HomeMy WebLinkAboutSWG2024-00405 - SWG Application / Design - 10/2/2024 ® MASON COUNTY 415N6SHSTREEL SRELTON,WA 03884
SBELTON:360-2754467.ENT 400
BELFAIR:380-275d987,EXT 400
Public Health & Human Services ELMA:360482-5269,ENT 400
FAX:350 427-7787
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 224332 SHELTON,WA 98684
Site Address: 330 E WOODLAND DR
Primary Parcel Number: 420125300002
Permit Description: Replace septic tank
Permit Submitted Dale: 10/02/2024
Permit Issued Date: 1010212024
Issued By: Rhonda Thompson
Current Permit Fees Paid: $265.0D Laauoaa Is"may b mculmd aeon Inslallaunn of paam7.
Permit Expiration Date: 1 010 212 0 2 5 leaaedandaleolmspe�l
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 Conditions:
3 Mason County Asbuilt Form, Record Drawing, and Installation lee must be submitted for
final installation approval.
2 Permit must be installed by a Mason County Ceaffied Installer unless prior written
authorization from Masan 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 OSS.
PROPERTY OWNERS ARE RESPONSIBLE FOR DETERMINING AND MARKING ALL PROPERTY LINE AND EASEMENT LOCATIONS.
THIS PERMIT MAY BE REVOKED IF THE S1TE 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.govfhoalthlenvironmentallonsitelose-Inspectlon-request.php or call:
360-427-9670,extension 400.
OFFICIAL USE ONLY
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SUMS SY3r CMIFICATICN
Property Owner F .,4 M..��c Address
Sewage Contrector T,ol. ��\e,.J Date Para
1JJonl ND (tip"1'2
1. Scale, 1 Sgeaiz - 101
2. Draw 1n Dby.ic urel fa be on let.
of well Show location of well or any Lodi of water.
E, Show location of eaptfo .,at. in otESonehlD t0 etruotu
Assume an 5. Ass .lavttion Of 100' at
ens lot the comer d indicate the ether lot orner
elevations in relation to it.
6. U.. Arrow. to show dirackion of elope.
2.
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I oertify that this $yet= Se ioatelled as shown above, and that al
requirements and allndards of Thurston- son Health District have
been satiened. Slgeatura
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