HomeMy WebLinkAboutSWG2025-00101 - SWG Application / Design - 3/27/2025 A 985M
® MASON COUNTY 415NBTHELTON: .SHELTON. EXT400
BHELTQN:360 275 8]0,EXT 400
BELFAIR:380-2]5-0467,E%T 900
Public Health & Human Services ELM.360-062-5269,E%T 400
FAX W0427-7787
On-Site Sewage System Tank Only Permit: SWG2025-00101 00
OWNER MACDONALD LISA CAROL&MARTIN Phone:
DOUGLAS
Address: 1090 E TREASURE ISLAND DR ALLYN,WA 98524
APPLICANT MACDONALD LISA CAROL&MARTIN Phone:
DOUGLAS
Address: 1090 E TREASURE ISLAND DR ALLYN,WA 98524
SEPTIC INSTALLER JOSH PETERSON* Phone: 253-255-6799
Address: 14198 COLONY AVE SOUTHEAST PORT ORCHARD, WA 98367
Site Address: 1090 E TREASURE ISLAND DR
Primary Parcel Number: 121055200124
Permit Description: Sand removal to expose coils and diagnose issues-drainfield
remediation with Jake Lowe
Permit Submitted Date: 03/2712025
Permit Issued Date:
Issued By: Rhonda Thompson
Current Permit Fees Paid: $825.00 (aaeaion.l tees meymreR,irea upon r,elelmaon msysleml.
Permit Expiration Date: 03/2712028 lasso o�aam oniupenionl
Type of Work OSS Repair
Components being Replaced: Other
Surfacing Sewage? No Existing Failure? Yes
Shoreline? No Horizontal Setbacks Met? Yes
Number of Bedrooms: 2 Drinking Water Source: Private Well/Spring
Additional Details: NIA
Permit Conditions:
4 Installer is responsible for obtaining Mason County installation approval prior to back(II of
system components.
1 Proposed development subject to zoning requirements and approval by the planning
department staNper Mason County Title 17.
5 Installer is responsible for obtaining Septic Designer/Engineer installation approval prior to
backfill of system components.
3 DrainOe/d installation not to exceed designed upslope and downslope depth speed on
design to=.
THIS PERMIT MUST BE ONSITE DURING INSTALLATION OF OSS.
PROPERTY OWNERS ARE RESPONSIBLE FOR DETERMINING AND MARKING ALL PROPERTY LINE AND EASEMENT LOCATIONS.
THIS PERMIT MAY BE REVOKED IF THE SITE CONDITIONS HAVE CHANGED SINCE THE SITE WAS INSPECTED AND/OR DESIGN
APPROVED.
FINAL INSTALLATION APPROVAL IS REQUIRED PRIOR TO TEMPORARY OR FINAL OCCUPANCY OF ANY RELATED STRUCTURES.
For Final Inspection visit: masoncountywa.gov/healthlenvironmentaUonsite/oss4nspectionwequest.php or call:
360427-9670,extension 400.
OFFICIAL USE ONLY
MASON COUNTY DMSR5 : -_
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ON-SITE SEWAGE TANK ONLY APPLICATION ; A
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TYPE CF WOB(N+NNa++1 ��//���� DRINKING WATER SOURCE () YL
[3NEWCONSTRUCTIONIUPGRADES IIFL FMRIREPLACEMENT 0 M �PARTY PRIVATE INDDUALWELL 0 PRIVATETWOWELL 2 'A/ 1
COAPCNEM(9)TO BE FIEPIACfdIN9TNlED ® PUBLIC WATERSYSTEM
❑ SEPTIC TANK 0PUMP TANK ❑RV HOLDING TANK 9EDROOMs LOisISE lyI
'OTHER ZDA cs.. C 1 S 2
OTHER DEfAIL$(6pbUAY tlyl grlNy) TPNK($ SETBACK CHEC U$T O IN
❑ SURFACING SEWAGE 17 EXISTING FAILURE 13SHORELINE PUBLIC(COMMUNITY WELLS o Il'
susMl 5 --//50FTr PRIVATE WELLS,SURFACE WATERS,STREAMS,RIVERS
PLOT PLAN(REQUIRED) 0 TANK CROSS SECTION(REQUIRED) yjpFt+DRINKING WATER SUPPLY LINES to
❑ PUMP DETAILS(IF APPLICABLE) ❑ WNVERIS)(WAPPLICABLE) /5FT*PROPERTY(EASEMENT LINES,FOUNDATIONS.FOOTINGS
PLOT FLAN CHEMIST
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PROPERTY LINESANO EASEMENTS EXI$TN(V PROPOSED STRUCTURES LDIEXISTINGIPROPOSEO OSS COMPONENTS ANO LINES
WELLSWITHINlWFT C'WATERSUPPLYUMES CHAIVEWAYSIPARMINO RFACEWATE EAMS,RIVER%ETC... I1•
M00JECTIONOFSLOPEICONTOURS 041ERIMETERICUFFFAINDRAR4S ORTHARROW MMEBAR
DIRECIHXISTOSMANDSITE CONNTMMS:fox.hdadpWf APPROVED
APR 02 2025
MASON COUNTY ENVIRONMENTAL HEALTH
RET
OFFICIAL USE ONLY BELOW THIS LINE
',, LIFGRAOE(FULURE Sau3CE{wnPomO9 Pu�Pua.)
OVOLUNTARY E3MAINTENANCEIPUMPING OBUILDINGFERMIT 13HOMESALE [3COMPLAINT OOTHER:
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SE TMMMU6 eB LISTEDUNDERW -LIVT REGISTEREDSEWAGETANKS'.TANKS MAST MEET CUFRENTMINIMUMSM REQUIREMENTS,EQUIPPED WITH RISERS
ANDUOSTOSURFACE,AHJINLlU MEFFLUENTFILTER(IFAPWIG9BLE). RECOR WINGAN WR9 TIONREPORTREWIREOFORFRµ RMV
INSPECTOR SIGNATURE DATE I APPLICATON EXPIRATION DATE APPLICATONAPPROVE01195Um SY DATE
3 2(0gILOf ern'► 3M-7
THIS PO@I MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW OR THE MASON COUNTY WEBSITE REVISED 127rz015
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