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HomeMy WebLinkAboutWAI2024-00104 - WAI Health Waiver - 11/12/2024 t,'zz;r� C)L aoia� MASON COUNTY COMMUNITY SERVICES auilding.Planning.Environmental Health Community Health 415 N e Street, Bldg 8, Shelton WA 98584, Shelton: (360)427-9670 ext 400 4• BeNair (360)2754467 ext 400 4 Elms: (360)482-5269 ext 400 FAX (360)427-7787 Iwmnlym Application for Waiver/Appeal tltltltltllllllJlJlJIJIJIIIIII Amount Paid: o;LQS NOV 12 Receipt Number.ai Ins ons _---- 1. Complete Parts 1 and 2. No determination can be made until these parts are fully completed. 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. ApplicanUParcel Identification Nameof f� >-�Applicant A Telephone 3/oDr �gl�•�56,R Mailing Address of Applicant P. n pr)y :i 1 7?- city J-l n ion State U/+ zip 49592 12-0igit Tax Parcel No. 3— 2 2 a y' — 4 3- - Q ,Q —L 0 Z Site Address g 26 q G 5+ate. Route 1010 t f In ir)r) WA RSS42 Subdivision Name and Lot PART 2: Nature of Waiver/Appeal ❑ Contractor Certification Requirements ❑ Class B Reduction in Vertical (Installer, Pumper, O&M Specialists) ❑ S aretion ❑ Food Sanitation Requirements u ding Permit Review Policies ❑ Group B Water System Regulations— cation, WAC 246-272A-0210 ❑ Water Adequacy Requirements Holding Tank WAC 246-272A-0240 ❑ Enforcement Timelines ❑ Mason County Onsite Standards ❑ Departmental Determinations 04 'X, Other Description of Waiver/Appeal(include justification, additional Im� 'tateriall may be attached.): `IAKl VPr i-O fPl1u f[_ tr- S,T bxk, a +he ��9 f7d m nk owte / c Applicant Signature: Date: 1/ lr 1:\EH Forms\Waiver-Appeal Meson County Local Revised 1/20/2017 Page 1 of PART 3: Public Health Evaluation (Staff Use Only Local 1. Type of Determination Required: Type of Onsite Waiver(if applicable) ❑Appeal 9 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) WAC 246-272A-0210 3. Nature of Appeal: Reduce the minimum horizontal separation between the building foundation and the septic tank from 5 ft to not less than 2 ft.The tank is currently installed 4 ft 9 in from the foundation. 4. Hearing Official. ❑ Board of Health ❑ Health Officer ❑ Pollution Control Hearing Board ❑ Public Health Director ❑ Certified Contractor Review Board 14 Environmental Health Manager 5. Mitigating Factors: The building foundation is not down-gradient from the septic tank. 6. 1 have received this waiver/appeal request. It is complete and mitigation required by the state and local policy has been s mitted. Staff Signature: Date: II I 2 PART 4: Determination of the Hearing Official kQ, 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: It 1,13 / ?Oz 1 1:\EH Forms\Waiver-Appeal Mason County Local Revised 1/202017 Page 2 of2 'w , -irb Ir t1 E TA7.E :i1�k•`3 GGtoL wv fogrE i0 b +J7.a � 0t.D2oz4-oce ) 1 5' rim�lyy�,y y I lq xrS..II 0 L O1 ,tiyJttfl yc' L.lteca.c� � � N y Bt g t•trr /� 5 min o 16' �okto r Hg (� t EH Setba s A.) Drairl requ as10'aet from botingrouMarons 9)SN requires y setback f all Motlagdcuodarons c.l NiD rounaadonlpanmata rat namt do ,Malemnf tp(gLL Dralnnammaserve area 1fj611 0.)No cut aenx(s)(grezter an and over m ma,501E down gredlent orDain elN ea rve area APPRnvL-. �yy , Disclaimer: Mason County does not require a a EH APPROVED 41 IUN surveyto obtain a buildingpermit. As a result, site �5�5` 'ncl plans may not reflect accurate data. It is the applicant's responsibility to comply with setback © AUEb-V1suel Au requirements. © Cs" UL RR5 Zoning Front Yard Setback.25'. © NUWm 13liR-5tlp ATU Tank Side&Rear Yard Setbacks.Residential dwelling and accessory structures is 20'. Je4bock k f "o 1,000 Owl p=W m ytr OR 10%width of lot if not more than 100 wide Cull( '�Wflr,(QhGG W`W,f'r*y-5;vi OR approved ADV SR vid.cnv,laW_yyyyy,,l.y,1, 09/12/2024 Feducec{ f„ h s ff yo APPROVED A* (eSs fhol z ftt'. MASON COUNTY DCD PLANNING f✓niYPY: Wf{y�2y•DG(dH 9-1off ZUEQY,AICP