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HomeMy WebLinkAboutWAI2024-00093 - WAI Health Waiver - 9/27/2024 415 N 6TH STREET,SHELTON,WA 98584 MASONCOUNTY SHELTON:360 9670,EXT 400 BEL :360-2754274467,EXT 400 Public Health & Human Services ELMA:360 82-5269,EXT 400 FAX:360427-7787 STEWART ET AL ROBERT G 550 E WOOD LN SHELTON, WA 98584 Applicant: STEWART ET AL ROBERT G Parcel Owner: STEWART ET AL ROBERT G Site Address: 560 E Wood Ln Primary Parcel Number: 320215602028 Waiver Request Number: WA12024-00093 Waiver Description: Onsite: Location,WAC246-272A-0210 Waiver Submitted Date: 09/27/2024 Waiver Review Date: 1011INY Waiver Status: APPROVED If you have questions or concerns let us know. Sincerely, David Anderson 360427-9670 Ext.353 danderson@masoncountywa.gov 01 SEP 21 2024 MASON COUNTY BY:_____________ COMMUNITY SERVICES Building,Planning Emiron mental Health,Community Health 415 N Ein Street, Bldg 8, Shelton WA 98584, Shelton: (360)427-9670 ext 400 O Belfair: (360)275-4467 ext 400 P Elma: (360)482-5269 40 FAX (360)427-7787 Application for Waiver/AppealAmoun Paid: 1Lb— ReceipttNumber: Ot-I I7`f R�C�if'FpOjOI� Instructions 1. Complete Parts 1 and 2. No determination can be made until these parts are fully completed. j 2. Fees may be 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 III- Mailing of Applicant gc�\'L��� 6..SltLtAbt(�Telephone NW) ` ' `�'� I ` Mailing Address of Applicant _5-so C. W otA city 45� e 14m� n State %VJ Pc Zip C?8 584 12-digit Tax Parcel //No. G � \�` dl Site Address�G� E. W I—W Subdivision Name and Lot 5lnorscres�'�av-...ce 3�k�clal. BLK G (--" t Z�J 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 ❑ Group B Water System Regulations ❑ Location,WAC 246-272A-0210 ❑ Water Adequacy Requirements ❑ Holding Tank WAC 246-272A-0240 ❑ Enforcement Timelines ❑ Mason County Onsite Standards ❑ Departmental Determinations ❑ Other Description of Waiver/Appeal(include justification, additional material may be attached.): I e a e^c-e A%> O 0) Applicant Signature: Date: 2.7 S lP 7-O24 J:\EH Fomvs\Waiver-Apped Mason County Local Revised 120,2017 Page l of2 PART 3: Public Health Evaluation (Staff Use Only) toca 1 1. Type of Determination Required: Type of Onsite Waiver(if of pplicable) ❑Appeal Y Waiver ❑ None required ❑ Class A ❑ Class B ❑ Class C 2. Identification of Specific Code/Standard/Determination (include date of determination or latest Code/ Standard revision) 3. Nature of Appeal: m Uri mftunwn hortmn#a Separaibn bCfi[Zn 6vlldnr 4omodn✓rn and +w. s Pkj rs io not less ice, + 4. Hearing Official: ❑ Board of Health ❑ Health Officer ❑ Pollution Control hearing Board ❑ Public Health Director ❑ Certified Contractor Review Board 1W Environmental Health Manager 5. Mitigating Factors:?M/ (f t/4,04 Ai fth Arn�hdl.,it- Are07 d6C di'm i;wdlls me( nAS 6. 1 have received this waiver/appeal request. It is complete and mitigation required by the state and local policy has been submitted. 77 Staff Signature: Date: V G PART 4: Determination of the Hearing Official I& 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: Hearing Official Signature: Date: 7 L 1:\EH Fore\Waiver-Appeal Mason County Local Revised 1/20,2017 Page 2 of 2 # 3 / Rg ) G ! $ M > M Z-O / 3 % APPROVE n � � 2@ ) \ ( / / NOV 22 ` 2 ° 7 ` •�> mA� - ` � ) { j , ^ ` ) / a ... ; < s x ©/ \ � . .! �� \gam { e _DYE "R