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HomeMy WebLinkAboutSWG2025-00027 TANK ONLY - SWG Application / Design - 2/3/2025... MASON COUNTY 415N 6 SHELTON: ,SHE7-967 WA,EXT 400 SH STREET, ,SHE TON, EXT564 BELFAIR:360-2754467,EXT400 Public Health & Human Services ELMA:3604625269,EXT 400 FAX:360427-T787 On-Site Sewage System Tank Only Permit: SWG2025-00027 APPLICANT Russell,Justin Phone: 3609701233 Address: Ito box 14531 TUMWATER,WA 98511 OWNER ANDERSON, LORI Phone: 360-701-5681 Address: 221 E ASHWOOD LANE SHELTON, WA 98594 SEPTIC DESIGNER JUSTIN RUSSELL" Phone: 360.956.7242 Address: PO BOX 14531 TUMWATER,WA 98511 Site Address: 221 E ASHWOOD LN Primary Parcel Number. 320215501003 Permit Description: REPLACEMENT OF FAILED SAND FILTER WITH NUWATER ATU Permit Submitted Date: 02/03/2025 Permit Issued Date: 02/12/2025 Issued By: Rhonda Thompson Current Permit Fees Paid: $270.00 (additional fees"be required upon Instaldatlen ofsysteml. Permit Expiration Date: 0211212026 (based on date or inspection) Type of Work OSS Repair Components being Replaced: Other Surfacing Sewage? Yes Existing Failure? Yes Shoreline? No Horizontal Setbacks Met? Yes Number of Bedrooms: 3 Drinking Water Source: Public Water System Additional Details: Number BNR600 Permit Conditions: 1 Horizontal setbacks per WAC246-272A-0210 must be maintained, unless pnorapproval is obtained 2 Permit must be installed by a Mason County Certified Installer unless prior written authorization from Mason County is obtained. 4 Proposed development subject to zoning requirements and approval by the planning department staffper Mason County Tide 17. 3 Mason County Asbuilt Form, Record Drawing, and Installation fee must be submitted for final installation approval. 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: masoncountym.gov/health/environmentallonsite/ms-inspection-mquest.php or call: 360-427-9670,extension 400. OFFICIAL USE ONLY MASON COUNTY 2/3/2025 y COMMUNITY SERVICES "M 7_ $270 "@ 0- 1 online m o rn PublMNxllh KanmuNry�nNEnvlmnmen(al Health � N SWG 2025 -00027 0 $ Z N ON-SITE SEWAGE TANK ONLY APPLICATION n $ m APPULWT PHWE m m LORI ANDERSON 36o- 3Fp1 -5681 z MNUNG kDDRESS-WRIST.f .SPkTE o ZIP 0 3 221 E ASHWOOD LANE, SHELTON,WA, 98584 00 00 SREglYgE55.6RiEET.CRY.➢P WOE 'm ,-m 221 E ASHWOOD LANE, SHELTON,WA,98584 I W lm NWEOF[E9C#EII qp,M ]I I N JUSTIN RUSSELL 360-970-1233 0I NrJ1EOFINsrqum PIS m O � irPE OF xaRlc tminw) paxaNc vwTERspuRCE y I N ❑NEWCONSTRUCT)HIUPGRADES ■REPAIRIREPIACEMENT ❑ PRNATEINDMOUALWELL OPRNATET PARTYNELL 2 I �COMPUNNN SMTOBERERALTTYINSMLIED L7 PUBUCMWRSYSTEM SHONECRESTESTATESWATERW. o OSEPTCTANK ❑PUMPTANK ORVHOLDINGTANK BEDROOM. 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OFFICIAL USE ONLY BELOW THIS LINE -_— IIPGRgpEIFNLUREWURCEBmnlw,llrymupan<) ❑VOLUNTARY MAINTENARCEIPUMPING OBUILDINGPERMTT OHOMESALE OWMPLAINT OOTHER: WMNEMBICONgFIpNS Replace failed sand filter with NuwaterBNR600 SETWC£TMMMU WUWEDUN RWK'UB RE MEREDBEYMCETg .TA MIISTMEETCIMREMMINIMUMM3EREAMREMEM3,EOUIN£ONITKRI8ER5 AND UDS TOSURFACF.AND IM]LLEANEF0.11EMFlllERRFN'RM.gM.EL gECORD MU'M1Y3NpINBTNUTMN REPORT REWIRED FOR FINALARRWAL I DATE NWLK'ATIgY E%FMATIXI DATE gPPLIGTIgIgPPROYEWISSIIEp BY DATE EH APPROVED RnoleaTn Psw OMs0z1 2/12/2026 EHAPPROVED Rnooa rnoiNaon avlveoxs THIS FORM MAY BE SCANNEDAND AVAILABLE FOR PUBLIC VIEWON THE MASDIICWMIYY1E88TTE REYISEDIW.15 ! } bCl U ( ® > � / � \ , z ` | \ \ J2 § \ \ \ IP ! : k : § ■ § �° 2 } \ ( ! /! 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