HomeMy WebLinkAboutSWG2024-00210 - SWG Application / Design - 5/10/2024 ON,
584
MASON COUNTY 415N6THELTON:STREET,SHELT967 ,EXT 400
SHELTON:360-027-9670,EXT 400
BELFAIR:360-275-4467,EXT 400
Public Health & Human Services ELMA:360482-5269,EXT 400
FAX 360427-7787
On-Site Sewage System Tank Only Permit: SWG2024-00210
OWNER RILEY STEPHEN F &DONA M Phone:
Address: 995 SW PERTH SHIRE DR LEES SUMMIT, MO 64081
APPLICANT RILEY STEPHEN F&DONA M Phone:
Address: 995 SW PERTH SHIRE DR LEES SUMMIT, MO 64081
SEWAGE DESIGNER PAULAJOHNSON' Phone: 360-898-2255
Address: 171 E VUECREST DRIVE UNION, WA 9a592
SEWAGE INSTALLER JOHN GILLILAND• Phone: 360-898-4388
Address: 1510 E MCREAVY RD UNION,WA 98592
Site Address: UNKNOWN
Primary Parcel Number: 322357500080
Permit Description: Add septic tank with pump in 2nd comp.
Permit Submitted Date: 05110/2024
Permit Issued Date: 05/1312024
Issued By: Rhonda Thompson
Current Permit Fees Paid: $265.00 (adcumoal fees may as regmmd upon inswuaton of sraleml.
Permit Expiration Date: 05/10/2027 Ieeend on date of Melonoal
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: 4 Drinking Water Source: Private Well/Spring
Additional Details: Septic tank with pump in 2nd comp.
Permit Conditions:
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.
3 Mason County Asbuilt Form, Record Drawing, and Installation fee must be submitted for
final installation approval.
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/onsiteloss-inspection-requ"t.php or call:
360-427-9670, extension 400.
OFFICIAL USE ONLY
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APPLICANL
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995 SW PertDr, Lees Summit, MO 64081 M
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80 E Hawks VUnion,WA 98592NAME OF DESIGNERPHONEArrow Septic , Inc (360)898-2255
PHONENAMEOFINSTALER
Arow Excava (360)B98-4388DRINKING AXTER SOURCEANEWCONST UPGRADES ❑ftEPNR(REPLACEMENT al PRIVATE INDIVIDUAL V.IELL D PRIVATE TNO-PPRTY WELL IZOl
D PUBLIC WATER SYSTEM I
cMIPoNENT(SI TO BE REPLACE°'INSTALLED I -4
BEDROOMS LOT SIZE
D SEPTIC TANK ❑PUMP TANK D RV HOLDING TANK 5.W aCNSS
BOTHER Sepik TBllkwM LMPungn2M CNmOM 4 m
OTHER IF
OETNLSI�NYe4MH IPWN TANKISISETBACKCHECKLIST 0 ,
[1 SURFACING BEWAGE D EXISTING FAILURE D SHORELINE ■ 10OFT+PUBLICICOMMUNITY AELLS 0 I O
(♦ 5GFT+PRIVATE WELLS.SURFACE MISTERS.STREAMS.RIVERS
SURIDTALS ! 1OFT+DRINYINGWATER SUPPLY LINES
e PLOT PLAN(REOUIREDI 0 TANK CROSS SECTION(REQUIRED)
■ SIT.PROPERTY'EASEMENT LINES,FOUNDATIONS,FOOTINGS
E WMP OETAll3(IFAPPLILABLE) D VMNER(5)(IF APPLICABLE) r
FLOTPLANCHECKLIST 0 O
■ PROPERTY LINES AND EASEMENTS ■ E%ISTINCU PROPOSED STRUCTURES 0EXISTINGIPROPOSED OSS COMPONENTSAND LINES
■ VVELLSWITHINIOUFT N WATER SUPPLY LINES ■DRIVEMYSIPARKING ❑SURFACE VATERS,STREAMS.RIVERS.ETC., I IOD
NDIRECTIONOFSLOPEICONTOURS ❑ PERIMETER/CURTAIN DRAINS ■NORTHARROW NSCALEBAR IO
DIRECTIONS TO SITE PNO SITE CONDITIONS,IN, KKh]XPN
Go out E Brockdale Rd/ E McReavy Rd to Union, turn (R) onto E Dalby Rd, turn (R) onto E
State Rte 106, turn (R)onto E Timber Tides Dr, turn (R) onto E Hawks View PI, property is
on both sides of the road, house will be on (R) and tanks/drain8eld are by the shop on the
(L)side of the road.
• OFFICIAL USE ONLY BELOW THIS LINE
UPGRADE I FAILURE SOURCE(MnP:.eq puWOel r
1
O VOLUNTARY DMAINTENANCEPUMPING BUILDING PERMIT OHOME SALE OCOMPUINT ODTHER;
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COMMENTS/CONDRIOHS
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BE SMUSTBELISTEDUNDERCOH'LISTOFREGISTEREDSEV GETANKS TANKS MUST MEETCURRENT MINIMUM SIZE REQUIREMENT5.E0UIPPEDPoTXTIRE
DUDSTOSURFACE.AND INGLUDEAN EFFLUENT FILTER(IFAPPUUBLE). RECORDOR NGANDINSTPL TICNREPO TR MIREDFORFIWILPFPFO AL. DATE
INSPECTOR SIGNATURE DATE MPUUTION EXPIRATION LATE APNUTION PPPR%'ECJISSUEO BY
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THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC YIEW ON THE MASON OWN TY WEBSIIE
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PAVLAEli JOMiNS � APPROVED
® MAY 13 2024
Qa 0 VAOUSE ON COUNTY ENVIRON.4IENTALHEALTH
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Ha (5) 3X 59' FZIMgRy Dr
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WITH 1200 Sq{{ DRIB
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/ ^ 3 Cleanout
Q 1200 Gallon Septic Tank
/ '^ 2-Compartment with
`` �r • Effluent Filter
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17.00 Gallon Pump Chamber
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5 Valve Control Box
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SKV50 - Submersible Sewage Ejector PUMP
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2.compartment Septic Tank with Solids Pump in Second Chamber
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,SIC APPROVED
MAY MAY 13 2024
MASON COUNTY ENVIRONMENTAL HEALT
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PAU� JOY JOHNSON