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BLD Sewer Adequacy - 6/25/2025
NSpN COU v Public Health Always working for a safer ii healthier Mason County 415 N.6th Street,Bldg 8,Shelton WA 98584 360-427-9670 or 360-275-4467,extension 400 Application for Determination of Sewer Adequacy Instructions: 1. Complete Part 1 of application. Permit number may be added at later date. 2.Take application, Site plan, and any other associated information with the proposed development to the Sewer System Manager or Designated Employee for approval. 3. Submit completed application and information to Permit Center or Mason County Public Health for review. NOTE:You must supply the System Manager with a site plan for the project, showing all existing or proposed sewer components and lines in relation to proposed development and property. Part 1: Applicant I Parcel Information (,,r Applicant: tl� l‘r l Q \- IL Jv 3� Date: L`` 11 Mailing Address: l \q_,Q,(I vOGLJ City,State,Zip: Site Address: 1,ttR t r / u. Phone: �,n/ Parcel Number: v -- 1 (`c 0 ( Permit Number: J�+ ' (jt Z-S DoZz- Part 2: Sewer System Information -�,vJ Name of Sewer System: C.::( 6-� Jr�[ton [.Site Plan attached? Official use only: Sewer System Manager or Designated Employee is to complete. n New Connection: I have reviewed the applicants information and have no issues with Mason County Public Health approving the corresponding Mason County Permit. ❑ Existing Connection: I have reviewed the applicants information and have no issues with Mason County Public Health approving the corresponding Mason County Permit. I have reviewed the applicants information and have determined sewer connection is currently NOT available to this property. Yv Please add the following condition(s)on the corresponding Mason County Permit: (optional) CITY NkT6E6Z .T ?3NG CONVECTION 7v C.rr i 5r-AA'ER. At 'T HIS Tsrn rHE Ct tRrZEl.�I Rivt`c.42 f-tTURE NoMf OI.itU E R MUST To (1 14.1:CT 13Ecct )t3 Av,U I LE "M7 Abize, E To e 6N A No PRonEsr To ANPExAT•Tc,A./ AGRt mfiv,• 1.< 10A:y ©QF-RU 06/2;/ands Printed Name of System Manager/Employee Signature o ystem Manager/Employee Date Part 3: Mason County Public Health Review/Approvalvs-p Satisfactory ❑ Unsatisfactory Signature of Environ ental Health Specialist Date ZZZ716S This form may be scanned and available for public view on the Mason County Web Site. REVISED 10'28.'2015 2227 168 MASON CO WA 06/25/2026 09:09 AM POR CITY OF SHELTON #211128 Roo Fee. 306.50 Pages: 3 AFTER RECORDING, RETURN TO: I II III IIIIIIIIIIIIIIIIIII11111IIIIIIIIIIIII11I11I1111111111IIIII111111II City of Shelton 525 W. Cota Street Shelton, WA 98584 NO CHANGE IN TAX STATEMENTS APPLICANT/GRANTOR: S k y J_•e.S`S < Name Address ( City,State ZIP CITY/GRANTEE: City of Shelton, a Washington municipal corporation SITE ADDRESS: 1561 W Railroad Avenue Shelton WA 98584 ASSESSOR'S TAX PARCEL NUMBER: 42024-15-01150 REFERENCE NUMBER OF RELATED DOCUMENTS: b 5 fie t 6 v\S t 3 7 T R IA5- POWER OF ATTORNEY AND AGREEMENT NOT TO PROTEST ANNEXATION WHEREAS, the undersigned property owner(s) ("Owners") own the real property situated in Mason County, Washington, legally described in Exhibit "A" attached hereto and made a part hereof("Property"); and WHEREAS, the City of Shelton ("City") has entered into a utility extension agreement with Owners to provide water and sewer services to the Property hereto described; and WHEREAS, the Chapter 17.10 of the Shelton Municipal Code requires the Owner to grant unto the City an irrevocable power of attorney to execute any annexation documents on behalf of the Owner or as may be necessary to complete the annexation, as a condition of receiving utility service; and Shelton UGA Agreement Not to Protest Annexation—page 1 of 3 City Attorney Review 10/20/2021 I NOW, THEREFORE, for and in consideration that the action of the foregoing, the owners jointly and severally hereby (1) appoint the City as the owners' true and lawful attorney in fact for them in their name, place and stead and as an irrevocable proxy to sign a petition for the annexation of the Property to the City, and (2) waive their right to protest annexation. The