRINKING WATER SOURCE
0 NEW CONSTRUCTION/UPGRADES I1 REPAIR/REPLACEMENT 0 PRIVATE INDIVIDUAL WELL ElW PRIVATE TO-PARTY WELL Z 451
' • PUBLIC WATER SYSTEM — I
COMPONENT(S)TO BE REPLACED'INSTALLED
® SEPTIC TANK 0 PUMP TANK 0 RV HOLDING TANK BEDROOMS LOT SIZE I'�
❑ OTHER
aa4'x 1613 Al CO W cr.,
DETAILS(select all that apply) TANK(S)SETBACK CHECKLIST O
❑ SURFACING SEWAGE 0 EXISTING FAILURE ❑SHORELINE III 100FT+PUBLIC/COMMUNITY WELLS
0 SOFT+PRIVATE WELLS,SURFACE WATERS.STREAMS,RIVERS
SUBMITTALS
® PLOT PLAN(REQUIRED) ® TANK CROSS SECTION(REQUIRED) E 10FT+DRINKING WATER SUPPLY LINES 'Cr
❑ PUMP DETAILS(IF APPLICABLE) ❑ WAIVER(S)(IF APPLICABLE) El 5FT+PROPERTY!EASEMENT LINES,FOUNDATIONS,FOOTINGS
PLOT PLAN CHECKLIST
IN PROPERTY LINES AND EASEMENTS ® EXISTING!PROPOSED STRUCTURES ® EXISTING!PROPOSED OSS COMPONENTS AND LINES I '
13 WELLS WITHIN 100FT El WATER SUPPLY LINES um DRIVEWAYS/PARKING IN SURFACE WATERS.STREAMS,RIVERS,ETC... v 7
® DIRECTION OF SLOPE!CONTOURS 0 PERIMETER/CURTAIN DRAINS II NORTH ARROW ® SCALE BAR _ I I`A/
DIRECTIONS TO SITE AND SITE CONDITIONS'(on.locked gate) I
A& Redly 10 n'to A . L o nio ,E Vke_C re$4-• 14cuce 0 n 12\.4 A
y DEC 0 7 2023
-------- --- OFFICIAL USE ONLY BELOW THIS LINE
UPGRADE!FAILURE SOURCE(tor reporting purposes)
❑VOLUNTARY ❑MAINTENANCE/PUMPING ❑BUILDING PERMIT 0 HOME SALE ❑COMPLAINT 0 OTHER.
COMMENTS!CONDITIONS
V,CQ, Se ' C \C____
SEWAGE TANKS MUST 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(IF APPLICABLE). RECORD DRAWING AND INSTALLATION REPORT REQUIRED FOR FINAL APPROVAL.
INSPECTOR SIGNATURE DATE APPLICATION EXPIRATION DATE APPLICATION APPROVED:ISSUED BY DATE
..--------. \ -241.5-1i LI Walfeln (Z 11 S-13
THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE REVISED 1217/2015
Y 1 200NCSR & 1200NCSR-HW
' ...,E ,.....#
1-. 102"
I 63" 31
. ____H�'
2 --
I f
1 ! I 71
[ (� 18 24 TOP VIEW Li 3
, ; ,. 65„
4
i li .iii.1.i ,
IR 7 i�; . L L L _L-
4.31 % ....
r
,,,at, ;i
:,::, . , MASTIC
24' ORENCO TANK ADAPTERS
---......N...
win
i = ---;
O, 4' CAST—A—SEAL GASKET . rp-4----\\'*--
4
} 4' PVC BAFFLE I
4
1
li
FLOOD CAP. 965 GALS. T FLOOD CAP. 65"
463 GALS.
s: 54" 51
1 i: 30"
.
v.1
PROVE [
3" EC 15 2023
I MASON COUNTY ENVIRONMENTAL HEALTH
titAPPROX. WEIGHT 11 ,000 CBS.
RET
1, il .
t gq '.
3el
Y-.0 "SQ
/
C tca0+e.--t
4�
11 i').a. '
t goo ‘bv, 4o 5 ca'e= 1 `4 a•
/ -�o sa✓{��c Vi f" PEa-v�
I sAsc,...444 4-Kgsvi ucS.
/ K.el4 3Zao5-7b-4o t53 _
/ / t. Vtketrey}-Dr. 0114",
1 / / / ,
.p.C--& -A\-\*-
t'D\ 1 t
I
73 w
ti
=d
•
0
\
��5k ROVE P T. �-- -N��
�, �e"r✓ DEC 15 2023 pis...,, o -�. •+
MASON COUNTY ENVIRONMENTAL HEA
?reps RET ,ramt0 H
50349 {
�00V., e + .r16.7 PAULA JOY JO ON
Pr6.- 'Joni asnCounty ,)MMS
Printed horn Mason County WAS _ ---.-- _.