Loading...
HomeMy WebLinkAboutSWG2024-00459 - SWG Application / Design - 12/10/2024 ® MASON COUNTY I15 N6SHSTREETSRELTO70,EXT 400 6HELTOR:360427-9870,EXT 400 fiELFAIR:360-2T5-048].ECT 400 Public Health & Human Services ELMA:3804825286,EXT 40D FAX:360-427-7787 On-Site Sewage System Tank Only Permit: SWG2024-00459 OWNER VO-NGUYEN INVESTMENTS LLC Phone: Address: 8258 S 192ND ST KENT,WA 98032 APPLICANT VO-NGUYEN INVESTMENTS LLC Phone: Address: 8258 S 192ND ST KENT,WA 98032 SEPTIC INSTALLER SHANE MAPLES" Phone: 360-463-8474 Address: 911 SE Arcadia Road SHELTON,WA 98584 Site Address: 2170 E STATE ROUTE 3 Primary Parcel Number: 320106100043 Permit Description: Replace septic tank Permit Submitted Date: 1211012024 Permit Issued Dale: 12110/2024 Issued By: Rhonda Thompson Current Permit Fees Paid: $265.00 (eddpbnel law may be"Und UPw Neblledan or sysl 1. Permit Expiration Date: 12/10/2025 leased oo dale of mpecuonl Type of Work OSS Repair Components being Replaced: Septic Tank Only Surfacing Sewage? No Existing Failure? Yes Shoreline? Yes Horizontal Setbacks Met? No Number of Bedrooms: 3 Drinking Water Source: Private Well/Spring Additional Details: Roth 1250g Permit Conditions: 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 staffper Mason County Title 17. 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 written authorization 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 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: masoncountywa.gov/healthlenvironmentatonsite/ova-Inspection-request.php or cell: 360-427.9670,extension 400. OFFICIALUSEONLY- --- MASON COUNTY I - 10 - 2024 a COMMUNITY SERVICES SRN NDAE o y PNIx NUIIN I�CemmRNIYNrX1UEmMomNRW IMRM z y �YAOn,Rr,m.,P SING 02�1 -�N59 o A 2 Dl ON-SITE SEWAGE TANK ONLY APPLICATION 3 .I.T FNDXE IR LLC u H MNIINDADM1E99 EEI CRY,9TATE,IP CODE '� 52,5b s lqLna } . On} %032 A BVEADDRESS STREET,CITY.2PC(VE 21�o E i2 Roue 3 IW WIAECFffSIDNER PIPE � N I � NMIF OFIN9TALIEfl RICRF lO (495-$4-7L! TPECFKtlRI(feFMlas) dINJNINB WATER 8011RCE p NEW CONSIRUCTIW IUPGMDES �FREPNRIRFILACEMENT �Ip PRNATENIDMIXIALWELL 0PRIVATETWOPMLYW9.L ODM��PoNEMIN MBEREP INWSTµIED p PUBLICWATERSYSTEM 1BISEPTM:TANK 0PUWTANK DWHOLDNOTANN MOROtt13 LOT BL r' O OTHER OTHER DEruBfFFl.drvulepgy) TAwye)SETN,G(GIECIRBT �' p SURFACNG SEWAGE jrr XISTIND FAILURE p9HORELINE Qrr t)(IFTfl PUBUC/COM LL MUNITYWES I L MglyllAS Ay MNATE WELLS,SURFACE WATERS,STREAMS,RIVERS I O CIROTPLW(REOUIREO) YJIANNGRMSSECTION(REWIRED) �FN FH DRINKING WATERSUPPLY LINES lO ❑PUMP DETAILS(WAPPLICABLE) p WANER(S)BFAPPLICASLE) Q4BFTaPROPERTY/EASEMENT LINES,FOUNDATIONS,FOOTINGS ROTaWILNEFMOT Q 10 p PROPERTYLINESANDMILEMEHT6 13EXIIITING/PROPOSEOSTRUCTURES 13EXISTINGI PROPOSED 099 COMPONENTSAND LINES p WELLSWITHINWOFT p WATERSUPPLY LINES 13DRWEWAYWMKNG ❑SURFACE WATERS.STREAMS,RIVERS,ETC.- I I` p OIRECTNN OF SLOPE/CONTOVRB ❑PERMETEIUCURTAINDRAN9 ❑NORTHMRCW pSCALESAR IW DIRECTbN....ANDSaECO ..M1e M[40PIy T' OFFICIAL USE ONLY BELOW THIS UNE IlFpll/DE I FAwRE sanw Im nPxNE P,PNF) I VWUNTARY MAIxTENANCETUMPNG OBWLDMGPERMIT EJHOMESALE pCOMFLANT GOTHER. CONMEN19IDL,os Qcc uric BNYMIE TAMIB MIIBTBE IIBIEOUNDFl1 CC11'LIeTOF REOIBRMO6EWMiETA1N8'.TAMS MIIBTM![iCURRIRT MMMUTA SQE aEWNENEMB,EW VPID WITM RI8ER3 ApNW MBURFACE.AIA MYUOEAN EFFIUENi FLTFRIV p➢RMAAET RECgW gNMNOINOMTNIApH REPDRT REWMEDFgi FNALAPNWN, WS", MNONATURE DATE I APPLMIDN EMM "MW APPLIWTRWAPPROVENIS9UE08T DATE 21n I I, w 1v(lo THIS FORM MAYBE N;ANNEDANDAVAILABLE FOR PUBLIC VRWON THE MANN COUNTYWEBBITE REVISEDWRINIS W ATGz ._ �miei.