HomeMy WebLinkAboutSWG2025-00246 RV HOLDING TANK - SWG Application / Design - 6/26/2025 MASON COUNTY 415 N 6TH STREET,SHELTON,WA 98584
SHELTON: ,S 42 TON, ,EXT 400
584
A BELFAIR:360-275-4467,EXT 400
Public Health & Human Services ELMA:360 FAX: EXT 400
7400
On-Site Sewage System Tank Only Permit: SWG2025-00246
APPLICANT NOLTE ET UX JACOB Phone: 503.593.7914
Address: 14709 26TH AVE NE SHORELINE, WA 98155
OWNER NOLTE ET UX JACOB Phone: 503.593.7914
Address: 14709 26TH AVE NE SHORELINE, WA 98155
SEPTIC INSTALLER SHANE MAPLES* Phone: 360-463-8474
Address: 911 SE Arcadia Road SHELTON, WA 98584
SEPTIC DESIGNER PAULA JOHNSON* Phone: 360-898-2255
Address: 171 E VUECREST DRIVE UNION, WA 98592
Site Address: 1141 E Benson Loop Rd
Primary Parcel Number: 220215000900
Permit Description: RV Holding Tank for part-time recreational use
Permit Submitted Date: 06/26/2025
Permit Issued Date: 07/14/2025
Issued By: David Anderson
Current Permit Fees Paid: $270.00 (additional fees may be required upon installation of system).
Permit Expiration Date: 06/26/2028 (based on date of inspection)
Type of Work OSS New Construction
Components being Replaced: RV Holding Tank
Surfacing Sewage? No Existing Failure? No
Shoreline? No Horizontal Setbacks Met? Yes
Number of Bedrooms: 0 Drinking Water Source: Private Two-Party Well
Additional Details: Hagerman concrete 1500 gal
Permit Conditions:
4 Proposed development subject to zoning requirements and approval by the planning
department staff per Mason County Title 17.
1 Horizontal setbacks per WAC246-272A-0210 must be maintained, unless prior approval is
obtained
2 Permit must be installed by a Mason County Certified Installer unless prior written
authorization from Mason County is obtained.
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: masoncountywa.gov/health/environmental/onsiteloss-inspection-request.php or call:
360-427-9670, extension 400.
OFFICIAL USE ONLY________MASON COUNTY DATE RECENED. / /04e, / ^ 5 Cf)C >J ~ b RECENED 8!Y/: /VX` � �
- , Public Health & Human Services AMOUNT 59-5r �� m
415 N. 6tn St. Shelton, WA 98584 Q
(360) 427-9670 ext.400 SWG Q'Z.b ,S - 2
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ON-SITE SEWAGE TANK ONLY APPLICATION
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PH.9N_ n r-
P.t,a�.:ANT
Nolte 1 (503) 593-7914
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MAILING ADDRESS-STREET.CiT".STATE.ZIP CODE 0 rnco
14709 26th Ave NE, Shoreline, WA 98155 CO a
SITE ADDRESS-S MEET.CITY,ZIP COCE �
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1141 E Benson Loop Rd, Shelton, WA 98584 n I N
(360)898-2255
NAME OF DESIGNER
PHONE
Arrow Septic Designs, Inc o
NAME OF INSTALLER PHONE
Maples Excavating (360)463-8474 I N
TYPE OF WORK(SB)eCt one) DRINKING WATER SOURCE Q
El NEW CONSTRUCTION/UPGRADES 0 REPAIR/REPLACEMENT 00 PR PRIVATE
IND SYSTEM
ELL ❑ PRIVATE TWO-PARTY WELL Z I
IVIDUAL BLIC
WA
COMPONENT(S)TO BE REPLACED!INSTALLED I
CI SEPTIC TANK 0 PUMP TANK MI RV HOLDING TANK BEDROOMS I LOT SIZE
n/a 5.45 acres
CI OTHER I 0
OTHER DETAILS(Se/eCi all that apply) TANK(S)SETBACK CHECKLIST 0 I
