HomeMy WebLinkAboutSWG2024-00367 - SWG Application / Design - 8/27/2024 WA
MASON COUNTY 415N 6THELTON , 0427-970EXT 400
BH .
STREESHEL ON, EXT584
BELFAIR'.360-275-4467,EXT 400
Public Health & Human Services ELMA 360482-5269,EXT 400
FAX 360-427-7787
On-Site Sewage System Tank Only Permit: SWG2024-00367
APPLICANT Sam Skinner Phone:
Address: PO Box 920 EAST OLYMPIA, WA 98540
OWNER RENN NANCY Phone:
Address: 1801 12TH AVE S SEATTLE, WA 98144
SEPTIC DESIGNER JIM HUNTER' Phone: 360-753-1226
Address: PO BOX 162 OLYMPIA,WA 98507
SEPTIC INSTALLER SAMUEL SKINNER' Phone: 360-536-7678
Address. PO BOX 920 EAST OLYMPIA, WA 98540
Site Address: 191 E NORTH ISLAND DR
Primary Parcel Number: 220033400011
Permit Description: Tank replacement and drainfield repair
Permit Submitted Date: 08/27/2024
Permit Issued Date: 09/04/2024
Issued By: Rhonda Thompson
Current Permit Fees Paid: $265.00 (additional fees may ad required upon installation of system).
Permit Expiration Date: 09104/2025 (based an dale of inspection)
Type of Work OSS Repair
Components being Replaced: Septic and Pump Tanks
Surfacing Sewage? No Existing Failure? No
Shoreline? No Horizontal Setbacks Met? Yes
Number of Bedrooms: 2 Drinking Water Source: Private Well/Spring
Additional Details: Septic and pump tanks
Permit Conditions:
1 Proposed development subject to zoning requirements and approval by the planning
department staff per Mason County Title 17.
3 Drainfield installation not to exceed designed upslope and downslope depth specified on
design form.
6 Mason County Asbuilt Form, Record Drawing, and Installation fee must be submitted for
final installation approval.
2 Permit must be installed by a Mason County Certified Installer unless prior written
authorization from Mason County is obtained.
4 Installer is responsible for obtaining Mason County installation approval prior to backfill of
system components.
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/environmentallonsite/oss-inspection-recluest.php or call:
360.427-9670,extension 400.
MASON COUNTY 415N 6HELTON: OA27-9N ,EXT 400
H STREET
360-02TO ,WA
S
BELFAIR:360-275A467,EXT 400
Public Health & Human Services ELMA.360482-5269,EXT 400
FAX:360-427-7787
5 Installer is responsible for obtaining Septic DesignerlEngineer installation approval prior to
backfill of system components.
7 Horizontal setbacks per WAC246-272A-0210 must be maintained, unless prior approval 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/environmentallonsiteloss-inspection-request.php or call:
360.427.9670, extension 400.
