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HomeMy WebLinkAboutWAI2024-00067 - WAI Health Waiver - 7/16/2024 L-0P. 1 za 2 _ 0Go � } MASON COUNTY COMMUNITY SERVICES Building Planning,Environmental Health,Community Health 415 N 6°Street, Bldg 8, Shelton WA 98584, Shelton: (360)427-9670 ext 400 i• Belfair (360) 275-4467 ext 400 Elmo: (360)482-5269 ext 400 FAX (360)427-7787 Application for Waiver/Appeal Amount Paid '�qSy— Receipt Number. Instructions 1. Complete Parts 1 and 2. No determination can be made until these parts are fully completed. 2. Fees may be billed far waivers and appeals, based on the Environmental Health Fee Schedule. 3. Submit completed application with attachments to Mason County Public Health for review. PART 1. Applicant/Parcel Identification y� Name of Applicant ZtycAkj Groin KW LLG �r7Tellephone LL59 ZZ'5- 2QOg Mailing Address of Applicant �1 q c NaY✓ ;$ Ra 5E City Port- Orc'l,-�d State pLH- Zip 15!f V,e 5" o 12-digit Tax Parcel No. 2 2 Q S- - 5 — D D SL Site Address f aw AyvN lslcy Ply 5ti_ el_-�-ov LIM 9R5B Subdivision Name and Lot 2. # S L of 9 PART 2: Nature of Waiver/Appeal ZEI Contractor Certification Requirements ❑ Class B Reduction in Vert II�� ((��11 (Installer, Pumper, O&M Specialists) ❑ Separation O LS UFood Sanitation Requirements ❑ Building Permit Review P sGroup B Water System Regulations • LOpatlgnWAC 246-272A- O ,fi Water Adequacy Requirements Holding TanIt WAC2462 0240 Enforcement Timelines ❑ Mason CountyOrateSta tlards Departmental Determinations gyOther Description of Waiver/Appeal (include justification, additional material may be attached.): Applicant Signature: Date: Y.rEH Forms\Waivc-Appeal Meson County Local R-viscd'.CN2017 Page I of 2 PART 3: Public Health Evaluation (Staff Use Only) 1. Type of Determination Required: Type of Onsite Waiver(if applicable) C Appeal iXV4aiver None required - Class A ^_ Class B = Class C _ 2. Identification of Specific Code/Standard' Determination (include date of determination or latest Code/ Standard revision) r�ft �f , /ten !L�'uo 3. Nature of Appeal: r hkA�;�n✓ k 5t G ft- '— YY\fa fn In -WA in a Z F 4. Hearing Official_ ❑ Board of Health ❑ Health Officer ❑ Pollution Control hearing Board ❑ Public Health Director ❑ Certified Contractor Review Board X, Environmental Health Manager 5, Mitigating Factors_ t ?AY\s, -�� lJ�v CV env IhA_;DaTiYY�R� mfi Ina Wa CaErg 6. 1 have received this waiver/appeal request. It is complete and mitigation required by the state and local policy has been submitted. Staff Signature: fkYYQ" ' 1 Date: PART 4: Determination of the Hearing Official The hearing official has determined that approval of this request will not adversely affect public health and is hereby granted. This decision is based on the following findings and conditions: ❑ The hearing official has determined that approval of this request could potentially adversely effect public health and is hereby denied.This decision is based on the following findings and conditions: Hea my Ofi<ial SiynaWt Date: / �r� J'EH Fortes\Waiver-Appeai Maanr.County LocaF Reined :2d201] Pane 2 of 2 Application for Waiver/Appeal Mitigation 7-2-24 Owner: Zenith Group NW, LLC Phone: (253) 225-2808 Mailing Address: 110 W K St, Suite C. Shelton, WA 98584 Site Address: 100 E Hammersley PI, Shelton, WA 98584 Parcel Number: 22018-53-00098 Property Description: Timberlake 951 Lot 98 1) Local Waiver Sought: Reduce horizontal separation between house foundation and primary drainfield from 10' to a minimum of 2'. 1) Mitigation Measures: Land slopes away from foundation. Drainfield effluent will drain away from foundation, not toward it.