�loi elan �— I'm%Owl SIW 99M�a :dY4'Slpb19 /ehlo YI )gym r' 0 y„aoxLxW�W�'"' Evsf.y RpV� �Pti'L La I pu 0. l9 2 &1r. Nemc lbme R I �a bi LAtMrm i•vl� I1 Gnanot a a � Purkn9 i".ao' •�I 0.r.d u Y10A It -fo �A5, Co,�2p ConV1[Y21-C fu0.✓ SI Bel\r able +0 5C- 12bD etc wu(I yltiW 4-0-elv- (/ 11 6C_ 3_L( tCt¢.4 Cloirr }o but k he"3 t.. - rn ?Qer d ec'w P"o 1ti�j o.,\ 4o( +tx'1K 'eh 1S F:^) 1UtMO �af:ln s�`Y$ 1� 7`tW�.e. IoC..Li favl APPROVED DEC 10 2024 MASON COUNTY ENVIRONMENTAL HEALTH RET faaccur,AP PralnReld&mmlrold .- orientation &layout p 641~1 7Yeacit,Ased dlmeaelane. / and wheal chances .. within layout fdlSepta/pump seek placement. L.Umofbulldings. IS _ ftr1/sdld�fa tA . a/Obsemtion part&Clean- /m1t locedon. I��' y oo W"1Lacerion orweBs& A P P R�LJ ` .'O .r tj C-610% .sagk roods; 4-` DEC 10 2024IP Undisturbed move n4lASON COUNTY ENVIRONMENTAL HEALTH ^ between benches. R l+I North straw /�odCSe CA Oel:MIner WJm Rubsrgic l+N[braioa and dreMdd orknWtOa nudcmdw(Wd Yew buWlerw�aMnDyaa�ylem �e dr�rrmwnt eNdw AvW tic*WdmevWnwnru.Mmonn lac MaEllltYeflhe ryrrrm. l[b lhs.,..i aWiv qb wdaW 3omd bairn rmrdalam bcfm .us6.ny acYWlons fpm dndaga UW h a.the aysemv nllb b r apprerd Owrdw shawnsbora b. devlakm fromme tpp, dnlan mutt be Installer Check a box from Row"A"and"B",sign end date the certification A. �1 certify that I Installed the system without any ❑ 1 certify Nei all deviations from the design stamped deviation from the design stamped"APPROVED"by 'APPROVED"by MCDHS ere shown above.MCDHS B. td' I certify that l wataued the designer and left the ❑ I did not contact the desiggaacr prior to final cover because Ne system open far Inspection up to 48 ha prior to clulgner waived the notflcaton requhemmL 1further were Net all Just arons"oln wntadiaton Nisfarm Is oaccurate. 1understand N. Iflho InfomYatonwntahsed7tp Jynaf eOClrrale,there will bejusl cause farlmmedlate suspension ofmylnstellu1cutifiratlon. re-uwl VO �J far AA ;141 /1 3641 argn roio filer Date 7la undersigned approves NlsinstellationonbehelfofMason ComtyD tof &tviocs, a Sf�fe !§ ! } Lu p a= HiCl m \\ £# § | (w b _ - \ - § § . - - � ■ (rs�7������7((—r;;���7�—� k § * 2 �§ § 9 ® ■ \ ; - § � o ® '�© @ ■ c � ■ � ■ : $ ) 6j— , o ) / ' E � ( k � ° ■ § . & ƒ ° 2 k ` 0 k ) 7 \ ) § zuj [ w ci } ¢ \ \ ) « § < 0 ( ( ® k � = 5 \ 2 § k ) § } / � ! o SI m a 0 \\| ! \ � > § § w . e U) A \ 0 : w z \ z � 7 ■ iL ri i § i o| 2 i ■ to K m w § _ m i� \ ( \ ,� ( ) off § ■ § kkk \l\ k § ) § ■ 2k § ~ice [ § § k \ ) W W � e o � , = Q � co 5 � o a W § 0v 2 i 01 J L § ■ \ ( 2 ` o APPROVED ) ; w r. ■ BEE R A a J COUNTY a . ® -�® MASON § . _ ~ ] \ / � � § ® / c ® \ § \ � LLI \)� | , S ( ( 0 !\\! ` § Z (� § @ \ (� | \ \ E \a- � | I ° < CL f « 2 ) - f \ i o to \ co . Qo § ■ k \ ) }co7 { 2 ] &. < - eeo 2 kf � \ 2 § _ \ _ ■ -00- \ \/ / � w 0 i! ° //) § \ § o \ � a [ \ ( _ \ §\ § // J \ m0 / § / ] { / ! Q7 ) / / § } \ � ) 5 } k \ @ ® ® k � \� 7 ) $ �� , g \ § , _ \ (( k \ ( E § / ) k \ ) ia = ) [ /0 o | \ ` � e � e , � / a k ) / } ) k / : ) ( ( o E ! Ew4i0tta � ■ ® ( § � � : ,u-0 / ° ■ ■ ) ] - ) r � z222 � @ : APPROVED W00F= = 83 ) § ( ea01=0-a • , DEC R A o , ` / ) , =E cmc § 00 Nc,_o m R ` ` ` § � = E � � � £ evAil ® ƒ } ) ) ) k ) ) | \ ��� waa ¥ aaK ¥ * # ©: ' -