HomeMy WebLinkAboutWAT Application - 8/18/2003 MASON COUNTY
DEPARTMENT OF HEALTH SERVICES -
EmAlranmeotal Health Water Quahry trs Health
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LOCAL(360)427-%70
RECEIVED Application for Waiver/Appeal BEI�ILLPR2754467- -5 2-628
AUG 18 2003 FAX(360)427-7798
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ARCHICTInstructions
PART 1: Applicant/Parcel Identification
Name of Applicant Jillio F+ rini Date 8/18/03
Mailing Address 30330 9th Ave. s. Telephone 251-941-stan
Federal Way, We 98003
Assessor's parcel Number 22233 52 00087
Subdivision Name and Lot Madings sunny Shore Add f6 Tr 87 Ex a-b-c
PART 2: Nature of Waiver/Appeal
❑ On-Site Sewage Requirements ❑ Food Sanitation Requirements
❑ Buildingperndt mlewpolicies ❑ Solid Waste Requirements
❑ Location WAC246-272-09501 ❑ Group B Water System Requirements
❑ Holding tank WAC 2 46-2 72-12 5 01 ❑ Water Adequacy Requirements
❑ On-Site Standards ❑ Fnfarcement Timelines
❑ Certfeation contractor(pumper, ❑ Departmental Determinations
designer. installer, O&Mspec)requirements ❑ Other
Description of waivedAppeal(ineludejustilication,additional material may be attached):
The eItisting house on this roperty consists of a rox 2200 sq.ft. will be demolished
and a new one will he to tt R approx sr..Lt; mticri consists or on y 2 eedrecm.
t exis tng -- - rani
ileEn the
tic
s}stam-arkuch J m jr,infisj i nF 121 t;7r a a i:nes-th .
erve for same at 50 from the bulkhead. As a precaution a timer will also
be added Design for a new septic system is attached.
Applicant signature: Date:
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