HomeMy WebLinkAboutSWG2024-00140 - SWG Application / Design - 4/9/2024 SHELT
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MASON COUNTY 415N BSHELTON: 60427-O70,EXT 400
SHELFAIR 360-275-96T0,EXT 4M
BELFAIR:3fio-2754487,EXT/00
Public Health & Human Services ELMA:36"82-5269,EXT 400
FAX:360427-7767
On-Site Sewage System Tank Only Permit: SWG2024-00140
APPLICANT HOUSE BROTHERS Phone: 260-4954156
Address: PO BOX 1820 MCLEARY,WA 98557
OWNER NGUYEN ET VIR CHINH THI DUY Phone:
Address: 5001 NE 184TH ST LAKE FOREST PARK,WA 98155
SEPTIC DESIGNER ADAM HUNTER' Phone: 360-753-1226
Address: PO Box 162 OLYMPIA,WA 98507
SEPTIC INSTALLER JOE HOUSE' Phone: 360495-4156
Address: PO Box 1820 MCCLEARY,WA 98557
Site Address: 21 SE CHANNEL POINT RD
Primary Parcel Number: 320245100027
Permit Description: Add septic tank with pump in 2nd compartment
Permit Submitted Date: 04/09/2024
Permit Issued Dale: 04/12/2024
Issued By: Rhonda Thompson
Current Permit Fees Paid: $265.00 (additional sees may be required upon Installation of system).
Permit Expiration Dale: 04/0912027 (based on date ofimpactien)
Type of Work OSS New Construction
Components being Replaced: Pump Tank Only
Surfacing Sewage? No Existing Failure? No
Shoreline? No Horizontal Setbacks Met? Yes
Number of Bedrooms: 3 Drinking Water Source: Private Two-Party Well
Additional Details: Septic tank with pump In 2nd comp.
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/s obtained.
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
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/environmentallonsiteloss-inspection-request.php or call:
360-427-9670, extension 400.
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MIS FORM MAYBE SCANNEDAND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBBTTE 1 REVISED I WG015
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