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Home My WebLink AboutWAT2024-00204 - WAT Application - 4/9/2024 WAT 415 N.6°SnvcA MASON COUNTY Shdlmi,WA 985M 60 (a COMMUNITY SERVICES Shehoa:3427-9670,Ext.4W _._-. Bi,lfa .360-275-0 7,Iat 400 Elms 360482-5269,Ext,400 Application for Determination of Water Adequacy Instructions f. Complete Part 1. No detemlination can be made until Part 1 is fully completed. 2 Complete only the portion of Part 2 applying to the type of water connection utilized. 3. Submit completed application,with any required attachments for review. C An approved building site plan must accompany this application. Part 1: Applicant/ Parcel Identification Name on Applicant Richard and Holly Mullen Date: 4W4 Mailing Address: P.O.Box 81,Grapeview,WA 98546 Pinball 253-230-3718 Parcel Number. 221135100005 Type of Water System Reason for A�p7p�lica�ti/o�n�� ,,++�� ++ * PublidCommunily Water System(2 or more 12 Building permit 8c-1/A00,W-0015 connectiors) ❑ Division of land: ❑ Individual water source(one connection), #of Parcels? SPL ❑ Well ❑ Boundary line adjustment ❑ Spdng/surfacewaler ❑ Other(explain) ❑ Other(explain) ❑ Replacement or Remodel(please indicate name ff you have more than one residence connected of water system below if applicable—no to this well,check the Pubfic Communrity Water signature required) System box. Part 2: Water Connection Information Complete the section appropriate for the type of water connection being evalualed: Public Water System Name of Water System: McLalns Cove Water Facility Inventory(WFI)Number. 527407 (write"none'for two-party) ❑ 1 am the manager of this water system. The water system has been approved for services.There are presently connection(s)in use.This will be the connection. B I am the manager of this system.This connection will be to upgrade or change the use of an existing connection on this system(io.:recreational to full time).Please indicate on the following line the nature of this change: evstiig mnnx0on,issue ar0frama antler row wmw name This water system is able and willing to provide water to this (these)connectian(s)without exceeding the limits of the water system or any limits sal by slate and twat regulation. o Print Name of Water System Manager Sar stro, u omer Svc Mgr Pone Yll-tl - EfOW Signature of Water System Manager. Date t-I It) c This form may be scanned and available for public view at www.m.mason.wa.us. J:TH rOruvt umluos w,r a 1 14 77 02: Individual Water Well ❑ Water well report(attached to application). Depth ft. ❑ Well capacity Test(attached to application) gpm gpd. The well driller often performs well capacity tests at the time the well is constructed. Results from these tests are noted on the water well report. Results from these tests will be accepted. If the water rt oes not have a capacity test, a wwellell caps h tesrt cannot t which hted by provides stabilizati e applicant o of draw-down a if the water lnd recovery data, must be performed by a licensed contractor. ❑ Satisfactory bacteriological test(attach to application). Water Resource Inventory Area (WRIA) EWell pment within which WRIA http,t/a s co mason wa us/planning 140150161�22� use or limitation recorded................................... N/AQ_Yeses_ rilled ............................................................... Date Individual Spring/Surface Water ❑ WDOE permit(attach to application) ❑ Method of disinfection ❑ 1 have reason to believe that this water source can provide at least 800 gallons per day; and/or provides water at a rate of 2 gallons per minute based on the following observations. Author of Statement Date Relationship to Applicant Part 3: Mason County Community Services Evaluation (staff use only) �/ Satisfactory Determination: //`This determination does not address adequacy of the distribution system,guarantee an adequate supply of water indefinitely in the future,or guarantee compliance with all applicable W DOE water resource regulations. Recommended approval indicates requirements of Sanitary Code,Title 6,Chapter 6.68.040-Determination of Adequacy for Building Permits are satisfied. Additional Growth Management requirements may apply. Chapter 36.70A RCW. ❑ Unsatisfactory Determination: Applicants water supply does not appear adequate to meet the needs of its intended uae for the following reason(s). Environ. Health: Reviewer's Signatures: ,� Data �_ z miz CSD Director. Date Rhonda Thompson From: O'Dell, Shawn <sodell@wawater.com> sent: Monday,June 17,2024 9:52 AM To: Rhonda Thompson Cc: rpmhhm2014@gmail.com;Castro, Sarah;Customer Service Washington Subject Water Adequacy Form Attachments: FW: Richard Mullen water adequacy form for Caution:External Email Warningl This email has originated from outside of the Mason County Network. Do not click links or open attachments unless you recognize the sender,are expecting the email, and know the content is safe. If a link sends you to a website where you are asked to validate usingyour Account and Password, DO NOT DO SO! Instead, report the incident. Ms.Thompson, Please except Sarah Castro's signature in place of mine for this water adequacy form attached in the previous email. Due to unforeseen events, I was out of the office and Sarah Castro is our Customer Service Manager who at times is authorized to sign on my behalf. Please let me know if anything further is needed to complete this process. Thanks, Shawn Shawn O'Dell Operations Manager WASHINGTON WATER SERVICE Office:(253)313-9121 Quality.Service.value. wawater.com This e-mail and any of its attachments may contain Washington Water Service Company proprietary information and is confidential.This e-mail is intended solely for the use of the individual or entity to which it is addressed. If you are not the intended recipient of this e-mail, please notify the sender immediately by replying to this e-mail and then deleting it from your system. 1