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HomeMy WebLinkAboutSWG2024-00220 - SWG Application / Design - 5/17/2024 HELTON,WA MASON COUNTY 415 NBTHELTON: , 0427-97 ,EXT 400 SHELTON:360-2754 70,EXT 400 BELFAIR:380-275J487,EXT 400 Public Health & Human Services ELMA:360482-5269,EXT 400 FAX:360427-7787 On-Site Sewage System Tank Only Permit: SWG2024-00220 OWNER LEIR RICHARD M &ELAINE SUE Phone: Address: 3507-24TH AVE SE PUYALLUP,WA 98374 APPLICANT LEIR RICHARD M &ELAINE SUE Phone: Address: 3507-24TH AVE SE PUYALLUP,WA 98374 SEPTIC INSTALLER DARYL HEMLEY` Phone: 253-857-3241 Address: PO BOX 305 BURLEY,WA 98322 Site Address: 1390 E BENSON LAKE DR Primary Parcel Number: 221035100034 Permit Description: Replace septic tank Permit Submitted Date: 05117/2024 Permit Issued Date: 05/22/2024 Issued By: Rhonda Thompson Current Permit Fees Paid: $265.00 (addidwal fees may ee requlrel upoe mdalladon d system). Permit Expiration Date: 0 5/1 712 0 2 7 (bass!w date of inspection) Type of Work DES Repair Components being Replaced: Septic Tank Only Surfacing Sewage? No Exist ng Failure? Yes Shoreline? No Horizontal Setbacks Met? Yes Number of Bedrooms: 0 Drinking Water Source: Private Well/Spring Additional Details: Hagerman 1250 ST Permit Conditions: 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. 3 Mason County Asbuilt Form, Record Drawing, and Installation fee must be submitted for final installation approval. 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-inspection4equestphp or call: 360-427-9670, extension 400. OFFICIAL USE ONLY MASON COUNTY / W y COMMUNITY SERVICES AMODNTX o�*9�L�y I RKENEDXY: m m WMIe HeMU(�Commun Srya Xeal[M1/Enmm�menul HeaXM1I 5 0 m SWG �1� - 2D s p 2 N ON-SITE SEWAGE TANK ONLY APPLICATION > a m I m APPA T - !o - 8D Z 0 = ox-m Oz MPG D o rEDR A SITE ADDRESS-STREET LRY,ZIP CODE o � n I lon NAME DF DESIGN PHONE (�♦ NAME OF INSTALLER PHONE O TYPE OFr „NMY 7!0- vvjPR.�mI� DRINKING YNTE0.5 DE q8.2 y 0 0 NEWCONSTRUCTION I UPGRADES Ip REPAIR I REPLACEMENT 0 PRIVATE INDIVIDUAL WELL O PRIVATE TW'OPARTY WELL Z COMpPONENTISI TO DE REPLACEONNSTALIFD ❑ PUBLICYATER SYSTEM A. INSEPTICTANK OPUMPTANK 13WHOLDINGTANK BEDROOMS aeAv�YnLa/� LOT SIZE © ,.--a� N 0 OTHER v��O''�' OTHER DETAILS(aNe[i fltl IM1M+WIy) TANN$)SETBACK CHECKLIST 0 CI SURFACING SEWAGE XEXISTING FAILURE ❑SHORELINE m 1DDFT+PUBLICICOMMUNIIYWELLS 0 SUBMRTALS ❑ 50FT1 PRIVATE WELLS,SURFACE WATERS,STREAMS.RIVERS I� E3 PLOT PLAIN(REQUIRED) O TANK CROSS SECTION IREOUIRED) E3 10FT+DRINKING VATER SUPPLY LINES 16 E] PUMP DETAILS(IFAPPLICABLE) ❑ VPVER(S)(IFAPPUOABLE) 1 O 5FT-PROPERTY/EASEMENTUNES.FOUNDATIONS FOOTINGS PLOT PLAN CHECKLST 0 0 PROPERTY LINES AND EASEMENTS ❑ METING!PROPOSED STRUCTURES E7EXISTING/PROPOSED OSS COMPONENTS AND LINES W E3 MILLSWITHIN I DOFT O WATER SUPPLY LINES E3DRVEWAYSV PARKING E3 SURFACE VATERS,STREAMS.RIVERS.ETC... O DIRECTION OF SLOPEI CONTOURS ❑ PERIMETER/CURTAIN DRAINS El NORTH ARROW EI SCALE MR DIRECTIONS TO SITE AND SITE LONDNIGNS.IW,IOCNM ROW I� �g9cr man Precgs�- 1AS0 Dal {.Ae TLk LUA Mq�1 Ol OFFICIAL USE ONLY BELOW THIS LINE U W RPDE I FAI LURE BOURLE Nor repvdq pepaeF) OVOLUNTARY *1AINTENANCEPUMPING ❑BUILDING PERMIT MHOMESALE [3COMPLAINT DOTHM CIXAMENTS/CCNDRIONG fq kce, (3(�z+0nc SEYNGETMKSMUBTBELIBTEDUNDEfl LOH'USTOFREGISTEREDSE GETANKS.TANKS MUST MEET CURRENT MINIMUM SUE REQUIREMENTS.EQUIPPED WTH RISERS MD UMTO SURFACE.ANO INCLUW M EFFLUENT FILTER NFAPPLICA&E). RECORD ORAVANGAND INSVLLAPON REPoRT REOUIRED FCR FINALMPROVAL. INMMR SIGNATURE DATE AFRIpTION VPIRATION DATE APPUCATIONAPPROVENISSUEDBY DATE SI'1-Z12, z THIS FORMISAYIE SCANNEDANDAVAILABLE FOR PUMI:YRMONTHEIMB01100014TYWESSITE REVSED Thrz°IB f7R fotpe J WeLL LVCA`TIDN 13�1� � BE:N�N l.�►�-� D�IY� oogoo I, /�L�EU� rw 1 o - vlwr♦FlE�p 1 �i Fpsr 2> 34 NEVAVWrjW / 1/GfY�Ory ut tw.lrrFiew �� �K15TINCy %Nfu- _,_---,APeROVED �Av zz 2024 ""'COUNTY ENVIRONMENTAL HEALTH RET LOA - ?f," L-cga*Z, Wi3 0 50 JEW, Printed From. asW§cAun',yS. ? --.Q/Al Ra w Print ro aeon County DM6 Lsn3aa xvhb30vu S N :31V09 699L-L99 W90 :XVd999L-l99 0090 :3NOHd 1-d OM B d OSZ I N a a 60996 VM'ONnO'dD 3111 L60E X09 O'd g isosz� 'sosz «As almj."'a •ONI JNRi33NIJN3 N3 41 r o p as Win O ti W a a =g •g�cFa 2 c k •� 'gg- '�° S Zr- � s� I 3 i�# 33 a� a�"�`gsg� WE WaU - � g immp 80 . � a�a� �--LYJFx llIW.X yy HOW', F y JOSd�•60G2 .S9 Cy � y i�'$ a� $% � E a S r a $ 112 ZF e a c r �rr � a 3'6Os 4 �;gi aag pffiv o'a or s sy$ps� p� i i5YS3tle NtlwaaovH S1N :3ltlOS 698G-teB mBE) :JMd 889G-GEB 08E) :3NOXd N 1-d05Z1 '8d05Z1 tlM'ONOOa°J31G1tl9Gfi0f%09'O'd 'l-S09ZL 'S05ZL o, �NI JNN33NIJN3 )13 k i-. ..+. . s ....i....... . 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