OFFICIAL USE ONLY
MASON COUNTY ECCMED
COMMUNITY SERVICES AN° - RECEDEDR m
PoMic HoltF Con nrcvIAHNEnv nmemal FINtnt V�• < w
SWIG `�U °
o a
Z 41
ON-SITE SEWAGE TANK ONLY APPLICATION a >
3 A
0
Pucur PnoNE m r
A SAM SKINNER 360 537-7678 c
MAILINGADORESS-STREET.CITY STATE nP CDOE 3
PO BOX 920, EAST OLYMPIA, WA 98540 A
SITE ADDRESS-STREET,CITY.21P CODE
191 E NORTH ISLAND DR, SHELTON, WA 98541 �A_
NAME OF DESIGNER PHONE p)N
JIM HUNTER 3560 753-1226
NAME OF INSTALLER PHONE v Ir
SKINNER CONSTRUCTION 360537-7678 < I^
TYPE OF WORK'VEDIC one) CONSIDER WATER SOURCE
❑ NEW CONSTRUCTION I UPGRADES [I REPAIR)REPLACEMENT O' PRIVATE ININIOUAL VVELL ❑ PRIVATE CORE WELL Z IKry
COUPONENTISITCDEREPLACEDIrvslumo ❑ PUBLIC WATER SYSTEM
N SEPTICTANK ❑ PUMPTANK ❑RVHOLDINGTANK PRIOR MS LOTSZE
OTHER 2 O'�
OTHER DETAILS Reley a'J TEXP RI TANDIS,GETBACK C1ECRJX-
❑ SURFACING SEWAGE ❑EXISTING FAILURE ❑SHORELINE ❑ 100FT+PUBLICICOMMUNITYWELLS n
x
6UBMNTAIs ❑ SOFH PRIVATE WELLS SURFACE WATERS.STREAMS RIVERS
❑ PLOT PLAN N EOU I R ED) ❑ TAN K CROSS SECTION(REOUIR EDT O 10FH DRINKING WATER SUPPLY LINES
r
❑ PUMP DETAILS(IF APPLICABLE) ❑ WAIVER(S)UP APPLICABLE) O SET+PROPERTY/EASEMENT LINES FOUNDATIONS.FOOTINGS
P-OT PLAN CHPCKusT 0
O
❑ DROPS RT'LINES AND EASEMENTS ❑ E%I STING,PROPOSE DSTRUCNRES ❑ EXISTING/PROPOSED OSS COMPONENTS AND LINES
❑ WELLS YNTHIN 1EI ❑ WATER SUPPLY LINES ❑ DRIVEWAYS'PARKING ❑ SURFACE WATERS STREAMS.RIVERS,ETC._
❑ DIRECTION OF SLOPE'CONTOURS ❑ PERIMETER'CURTAIN DRAINS ❑ NORTH ARROW ❑ SCALE BAR
DIRECTIONS TO DUE All SITE CONDITIONA 11, 11
4G.,
0
OFFICIAL USE ONLY BELOW THIS LI
JPGHALE I FAILURE SOURCE DU AD,T,M PIDPOSU
❑VOLUNTARY AINTENANCEPOMPING O BUILDING PERMIT OHOMESALE ❑COMPL NT OOTHEft.
COMMENTS/CONUI-ONS I�
NNace vep 4anK w( r\. S hz fan ILR
g wn Fan�,�dcl ktr �051v ,mnnat40 Nw� er�
SEWAGE TANKS M STBEJS DUIIDERCOH'LIST OF REGISTERED SAOACI TANK$ 9MVST MEET CURRENT MIMNLN STE J PEC VJiTH RISERS
AND DES TO SURFACE.AND NCIIDEAN EFFLUENT EITHER p PAPPLICAF-EI RECORD DRAW NO SIR INCITATION REPORT REQUIRED FOR F NIL APPROVAL
wsvw TOR SIGNATu4E DATEARCTIC AT ATOACA'E RATION APPROJEDn59uLD'T A
SON �lylzy
THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE REVISED'2112e15
Jim Hunter and Associates
LOCATION: 2201 "A" 93rd Ave SW • Olympia, WA 98512-9195
MAILING: P.O. Box 162 • Olympia, WA 98507
(360) 753-1226 • FAX: (360) 705-1360
SEPTIC SYSTEM DESIGNERS
Date: August 26, 2024
To: Rhonda Thompson
Mason Couty Environmental Health
From: Jim Hunter
Re: 191 E North Island Dr
Rhonda,
This is the site we spoke of a week or so ago. There is an existing system far this house. The
drainfield is not in failure but is draining slowly. There is also another permitted structure on the
property that serviced a mobile home that has been removed.
This proposal is to replace the existing tank with a new septic tank and pump chamber and to
dose both existing systems. The system currently used will be dosed in various locations to ensure equal
distribution. The system will also be jetted to ensure there is no line blockage.
If you have any questions,call me at 360753-1226.
08262024.1 I J
it
A a
lk
_ V, L�LLi_I�
P
n
II "
H
_I i k
e
Ig �Q� P III
-0.
f _ 1
ry
z
N A m
S
_'4
JN
}
u
Ci >