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Home My WebLink AboutSWG2021-00463 - SWG Application / Design - 8/9/2024 584 MASON COUNTY 415N6SHELTON: 60427-O70.EXT 400 aHELFAIR 360i2] 7.EXT 400 BE ELMA,360-275d467,ENT 400 Public Health & Human Services ELMA:3804825269,ENT 400 4 FAX:360427-7787 On-Site Sewage System Permit: SWG2021-00463 APPLICANT CANNADY DAVID&ANGELA Phone: 360580-4413 Address: 5 SCENIC PL MONTESANO, WA 98563 OWNER CANNADY DAVID&ANGELA Phone: 360580-4413 Address: 5 SCENIC PL MONTESANO,WA 98563 SEPTIC DESIGNER JUSTIN RUSSELL• Phone: 360.956.7242 Address: PO BOX 14531 TUMWATER,WA 98511 Site Address: 350 W Satsop Dr Primary Parcel Number: 519085000027 Permit Description: New two bdrm-pressure trench Permit Submitted Date: 08/09/2021 Permit Issued Date: 12/01/2021 Issued By: Jeff Wilmoth Current Permit Fees Paid: $870.00 (additional ees may be required upon maaliato„ofayscem). Permit Expiration Date: 08/1712026 (based on dale or inspection) 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 ball of system components. 5 Installer is responsible for obtaining Septic Designer/Enginaer installation approval prior to baci ll of system components. 6 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 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-inspection-request.php or call: 360-427.9670, extension 400. ® MASON COUNTY 415 NBTH STREET,SH27-967 ,E 98584 BHELTOR:360-275- 1T0,EXT 4W BEEUMA 360-2T5-4467,EXT 4W Public Health &Human Services ELMA:380/62-5269,EXi 400 FAX:360427-7787 7 The approval of this project is subject to the recommendations and specifications outlined in the attached geotechnica/report or assessment.All applicable recommendations and specifications shall be applied to the development on this site. Any deviation requires stamped written approval from the registered design professional responsible for the report and may require special inspection by same. Structures and/or/and modifications (grading, cuts, fills, etc.)required in the geotechnical report, may require a separate permit. 8 Comply with all recommendations in Geo Report 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 SUE 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.gov/health/environmental/onsite/oss-inspection-request.php or call: 360-427-9670,extension 400. ® MASON COUNTY Nd^aT sou-ELTpNwAwal d EAT,4(10 Public Health&Human Services aaLrAl^:mnsadm,ax*.dN �u� a i zaZa APPLICATION FOR EXTENSION Amnu„r Nld: L O r BY R.—,Numbo-: Insmoc5ons: ApP kale tp mmp ate Parts 1 ale 2 ale sepal tlasignarleng neer ton complete Part 3.Submit application with extension permit lee. Make check payable to Mason County Treasurer. Staff will review your apdicalim and tlelmmine if Ne extension can be apPrPoetl. Conditions W approval are outlined in dlis applicaWn. Prior to or after expiration of en approved design,the applicant may apply for a permit AG extension.The permit extension shall extend transpiration of the deem for up to two years, p 49 but not exceed floe years Mann the Spread.data of the EmnranmeMal Health Spooning 8 sae inspeceon(Per WAC 246-2]2A-200(4xe)) Rpp pp 6149 Alt approved sepal designs may receive one extension.Additional extenslons shall not be tempted and would instead require a renewal. PART 1: APPLICANT AND PARCEL INFORMATION Name MApgicant' AVID CANINOY Phi, 3605 113 Mailing Address of AppkaI 6 SCENC PLACE CRL,. MONTESAND Stele. WA 9W3 12Eigit Tm Pmen Nulsto stBOB3OOppZ) Sire Address. 35p W SATSOP tl1NE FIIIA 065d1 Permit Number:SING Sees,MI-0016a PART 2: EXPLAIN MY YOU NEW AN EXTENSION THE APPLICANT IS SAWING MONEY FOR THE NSTALIATIc,OF SEPNL SYSTEM JIM HENRY HAS RETIRED,LAPIN SEPTIC SOLUTION.LLG HAS TALON OVER THIS PROJECT THE PROPOSED DESIGN APPEARS TO MEET ALL CURRENT 0006A Iles form may he molted and notable for ablic Weer on Ns NNpn cymy web WOa synNx PART 3:ORIGINAL DEGIGNERIENGINEER REVIEW AND APPROVAL I,Me undersigned!original Dasigner Ergineer,attest Mat I have minspecled the property and fautM the idloveng candi h ns to b s sue as of Me data of my signaMte below: • NO pad of Me proposed DMIrMeld or Reserve area has been elMretl or Mended!in such a eey Mal may render the proposed design invalid. • NO development has oaurred p Mis parcel or nelghbaing parpk vMkh eouM pose the proposed system to no longer meat minimum sedescks. • NO Boundary lirre adjustments or subdivisbne have occurred wMan eauM puss the Property M fall below the minimum land eras requlrentents of WAG 246.272 ' o• —Anesa•rm d12R4 I !�n/=fl ndrm oeslgnefEnglnee Date CohnmentslCors idons: — — — — — — —I DESIGNMi C1WM£DIE TD ORGINAI DUMERG RETIREMENT PART 4:HEALTH DEPARTMENT DETERMINATION(staff use only) ❑ E.I.W.Denied P1 Etdension Approved Nee Expiration Date: 4 1 V •v CommenuIMP EnNmmnary M:geclebt Glg�Wre: V� rnMmdn nrwawnlM.M.vINhM ier VubLcvinuoA ��V0 ��4 Nh?do �,A is