HomeMy WebLinkAboutSWG2024-00284 - SWG Application / Design - 6/27/2024 (2) 415 N BTH STREET,SHELTON,WA BB6e4
MASON COUNTY SHELTON:3604274467,EXT 400
BELF MA:360-275.4267,EXT 400
ELMA:3804a2-5269,EXT 400
Public Health & Human Services FAX:300-427-7787
On-Site Sewage System Tank Only Permit: SWG2024-00284
OWNER CHEYNE TRUST RAYMOND&CAROLE Phone: 425-821.5423
Address: 12439 NE 136TH PL KIRKLAND,WA 98034
APPLICANT CHEYNE TRUST RAYMOND&CAROLE Phone: 425.821-5423
Address: 12439 NE 136TH PL KIRKLAND, WA 98034
Phone: 360-790-3021
Address:
SEPTIC INSTALLER DPO BIOX 1336 HOODSPORT,WA 98548
Site Address: 201 BE WILDCAT COVE RD
Primary Parcel Number: 319115200012
Permit Description: Replace septic tank
Permit Submitted Date: 06/2712024
Permit Issued Dale: 0710112024
Issued By: Rhonda Thompson
Current Permit Fees Paid:
$265.00 (edmna„el roes may be m4ao-ed upon paternal"Of a)neaq.
Permit Expiration Date:
07/0112025 (based an date of l nepecliOO
Type of Work OSS Repair
Components being Replaced: Septic Tank Only
Surfacing Sewage? No Existing Failure? Yes
Shoreline? No Horizontal Setbacks Met? Yes
Number of Bedrooms: 3 Drinking Water Source: Public Water System
Additional Details: 1250 G Hagerman
Permit Conditions:
3 Mason County Asbuilt Form, Record Drawing, and Installation fee must be submitted for
final installation approval.
4 Proposed development subject to zoning requirements and approval by the planning
department staff per Mason County Title 17.
1 Horizontal setbacks per WAC246-272A-0210 must be maintained, unless prior approval is
obtained
2 Permit must be Installed by a Mason County Certified Installer unless prior written
authorizailon from Mason County is obtained.
THIS PERMIT MUST BE ONSITE DURING INSTALLATION OF OSS.
PROPERTY OWNERS ARE RESPONSIBLE FOR DETERMINING AND MARKING ALL PROPERTY LINE AND EASEMENT LOCATIONS.
THIS PERMIT MAY BE REVOKED IF THE SITE CONDITION FPF HAVE SINCE THE SITE WAS INSPECTED AND/OR DESIGN
FINAL INSTALLATION APPROVAL IS REQUIRED PRIOR TO TEMPORARY OR FINAL OCCUPANCY OF ANY RELATED STRUCTURES.
For Final inspection via It: masoncountywa.govfhealthlenvironmentallonsiteloss-Inapeclion-request.php or call:
360427-9670, extension 400.
OFFICIAL USE ONLY
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APPROVED
JUL 01 2024
MASON COUNTY ENVIRONMENTAL HEALTH
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