HomeMy WebLinkAboutSWG2024-00295 - SWG Application / Design - 7/9/2024 SHELTON,
A 985M
MASON COUNTY 415N6SHELTON: 00427167 WEXT400
SHELTQN:360-E27-9670,EXT 400
4 BELFAIR:380.2]5-046],EXi 400
Public Health & Human Services ELMA:3 82-5269,ENT 400
FAX 36"27-7787
On-Site Sewage System Tank Only Permit: SWG2024-00295
OWNER PERSA AUGUSTIN &CLAUDIA Phone: 360-606-3486
Address: 2008 NW KELLY DR VANCOUVER,WA 98665
APPLICANT PERSA AUGUSTIN&CLAUDIA Phone: 360-606-3486
Address: 2008 NW KELLY DR VANCOUVER,WA 98665
SEWAGE INSTALLER THAD BAMFORD• Phone: 360-790-2364
Address: 301 WALLACE KNEELAND BLVD STE 224-332 SHELTON,WA 98584
Site Address: 5700 E Mason Lake Dr W
Primary Parcel Number: 222335100115
Permit Description: Tank Only Repair
Permit Submitted Date: 07/09/2024
Permit Issued Date: 07/10/2024
Issued By: David Anderson
Current Permit Fees Paid: $265.00 (additional r000 mar ba nadi awn iosunomo ofsysloml.
Permit Expiration Date: 07/09/2025 (basodondareormoreomnl
Type of Work OSS Repair
Components being Replaced: Septic and Pump Tanks
Surfacing Sewage? No Existing Failure? No
Shoreline? Yes Horizontal Setbacks Met? Yes
Number of Bedrooms: 2 Drinking Water Source: Private Well/Spring
Additional Details: BPS 1250
Permit Conditions:
2 Permit must be Installed by a Mason County Certified Installer unless prior written
authorization from Mason County is obtained.
3 Mason County Ast itt Form, Record Drawing, and Installation fee must be submitted for
Final installation approve/.
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.
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 ANO/OR DESIGN
APPROVED.
FINAL INSTALLATION APPROVAL IS REQUIRED PRIOR TO TEMPORARY OR FINAL OCCUPANCY OF ANY RELATED STRUCTURES.
For Final Inspection visit: masoncountywa.gov/heakh/environmental/onsite/oss-inspection-request.php or call:
360-427-9670, extension 400.
OFFICIAL USE ONLY
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ON-SITE SEWAGE TANK ONLY APPLICATION 3
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Daniel Parse 36 -606-3486 c
MAILING ADDRESS-STREET.CITY STATE,ZIP CODE
2008 nw Kelly Dr. Vancouver,WA 98665 MW
SITE ADDRESS-STREET.CITE ZIP CODE
5700 E Mason lake DR. W Grapeview, WA 10
NAME OF DESIGNER PHONE I�
NAME OF INSTALLER PHONE Q I N
Bamford Septic Repair 360-790-2364 w
TVPECf W°RK(Wxfmof DRINKING WATER SOURCE O
❑NEWCONSTRUCTION/UPGRADES M REPAIRIREPLACEMENT ® PRIVAMINDNIDUALWELL O PRIVATE TWo-PARTY WELL Z I.
CGM`CHENT(S)TOBEREPLACENINSTALLFD O PUBLIC WATER SYSTEM I
® SEPTICTANK NPUMPTANK ORVHOLDINGTANK BEDROOMS LOi SIZE '�r Imo\
O OTHER 2 0,0 ED I,
OTHEROETNLS(sMr ,M4 ARPY) TAN(ISI SETBACK CHECKLIST Q
OSIRFACINGSEWAGE D EXISTING FAILURE OSHORELINE Y 100FT+PUBLIC/COMMUNITY WELLS O
SUBMITTALSPLO
SOFT-PRNATE WELLS,SURFACE WATERS,STREAMS,RIVERS 0"
PLOT PIAN(REQUIRED) ❑TANKCROSS SECTION(REQUIRED) � 10FT+DRINKING WATER SUPPLY LINES to
O PUMP DETAILS(IF APPLICABLE) WAIVER(S)(IF APPLICABLE) 1FT+PROPERTY/EASEMENT LINES,FOUNDATIONS.FOOTINGS
PLOT PLAN CHECKUST O 11
PROPERTY LINES AND EASEMENTS E EXISTING/PROPOSED STRUCTURES E EXISTING/PROPOSED DES COMPONENTS AND LINES -1
■ WELLS WITHIN 100FT O WATER SUPPLY LINES ■DRIVEWAY&PARKING M SURFACE WATERS,STREAMS,RIVERS,ETC._ I I
M DIRECTION OF SLOPE/CONTOURS [3 PERIMETER/CURTAIN DRAINS ■NORTH ARROW ■SCALE BAR
DIRECTp TOS(IEANDSRECONDITIONS:(m.ISFAIIPale)
proposed tank replacement would be to meet set back for construction permit. We would
be installing 2 -1200 concrete tanks and adding a control panel with time dose and cycle
counter. Decommissioning of old tanks and installing new transport line to D-box.
OFFICIAL USE ONLY BELOW THIS LINE
UPGRA➢E/FAILURE SOURCE(lv mIxHW gepce69)
OVOLUNTARY OMAINTENANCEIPUMPIND OBUILDINGPERMIT OHOMESALE [3COMP1_AINT DOTHER:
COMMENTS I CONDITIONS JUL 0 9 2024
W/�I Zo2Y -o000' l
BY
SEWAGE TANKS MUST BE LISTED UNDER DOH IUST OF REGISTERED SEWAGE TANKS'.TANKS MUST MEET CURRENT MINIMUM SIZE REDUIREMENTB.EQUIPPED WITH RISERS
AND LIDS TO SURFACE,AND INCLUDE AN EFFLUENT FILTER(IF APPLICABLE). RMC DMWINGMDINSTALIATpNREP TP MIREDfMFI A APPROVAL.
INSPECTCRSWNATURE DATE APPLICATIC14MPI114TION7 APPII APPROVED/ISSUED BY DATE
THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC WEW ON THE MASON COUNTY WEBSITE RENSE01WC0I5
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APPROVI' E
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APPROX. WEIGHT 11 .000 LBS.
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