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Home My WebLink AboutWAI2024-00087 - WAI Health Waiver - 9/4/2024 off- i MASON COUNTY COMMUNITY SERVICES Building Planning Environmemnl Health,Community Health 415 N EP Street, Bldg 8,Station WA 98584, Shelton:(360)427-9670 ext 400 4 Belfair. (360)2754467 a rt 400 4 Elms:(360)482-5269 ext 400 FAX (360)427-7787 Application for Waaivveer/Appeal S� Amount Paid: acr.eI I' I �f Receipt Number:�= �f7 7p1✓ Instructions 1. Complete Parts 1 and 2 No determination can be made until these parts are fully competed. l 2. Fees maybe billed for 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 Nameof Applicant Park g VA«�— Telephone SLO c 'Zl—`IZS7 Mailing Address of Applicant 1 216& city `t 2E U: iV— State IJA _ zip /96 Z A 12-digit Tax Parcel No. Site Address ';21 WCkhTChF-MAk / AI LF.fil2 LJA RRSLFl Subdivision Name and PART 2: Nature of Waiver/Appeal ❑ Contractor Certification Requirements ❑ Class B Reduction in Vertical (Installer, Pumper, O&M Specialists) ❑ Separation ❑ Food Sanitation Requirements ❑ Building Permit Review Policies la Group 8 Water System Regulations W ❑ Location,WAC 246-272A-0210 ❑ Water Adequacy Requirements r( ICI ❑ Holding Tank WAC 246-272A-0240 ❑ Enforcement Timelines ❑ Mason County Onsite Standards ❑ Departmental Determinalions t v mA ❑ Other o ca p Description of Waiver/Appeal(include justification,additional material may be attached.): i r S ? t1iTrF! HE1 Applicant Signature: 1191, Data: Z L /:\EH Forme\Waiver-Appeal Mason County Local Revised 1/20/2017 Pagel of2 Rick Lukkasson P.O. Box 2166 Belfair Wa.98528 (360)821-4257 Re:Two Party Well-wel204-00039 I am requesting a waiver for a shared well. Finding on water permit:Two Party Well-we1204-00039 application was that a two party well is not allowed due to the size of lots. Requesting waiver because during subdivision of Parcel#12321-24-90080 pre-application meeting PAR20021-00022 expectation to share well from (new)Parcel#12321-24-90081 with new Parcel#12321-24-90082 and found to be acceptable. (The short sub#is SPL2021-00005.) Per the allocation statement on short sub#3139 sharing between all three lots divided was allowable. During my research a Group B system does not meet the setback requirements due to existing building location. Respectfully Rick D. Lukkasson PART 3: Public Health Evaluation (Staff Use Only) 1. Type of Detennination Required: Type of Onsite Waiver(if applicable) ❑Appeal ❑Waiver ❑ None required �Class A � Gass B u Class C Q�" 2. Identification of Specific Code/Standard/Determination(include date of determination or latest Code/ Standard revision) PlQfbq Cvmlfr Wr and Cagsfrvefar( of 6rsup 6 wafer SP*Akl. 3. Natu a of Appeal: eil acB f6c Z- Pad {�dfW 5osf°ms skip url land Re.utvrat fr-J-o fp �p o .1111- 0,11221TAI Z1Y4 s 4111 r t4717 YOU P7 4. Hearing Official: ❑ Board of Health ❑ Health Officer ❑ Pollution Control hearing Board ❑ Public Health Director ❑ Certified Contractor Review Board Environmental Health Manager 5. Mitigating Factors: r 2- wafer S g 4 ROfe( qS on, I*0 rf 5kr Sv ' S LZDZ 6. 1 have received this waiver/appeal request. it is complete and mitigation required by the state and local policy has been sub tied . Staff Signature: 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¢based on the fyllowi�B findings and m ition$ 2 v.a �, WaJ' g��r0 r[✓r a,I✓riN 1'h Y J'r.6.�i1/rd'104. —.7— 1 ❑ 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: Hearing Official Signature: Date: ` f 7 1V J:JFH From\Waiver-Appeal Macon County Local Revised lnonol7 Pagc 2 of2 I.b �a gillyy a gu 'x R lay y g3 93y}y}q}y}3agg; yi# 1y 8 � �A 9Yy bpi asb w Y o p. fa Y,G9as _ ay Rill ly a u *x �`�3e'� tl pp3 i —^ II 9 �:�# li �Y�3SYYs c 3itj al gyp# aa� e$! ® I CC-JJ - I # dill 9; # Jill , ��i.y� . w $ HAI £ # n i 4 p ss'� h'1°l\ upan 2Ad vN 00 Nosvw OCE99TZ r