HomeMy WebLinkAboutSWG2024-00189 - SWG Application / Design - 5/3/2024 MASON COUNTY 415N 6 H ELTON: 0427-970,EXT 400
H STREET.
.SHEL ON, EXT 400
S
BELFAIR:360-275A467,EXT 400
Public Health & Human Services ELMA:360-482-5269,EXT 400
FAX:360427-7787
On-Site Sewage System Tank Only Permit: SWG2024-00189
OWNER HAMA HAMA COMPANY Phone: 360-877-5811
Address: 35846 N US HIGHWAY 101 LILLIWAUP, WA 98555
APPLICANT HAMA HAMA COMPANY Phone: 360-8775811
Address: 35846 N US HIGHWAY 101 LILLIWAUP,WA 98555
SEPTIC INSTALLER JOHN GILLILAND` Phone: 360-8984388
Address: 1510 E MCREAW RD UNION,WA 98592
Site Address: 600 N ELDON LN
Primary Parcel Number: 324270000010
Permit Description: Repair septic tank only for 224 N. Eldon Ln
Permit Submitted Date: 05/03/2024
Permit Issued Date: 05/16/2024
Issued By: Rhonda Thompson
Current Permit Fees Paid: $265.00 (additional fees may to required upon Installation of system).
Permit Expiration Date: 05/03/2027 (eased on data oflnspention)
Type of Work OSS Repair
Components being Replaced: Septic Tank Only
Surfacing Sewage? No Existing Failure? Yes
Shoreline? No Horizontal Setbacks Met? Yes
Number of Bedrooms: 0 Drinking Water Source: Private Two-Party Well
Additional Details: Hagerman 1250 ST
Permit Conditions:
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.
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/onsite/oss-inspectiontequest.php or call:
360427-9670,extension 400.
OFFICIAL USE ONLY
MASON COUNTY h� D
COMMUNITY SERVICES REEE (a H
m hMcNaW,ICommunlry NeaM,/EmVronmmGl HeakM1l I Ln (MA
SWG s N
.I,R W .,ARonMk,MM � _�� ra o
A
2
ON-SITE SEWAGE TANK ONLY APPLICATION a a
APPLIDANr PHDNE m m
Hama Hama Company 17
z
P Y 360-877-6172 Z
MMLINGADDRE86 6TRFET,CNY STATE,21P CODE C
35846 US Hwy 101, Lilliwaup, WA 98555 m
SITEADDRESS-STREET,CT',21PCDOE �T
224 North Eldon Ln., Lilliwaup, WA 98555 w
WINE OF DESIGNER PHGIIE
IN
NAME OF INSTALLER PHONE O I A
Arrow Excavating-John Gilliland 360.898-0388
TWE OF WORK I.N.lone) DRINKING WATER SOURCE N I N
ONEWCONSTRUCTION/UPGRADES ■ REPAIR/REPLACEMENT ❑ PRIVATE INDIVIDUAL WELL O PRIVATE TWCPARTY WELL 2 I v
COMPONENT(S)TO BE REFEACEW INSTALLED D PUBLIC WATER SYSTEM
I
■SEPTICTANK OPUMPTANK ORVHOLDINGTANK BEDROOMS LOTS I O
O OTHER no record
OTXER DETAILS(eebp NtlwtkppyJ TANKISI SETBACK CHECNUST O
O SURFACING SEWAGE ❑E%ISi1NG FAILURE O SHORELINE 100FT-PUBLICI COMMUNITY WELLS 0
SUBMITTALS 0 50FH PRIVATE WELLS,SURFACE WATERS,STREAMS,RIVERS I CD
D PLOT PLAN(REQUIRED) ❑TANK CROSS SECTION(REQUIRED) 0 10F7.DRINKING WATER SUPPLY LINES
O PUMP DETAILS(IFAPPUCABLE) O WAIVER(S)QFAPPLICABLE) 9 SFT.PROPERTY/EASEMENT LINES,FOUNDATIONS,FOOTINGS Ij 0
PLOT PLAN CHECKLIST O I CDPROPERTY LINES AND EASEMENTS ■ EXISTINGI PROPOSED STRUCTURES O EXISTINGI PROPOSED GIGS COMPONENTS AND LINES ~
D WELLS WITHIN 1 WFT O WATER SUPPLY LINES ■DRIVEWAYS/PARKING OSURFACE WATERS,STREAMS,RIVERS,ETC...
D DIRECTION OF SLOPEI CONTOURS D PERIMETEW CURTAIN DRAINS .NORTH ARROW OSCALE BAR
DIRECTIONS SITE AND SITE CMDITIMS:I—I[k%f Belo) Q
From Shelton head North on Hwy 101. Just past Hama Hama Company turn left onto North
Eldon Ln. Follow road two blocks in, property will be on right.
-- - -------- OFFICIAL USE ONLY BELOW THIS LINE ----- ------
UPGRADE I FAILURE WUNK,IBV rq wWrFm )
OVOLUNT NTENANCEPUMPING O BUILDING PERMIT OHOMESALE OCOMPLAINT DOTHER:
COMMENTSICCNDITIONS
f2_y � cz art, L � ,J JL
SEWAGE TANKS MUST SE LISTED UNDER WIN'LIST OF REGISTERED SEWAGE TANKS'. WNKS MUST MEET CURRENT MINIMUM SME REWIREMENTS,EQUIPPED WITH RISERS
MO DDS TO SURFACE,NID INCLUDEM EFFLUENT FILTER(IF MPLICABLE). RECORD DMWINGMD INSTAWTnN REPORTWWIRED FM FINALAPIROVK.
INSPECTOR SIGNATURE GATE I A ,cSTION EMPIMTICN SATE APRIUTIDN PPPROVEDIISSUED BY LUTE
S// � Sm s- kf?
THIS FORM MAYBE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE RENSEDIWIM15
APPROVED
MASONCOVMryENW OH MENTALHEALTh
RET
Cb
T
O Tok
� o
T ` /
\ r
J
O
AP
2
p2
W
p 2
N
lz
4y
J
8
W �•
_ w
2 Z
e
Z Z 2
O
)Z O
G FJ w
O Z
w w
z z
z
E _ J
z
g
J �
Avg
MI a go"
61
§ uA 31+R R N
D » ice
si � € •z
"f E$3b � cr izsoex i:wr o� AK
'§a��Rc�3° A3f €ffi az g(� sa
RP9'; F E Yee
AAA9A 9 $
Mall
88 p
8a� gg a _ E BRA APPROVED
RFo�� �'8 �6 � °� �B • p"F
s=_ aa� �=� MAY 16 2 24
€ o ON COUNTYENVIRO AEKTALHEALTH
RET
�gss° g $�
g€ 26
DAM
EK ENGINEERING INC. DRA ' 8231
RAPreo er: 1250 S, 1250 S-T, m
P.O.BOX 309I BATTLE GROUND,WA 98 o.R.N. 1250 P & 1250 P-T a
PHONE: (38V W7-7WFAX: (36q W-7W SCALE. NM HA(iEPWNPNEU' si
,
@ �- - - .
. � ; '! , § ��z ...�2 ,I
| §
|
� /A \
\ i
. . | :
.. .� . .
. r ----, - m
--.
;
—4 2 :y
'- --:emu ,
§
A$
| i , 6 vU + 4 �; ; , • § d
) �| � ■
§ —
�
| � ƒ 941
_ ..- §
\~/
z ! z « a J x1)
�ƒy .
EK ENGINEERING INC. S, 1250 /
2 M _E ,mom