power hereby granted and the protest right hereby waived are irrevocable. This Agreement shall be a conveyance of an irrevocable interest in land and the owners do by these presents convey to the City such limited interest in the property. This Agreement runs with the land and shall be binding on Owner's (Owners') heirs, assigns and successors in interest; and shall be recorded, at the cost of the property owners, with the Auditor of the County of Mason. The Owners do hereby warrant that the persons named as "property owner" on the signature lines below are all of the persons or entities having any interest in the Property and that they have full power to execute this Agreement. IN WITNESS HEREOF, the parties hereto have hereunto set their hands and seals this 25th day of June, 2025. Property Owner(s) Property Owner(s) [] individual(s) [] partnership [] corporation By: State Position: O. 14.. State Position: STATE OF WASHINGTON) )_ss COUNTY OF MASON) On this day personally appeared before me3'r' )-en -A Oliox- Q1 to me known to be the individual(s) described in and who executed the within and foregoing instrument and acknowledged that 5A signed the same as `.jrc free and voluntary act and deed, for the uses and purposes therein mentioned, and certified that SA is/are fully authorized to sign for the above owner entity. Dated this 25th day of June, 2025. 6m( DONNA D NAULT I 0 � Notary Public ( �L' Nile} State of Washington Commission# 208736 My Comm. Expires Jul 18, 2027 Shelton UGA Agreement Not to Protest Annexation—page 2 of 3 City Attorney Review 10/20/2021 EXHIBIT A Legal Description of Property • D SHELTONS DON LAND CLAIM#37 TR 115 Shelton UGA Agreement Not to Protest Annexation—page 3 of 3 City Attorney Review 10/20/2021 Rhonda Thompson From: Kenny Oberg <Kenny.Oberg@sheltonwa.gov> Sent: Tuesday, June 24, 2025 4:10 PM To: Rhonda Thompson; Arnie Anderson Subject: RE: Septic system failure at 1561 W Railroad (PN 420241501150) Caution: External Email Warning!This email has originated from outside of the Mason County Network. Do not click links or open attachments unless you recognize the sender, are expecting the email, and know the content is safe. If a link sends you to a website where you are asked to validate using your Account and Password, DO NOT DO SO! Instead, report the incident. Hi Rhonda, Per our conversation earlier today I will provide you with the City's stance on this situation below along with a rough but most likely low estimate of the cost to complete the sewer main connection and extension if it was to be required.What it ultimately comes down to is we "Mason County and the City" could require the residence to be connected to City sewer through an extension of the sewer main that currently ends at Pacific Court within Railroad Avenue.What the City is not wanting to do is put a heavy financial burden on the homeowner when a viable alternative is available. So long as the submitted plans for the repair of the existing septic system are approved by the County and approved the installation the City is willing to not require connection to public sewer. For this to happen the homeowner will need to sign a conditioned sewer adequacy form that specifies that they will connect to City sewer when it becomes available and a no-protest to annexation agreement. A list of justifications/findings supporting this decision are below. 1. A gravity sewer main will very likely be installed in this location in the next 2-3 years by a large residential development(Coffee Creek). 2. The existing septic system appears to be repairable. 3. A sewer main extension would require the almost new pavement within Railroad Avenue to be cut and patched. 4. Time, Civil design, review, and City approval will likely take much time than either the County or City would like considering the current condition of the septic system. 