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HomeMy WebLinkAboutSWG2025-00178 - SWG Application / Design - 5/20/2025 MASON COUNTY 415 N 6TH STREET,SHELTON,WA 98584 SHELTON:360-427-9670,EXT 400 0,14,1.11, BELFAIR:360-275-4467, EXT 400 Public Health & Human Services ELMA: 360-482-5269, EXT 400 FAX:360-427-7787 On-Site Sewage System Tank Only Permit: SWG2025-00178 OWNER TOLBERT KAYLA Phone: Address: 571 E TIMBERLAKE EAST DR SHELTON, WA 98584 APPLICANT Hunter, Adam Phone: 360 753-1226 Address: 2201 93rd Ave SW Olympia, WA 98512 CONTRACTOR HOUSE BROS CONSTRUCTION Phone: 360-495-4156 Address: PO BOX 1820 MCCLEARY, WA 98557 Site Address: 571 E TIMBERLAKE EAST DR Primary Parcel Number: 220185000104 Permit Description: Rebuild failed 3bd Glendon Pods Permit Submitted Date: 05/13/2025 Permit Issued Date: 05/20/2025 Issued By: Rhonda Thompson Current Permit Fees Paid: $270.00 (additional fees may be required upon installation of system). Permit Expiration Date: 05/20/2026 (based on date of 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: glendon pod rebuild Permit Conditions: 4 Proposed development subject to zoning requirements and approval by the planning department staff per 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. 1 Horizontal setbacks per WAC246-272A-0210 must be maintained, unless prior approval 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/health/environmental/onsiteloss-inspection-request.php or call: 360-427-9670, extension 400. OFFICIAL USE ONLY DATE RECEIVED: 5/1 3/2 55 MASON COUNTY cn D Ik. • COMMUNITY SERVICES AMOUNT RECEIVED: RECEIVED BY: co u) 270 online o m Public Health(Community Health/Environmental Health) 360-42 e -400 or 360.275 4467,exl 400 S W G 2025 - 00178 a ° 6th Street 415 N.61h Streett Shelton,WA 98584 O z tq ON-SITE SEWAGE TANK ONLY APPLICATION APPLICANT PHONE rn m r HOUSE BROTHERS 3604701707 z c MAILING ADDRESS-STREET,CITY.STATE,ZIP CODE PO BOX 1820, MCCLEARY, WA 98557 co rn SITE ADDRESS-STREET,CITY,ZIP CODE 571 E TIMBERLAKE EAST DR, SHELTON, WA 98584 I fV NAME OF DESIGNER PHONE I ADAM HUNTER 3607531226 Co NAME OF INSTALLER PHONE Q v HOUSE BROTHERS 3604701707 < I O TYPE OF WORK(select one) DRINKING WATER SOURCECs ❑ NEW CONSTRUCTION/UPGRADES 0 REPAIR/REPLACEMENT 0 PRIVATE INDIVIDUAL WELL 0 PRIVATE TWO-PARTY WELL Z COMPONENT(S)TO BE REPLACED/INSTALLED ❑ PUBLIC WATER SYSTEM ❑ SEPTIC TANK ❑ PUMP TANK ❑ RV HOLDING TANK BEDROOMS LOT SIZE E OTHER GLENDON REBUILD 3 0.33 CO r OTHER DETAILS(select all that apply) TANK(S)SETBACK CHECKLIST ❑ SURFACING SEWAGE g EXISTING FAILURE ❑ SHORELINE ❑O 100FT+PUBLIC/COMMUNITY WELLS 0 SUBMITTALS O 50FT+PRIVATE WELLS.SURFACE WATERS,STREAMS,RIVERS CI PLOT PLAN(REQUIRED) I] TANK CROSS SECTION(REQUIRED) '❑ 10FT+DRINKING WATER SUPPLY LINES g PUMP DETAILS(IF APPLICABLE) 0 WAIVER(S)(IF APPLICABLE) 5FT+PROPERTY/EASEMENT LINES,FOUNDATIONS,FOOTINGS PLOT PLAN CHECKLIST I O PROPERTY LINES AND EASEMENTS 0 EXISTING/PROPOSED STRUCTURES El EXISTING/PROPOSED OSS COMPONENTS AND LINES —I E WELLS WITHIN 100FT ❑� WATER SUPPLY LINES I7 DRIVEWAYS/PARKING El SURFACE WATERS,STREAMS,RIVERS,ETC. O DIRECTION OF SLOPE/CONTOURS 0 PERIMETER/CURTAIN DRAINS I] NORTH ARROW ❑O SCALE BAR DIRECTIONS TO SITE AND SITE CONDITIONS:(ex locked gate) AGATE RD TO A LEFT ON E TIMBELAKE EAST DR TO SITE ON THE LEFT OFFICIAL USE ONLY BELOW THIS LINE UPGRADE/FAILURE SOURCE(for reporting purposes) ❑VOLUNTARY RI MAINTENANCE/PUMPING ❑BUILDING PERMIT ['HOME SALE ['COMPLAINT 0 OTHER: COMMENTS/CONDITIONS Rebuild Glendon pods SEWAGE TANKS MUST BE LISTED UNDER DOH"LIST OF REGISTERED SEWAGE TANKS'. TANKS MUST MEET CURRENT MINIMUM SIZE REQUIREMENTS,EQUIPPED WITH RISERS AND LIDS TO SURFACE,AND INCLUDE AN EFFLUENT FILTER(IF APPLICABLE) RECORD DRAWING AND INSTALLATION REPORT REQUIRED FOR FINAL APPROVAL. INSPECTOR SIGNATURE DATE APPLICATION EXPIRATION DATE APPLICATION APPROVED/ISSUED BY DATE 5/20/26 EH APPROVED Rhonda Thompson 05/20/2025 THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE REVISED 12/7/2015 § »/ ) / \/ § m o 7 eii o S , 4 \e 2 z , o o \ z / 7 z z \ s § g & \ ; \ § & § \ / \\ z § S / / 11 > k \ § 0 ° _ C 2 m / § _ 70 m } / 0 9 � � G ' U \ $ 1 / ©.m ,* - 2 : q\i: 1;:".= % / { \:fit 2 \1y ` . 03 (�^ 4.} m / }� / § 01 -&� 4II* 2 ` k ���� ^ 7 . \ h -0 \ _ /2 - o 0 q) > : ƒ § R ƒ ® z q ufl nz d 0 m> f \ : \ h _ -' , ; 22 ] m r § q $ ] \ 7 �z0 I _ ! AG % 2 § � � \ 77 \ IM: . ,2� = c 2d ; \i . > D. } 7 § / § 0 rn xi- \ cn0 � jrn 0 m \ Q § \ { \ ) ( \ { § / § _ 0\ ) _ 1 | | -� . 11§ | @ _,| ` 2 ) I m ) 0 >Cr' m3 m } j) � ( okk � � [ \) � |§ ©) § \ � \/ CO - a § I §a g 2 (2 z q# - | | I II 1 | II \« § (m ) k §§ \ ` z k/ ) }\\ \ k} \} / \�st \ $q )) § et" en§ q ■�/ � Im _ \ \ f14"..-111-M- |� \/ § m � K = / �I��[m = ` . 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