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Home My WebLink AboutSWG Application - 5/12/1967 f TEMON-MASON DISTRICT ITa. " I� ,- u Division of Sanitation Court House Annex Court House -=ex Shelton, 'Iashiagton a 3' o 9 Olympia, Washington Phone 426-8515 a9 � Phone 352-4851 3 - Ooofl I APPLICATION TO CONS kAIA'ER ANN INDIPIDIIAL SE:.'AGE DISPOSAL SYSTEM (Application required for each installation) Property Mor Pe / _Telephone l'� oa�j Print F°liiling Address of Site [ hCL SOA) t( :1v - { Location of Property, nc u Lot Hloe—k1 Other/p Detail d direct iOno.to �i+its: Ifl 1 RxoDertv Commeroiel 81ee ��Xz e t_Residence No. Bedrooms Haesmeat_TYR Water $apply: '.'ell Spring Other Is any water supply or body of rater within 50 feet of a wage a tem. Yee No_ Septic Tank.. a gallons. Drainage System length feet. Trench Width.3 Ft. ' (Refer to T-a leb 1 of Bulletin) (Refer to Table 2 of Bulletin) And/or system other than above Check for Installation of: .automatic Laundry E'q Automatic Dishwasher (Na) Garbage Grinder Is Contractor installing septic tank? yes , No Drainfield? yes,-no_ Name of Sewage Contractor - � Se� contractor must licensed by Thurston-Mason Health District SKETCH PLOT PLAN AND PLANS OF PROPOSED SYSd'EK ON SEPARATE SHEET OF PAPER THE IINDERSIGNED hereby applies for a permit to oonst t a new ( ) and/or alter ( ) a sewage, system on above propel � r e ru�th the Bulletin. Applicant's Signat Address_ Bulletin Washington State Department of W,alth Bulletin No 1 entitled' Septic Tank System for Your Rome for minimum requirements. __(Not,to be -Pilled in by Applicsu-t) Permit No a 3 ys Fee/OV Date Issued_. _ Dates Inspected---_ _ ._ . _._.__ — . __ _.._ . Remarks_,'---_— _—"----__ --- Date Approved Approved By� _ Ps 7---- � 9 tarian) �—y � 3 �-a DRAIN �,E�D ' IF 10, I I II tRIC% G Lege OaT Yq LUE -DRIVE bbr 1000 ' TAm I ✓ / I i` .33 ' `I DIS rK18QT10N I ) '., 'Bon I . Cady A. d Jim THRRSTCN-MASON HSAIJ& DISTRICT No._� Division of Sanitation Court House Annex Court House :,nnex Shelton, './ashington ' a3- a 9 — + 1 Olympia, Washington Phone 426-6515 Phone 352-4851 _ APPLICATION TO CONSTRUCT OR ALTAR AN INDIVIDUAL SO AGE DISPOSAL SYSTEK (Application required for each installation) Property Owner 1 ,4 n y Telephone r- 2 Z G Pl Print $siline see /7.-r -Z f o /A-' 6),4 ,7 N, Address of Site r GI-CCSaAj NU I SJ Location of Property, : Lot /�_ Slock,',' Other/ ,,,CCC Detail directions Ito its: Property Commercial Residence No. Bedrooms basemen Water 9uPP3Y: "ell Springy Other - - Is MW water supply or body of water within 50 feet of sewage tem Yes—se— Septic Tank &b Z! gallons. Drainage System length feet. Trench llidtkI Yt. (Refer to Table 1 of bulletin) (Refer to Table 2 of bulletin) And/or system other than above .: .. :Cbeck Yor.lustallation oft.- Automatic laundry V9 Automatic Dishwasher (NO) Garbage Grinder (W) Is Contractor installing septic tank? yes No Drainfield? yee�nc Name of Sewage Contractor � Seerege contractor most a licensed by Thurston-Ale.son Health District SKETCH PLAT PLAN AND PLANS OF PROPOSED SYSTEM ON SEPARATE SHEET OF PAPER THE UNDERSIGNED hereby applies for a pe t to oonstru t a new ( ) and/or alter ( ) a sewage system on above proper e , th the Bulletin. Applicant's Signs 1 = a � A Adares Bulletin Washington state Department of Avalth Bulletin -.3. No 1 entitled . septic Tank System for Your Rome for minimum requirements. (Not.to be filled in by Permit NO Fee%( _ Date Issued___ x�__ Area Sanitarian Dates Inspected_ Date Annroved ._J —= - _- -__ .approved : 3 � - � � �S itarian " Y I DRAIN A L IAE / . � I I [LdN OuT VALVE 17(?IV 1000 I I N DIAL TANK II - 133 ' II � / I / II MASON COUNTY DEPARTMENT of HEALTH SERVICES Shelton,Washington 98584 (360)427-9670• Belfair.275-4467 ENVIRONMENTAL HEALTH PERSONAL HEALTH WATER QUALITY P.O.BOX 1666 303 N. FOURTH P.O. BOX 1666 May 30, 1995 Jim Cady BE 351 Old Arcadia Rd Shelton, WA 98584 RE: - Parcel Number: 12329-41-00081 Site Address : Crazy EriC•s Restaurant, Hwy. 3 Dear Mr. Cady, We want to thank you for your cooperation with the Mason County Department of Health Services, Office of Water Quali- ty, sanitary survey of your on-site septic system. Your septic system was not found to be failing. If problems were observed during the survey that had the potential to shorten the life of your septic system, they were noted by field staff. The purpose of this letter is to inform you of the non-failing status of your system, and to advise you of any such problems. The following are observations our staff made on 5/25/95 while surveying your property: The septic system appeared to be functioning at the time of the dye test; no obvious problems were ob- served. Attached are some general comments about on-site sewage treatment/disposal systems. If you have any further ques- tions, please do not hesitate to contact me at (360) 275- 8733. Sincerely, Grant A. Holdcroft, R.S. Lower Hood Canal Lead