5. Cost to the homeowner: a. The extension would approximately 210 linear feet to meet the City's "to and across" policy.The existing sewer main is 12" diameter and would need to be extended at that size.The rough cost estimate considered the pipe size, length, existing roadway conditions, City sewer connection fees, and the cost of engineering design for the project. $8,400 asphalt $11,550 sewer pipe $1,900 clean out at end of main extension $5,000 sewer manhole $1,300 connection to existing manhole $8,080 City General Facilities Charge (GFC)for sewer connection. Total: $36,230. This total doesn't include engineering costs which are usually 10-15%or sometimes higher of the overall project cost,traffic control, haul off of the old roadway material, or the clean-out and lateral service line piping to house itself. Part of the reason for high cost of this, particularly the asphalt is that the asphalt thickness in Railroad 1 Avenue in this area is between 16"-18"thick. If you, or your colleagues would like more information on this or need clarification, please reach out to me or give me a call. Thank you. Kenny Oberg j Engineer Technician II City of Shelton, WA T: (360)432-5160 M: (360) 229-4061 E: Kenny.Oberg©sheltonwa.gov The City of Shelton is subject to the Washington Public Records Act, Chapter 42.56 RCW. This message and any attachments may constitute records subject to public disclosure pursuant to the Act. From: Rhonda Thompson <RThompson@masoncountywa.gov> Sent:Tuesday,June 24, 2025 8:26 AM To: Arnie Anderson <Amie.Anderson@sheltonwa.gov> Cc: Kenny Oberg<Kenny.Oberg@sheltonwa.gov> Subject: RE: Septic system failure at 1561 W Railroad (PN 420241501150) [EXTERNAL]This email originated from outside the City of Shelton. Do not click links or open attachments unless you recognize the sender and know the content is safe. Good morning Amie and Kenny, Is there any progress on this one?This is a failure, so we'd like to address it soon.The homeowner and designer are calling me. Thanks, Rhonda Thompson, RS Senior Environmental Health Specialist Mason County Public Health 415 N 6"'St. Shelton, WA 98584 360-427-9670 ext. 581 Rthom�son«masoncountywa gQv To register for upcoming homeowner septic workshops,please visit:https://exteasion.wSl_edu/masonLagriculture/Glasses/ From: Arnie Anderson <Amie.Anderson@sheltonwa.gov> Sent:Tuesday,June 17, 2025 10:19 AM To: Rhonda Thompson <RThompson@masoncountywa.gov> Cc: Kenny Oberg<Kenny.Oberg@sheltonwa.gov> Subject: RE: Septic system failure at 1561 W Railroad (PN 420241501150) 2 Caution: External Email Warning!This email has originated from outside of the Mason County Network. Do not click links or open attachments unless you recognize the sender, are expecting the email, and know the content is safe. If a link sends you to a website where you are asked to validate using your Account and Password, DO NOT DO SO! Instead, report the incident. Hi Rhonda, City sewer ends at Pacific Court. Ill look into this one and get back to you. Thank you, Arnie Anderson I Senior Inspector City of Shelton, WA T: (360) 432-5107 M: (360) 490-5729 E: Amie.Anderson@sheltonwa.gov The City of Shelton is subject to the Washington Public Records Act, Chapter 42.56 RCW. This message and any attachments may constitute records subject to public disclosure pursuant to the Act. From: Rhonda Thompson<RThompson@masoncountvwa.gov> Sent: Friday,June 13, 2025 1:15 PM To: Arnie Anderson<Amie.Anderson@sheltonwa.gov> Subject:Septic system failure at 1561 W Railroad (PN 420241501150) [EXTERNAL]This email originated from outside the City of Shelton. Do not click links or open attachments unless you recognize the sender and know the content is safe. Hi Arnie, I have a septic system failure at 1561 W Railroad (PN 420241501150)with ponding in the drainfield.A designer has submitted a repair design, but it appears this lot is probably less than 200ft to a sewer main. Our GIS map indicates it is surrounded by sewered properties even though it is just outside of the city limits. If it is less than 200ft and sewer is available,we will require connection. Please let us know. Thanks, Rhonda Thompson, RS Senior Environmental Health Specialist Mason County Public Health 415 N 6th St. Shelton,WA 98584 360-427-9670 ext.581 Btbompson@masoncountywa.gov To register for upcoming homeowner septic workshops,please visit:https://extension.wsu.edu/mason/agriculture%lasses/ 3