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SWG2021-00200 - SWG Application / Design - 4/19/2021 (2)
SHELTON,WA 684 MASON COUNTY 415N6THELTON , 0427-97 ,FXT 400 SHELTON:360-275A467,EXT 400 BELFAIR:360-275-048],E%T 000 Public Health & Human Services ELMA:360-4825269,EXT 400 40 FAX:360427-7787 On-Site Sewage System Permit: SWG2021-00200 APPLICANT Jennifer Chancellor Phone: 541-890-8250 Address: 1959 Galante Dr SW OLYMPIA,WA 98512 OWNER Jennifer Chancellor Phone: 541-890-8250 Address: 1959 Galante Dr SW OLYMPIA,WA 98512 SEPTIC DESIGNER PARNELL,WILLIAM Phone: 3604913243 Address: 10623 HUNTERS LN SE OLYMPIA,WA 98513 Site Address: 90 W Meadows PI Primary Parcel Number: 420087890074 Permit Description: New four bdrm-pressure sand-lined bed Permit Submitted Date: 04/19/2021 Permit Issued Date: 04130/2021 Issued By: Luke Canicula Current Permit Fees Paid: $640.00 leddnlonel maa may oe re4alred aPaa mslanmlaa at eystaml. Permit Expiration Date: 04/2712026 (based an data of napedonl Permit Conditions: 1 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 is obtained. 3 Drainfield installation not to exceed designed upslope and downslope depth specked on design form. 4 Installer is responsible for obtaining Mason County installation approval prior to backfill of system components. 5 Installer is responsible for obtaining Septic Designer/Engineer installation approval prior to backfi/l of system components. 6 Mason County Asbuilt Form, Record Drawing, and Installation fee must be submitted for final installation approval. 7 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 DESIGN APPROVED. FINAL INSTALLATION APPROVAL IS REQUIRED PRIOR TO TEMPORARY OR FINAL OCCUPANCY OF ANY RELATED STRUCTURES. For Final Inspection visit: masoncountywa.govlhealthlenvironmentallonsiteloss-inspection-request.php or call: 360-427-9670,extension 400. ( \\\ \ § , » ! ©§ � \ ; § \ . / 00 \ 7 -�z Mzx . \ oc \ ®\ \ § \ ( % � V =^ ) ` ; ) ® ` / ! § ( ` \ | \ ) Ma M § § / ( ; ! :! e $ § § ` § } § )% m z ( ! > \\ \ r M- m K« , ! ` � § �) ) / \ M e a : ! § \} ) \ / } � \ ; ; lr § E - : ! § ■ f . ) ] ( ) § � ' | 7 � § � E ) _ ( ! | ` ) ! ;