HomeMy WebLinkAboutSWG2024-00405 - SWG Application / Design - 10/2/2024 (2) MASON COUNTY 415N6SH LTON: , 0427-97 ,EXT400
H STREET.
SHEL ON.WA EX8584
BELFAIR:360.2754467,EXT 400
Public Health & Human Services ELMA:360482-6269,EXT400
FAX:360-427-7787
On-Site Sewage System Tank Only Permit: SWG2024-00405
OWNER SALGUERO MAYRA Phone:
Address: 19612 FOREST PARK DR NE SHORELINE,WA 98155
APPLICANT SALGLIERO MAYRA Phone:
Address: 19612 FOREST PARK DR NE SHORELINE,WA 98155
SEPTIC INSTALLER THAD BAMFORD• Phone: 360-790-2364
Address: 301 WALLACE KNEELAND BLVD STE 224-332 SHELTON,WA 98584
Site Address: 330 E WOODLAND OR
Primary Parcel Number: 420125300002
Permit Description: Replace septic tank
Permit Submitted Date: 1 0/0212 02 4
Permit Issued Date: 10/02/2024
Issued By: Rhonda Thompson
Current Permit Fees Paid: $265.00 (addiftwel fees may he reyulred uode mstall.wn of system).
Permit Expiration Date: 10/02I2025 (da eol on date of ins,ectiono
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: Septic tank
Permit Condltions:
3 Mason County Asbuilt Form, Record Drawing, and Installation fee must be submitted for
final installation approval.
2 Permit must be installed by a Mason County Certified Installer unless prior whiten
authonzation from Mason County is obtained.
1 Horizontal setbacks per WAC246-272A-0210 must be maintained, unless prior approval Is
obtained
4 Proposed development subject to zoning requirements and approval by the planning
department staff per Mason County Title 17.
THIS PERMIT MUST BE ONSITE DURING INSTALLATION OF 088.
PROPERTY OWNERS ARE RESPONSIBLE FOR DETERMINING AND MARKING ALL PROPERTY LINE AND EASEMENT LOCATIONS.
THIS PERMIT MAY BE REVOKED IF THE SITE CONDITIONS HAVE CHANGED SINCE THE SITE WAS INSPECTED AND/OR DESIGN
APPROVED.
FINAL INSTALLATION APPROVAL IS REQUIRED PRIOR TO TEMPORARY OR FINAL OCCUPANCY OF ANY RELATED STRUCTURES.
For Final Inspection visit: masoncounlywa.govihealthlenvironmental/onsite/oss-Inspection-request,php or call:
360-427-9670,extension 400.
OFFICIAL USE ONLY
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IdIZ/ZTNIB FONN IMY BE SCANNED AND AVAILABL U THE MA60N COUNTY WEBSITE REVI6Eo1ID2UIs
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APPROX. WEIGHT 1 1 ,000 LBS.
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SENAOE SYSTH CEETIFICATION
Property Owner F Address
Sawege ContraetorTI Ik-. ��\o�.J Date Paroolo
1. Scale: 1 Square . lo'
U./ocJ �uD (Y�RNOQ
2. Draw In physical
nof well ,ran to be on lot.
3. Snow location of wall or any loin of water.
4. Show location of at eaptla ayetat in relationship t0 st.tindicate
5. Asaunn an elevation of 300' at one lot corner A indicate Na other lot orner
elevation in relation to it.
& Use "me. to show direction of elope.
2.
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Saptic volume 1
Drainflald Len{Ebvnv
O is Yard. gravel used
I certify that this eyatam is Installed as shaven above, and that al
requirements and standards of Thurstan-Yaeon Health District have
been satisfied. S1Auture
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