ElSURFACING SEWAGE 0 EXISTING FAILURE E SHORELINE ® 100FT+PUBLIC/COMMUNITY WELLS 0 I O
ID SOFT+PRIVATE WELLS.SURFACE WATERS,STREAMS.RIVERS
SUBMITTALS p 10FT+DRINKING WATER SUPPLY LINES I O
IN
PLAN(REQUIRED) ®TANK CROSS SECTION(REQUIRED) I 1OFT PROPERTY!EASEMENT LINES.FOUNDATIONS.FOOTINGS
❑ PUMP DETAILS(IF APPLICABLE) Ili WAIVER(S)(IF APPLICABLE) r
C)
PLOT PLAN CHECKLIST -'b1 CD
Iil PROPERTY LINES AND EASEMENTS 0 EXISTING/PROPOSED STRUCTURES ■ EXISTING!PROPOSED OSS COMPONENTS AND LINES I O
IN WELLS VNTHIN 100FT ❑WATER SUPPLY LINES 0 DRIVEWAYS/PARKING ®SURFACE WATERS.STREAMS.RIVERS.ETC... 9.
—.
® DIRECTION OF SLOPE!CONTOURS 0 PERIMETER/CURTAIN DRAINS U NORTH ARROW ®SCALE BAR
r I 0
DIRECTIONS TO SITE AND SITE CONDITIONS rex rockeC ga:e)
Go out Hwy 3, turn (R) onto E Pickering Rd, at the T turn (L) onto E Benson Loop Rd, Turn
(R) to stay on E Benson Loop Rd, lot is on (L) water side at intersection with Big Skookum
Rd and E Cape Horn Dr.
OFFICIAL USE ONLY BELOW THIS LINE
UPGRADE/FAILURE SOURCE)for reporting purposes)
❑VOLUNTARY 0 MAINTENANCE/PUMPING ❑BUILDING PERMIT [3 HOME SALE ❑COMPLAINT El OTHER.
COMMENTS!CONDITIONS
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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 DATE
APPLC"` APPROVED!ISSUED BY
INSPECTOR SIGNATURE DATE APPLICATION EXPIRATION DATE 7(11//
76 7.1
___.- 6(7‘/Z0731
' , REVISED 07l092019
THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE
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Holding Tank Sewage Systems- Recommended Standards and Guidance
I Effective Date:July 1,2021
Introduction
A Holding Tank Sewage System (HISS) is an alternative to a conventional on-site sewage
system with very special and limited applications. Simply,the HTSS provides a means to collect
and temporarily store sewage from a facility or dwelling, for subsequent removal and transport to
an approved treatment and disposal site. Depending upon the facility served or the particular set
of circumstances surrounding the use of a HTSS, the expense of sewage pumping,hauling, and
disposal at an approved facility can be very costly especially on a long-term basis. In addition,
the potential for operational/management problems with resulting public exposure to raw sewage
is significant. For this reason, use of a HTSS must be closely regulated by the local health
agency.
A HTSS is an on-site sewage system that incorporates a holding tank, the services of a sewage
pumperihauler, and the off-site treatment and disposal of the sewage generated at the site served
by the HISS.
Figure 1. Longitudinal-Section of Typical Holding Tank Sewage System.
AI Warning Light and
i--- Audible Alarm
Access Riser with secured '� Pumping Access Port with
gas tight lid I i sloped concrete pad
,,_____ , ,,,,14---._ t,______4:
Inlet I d I ,�g� ��� @�/\
from�� � �
structure 1 S t - .
• I�Inlet �„
/� — pipe I Reserve Storage Volume t f „ tom,
pibib
I,,_i_ Ceq\c,v4-*C\-6(4--
• MgS,Nc l ® Normal Operating Volume
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*Septic tanks with plugged outlets are not allowed.Tank must not have an outlet.
DOH 337-006 Page 6 of 17