HomeMy WebLinkAboutWAT2025-00177 - WAT Application - 9/9/2025 WAT _ 2Q25_-O0177
415 N.6th Street
7"<,,,1:. Shelton.WA 98584
� , MASON COUNTY Shelton:360Shelto670,Ext.400
.��. COMMUNITY SERVICES Belfair:360-2754467,Ext.400
Building,Planning,Environmental Health,Community Health
Elma:360-482-5269.Ext.400
Application for Determination of Water Adequacy
Instructions
1. Complete Part 1. No determination can be made until Part 1 is fully completed.
2. Complete only the portion of Part 2 applying to the type of water connection utilized.
3. Submit completed application, with any required attachments for review.
4. An a roved buildin site Ian must accom an this a lication.
Part 1: Applicant/ Parcel Identification
Name on Applicant: Important Business Portfolio, LLCDate: September 9 2025
Mailing Address: 7002 Bailey St SE Lacey, WA 98513 Phone: (360)789-6781
Parcel Number: 32021-56-02015
Type of Water System Reason for Application
Building permit
Public/Community Water System (2 or more 0 Division of land:
connections)
❑ Individual water source(one connection), #of Parcels? SPL
❑ Well 0 Boundary line adjustment
❑ Spring/surface water 0 Other(explain)
❑ Other(explain) ❑ Replacement or Remodel (please indicate name
of water system below if applicable—no
If you have more than one residence connected signature required)
to this well, check the Public/Community Water 9
System box.
Part 2: Water Connection Information
Complete the section appropriate for the type of water connection being evaluated:
Public Water System
Name of Water System: Shorecrest Estates Water Company
"none"for two-party)
Water Facility Inventory (WFI) Number: 78620-1 (write
XI am the manager of this water system. The water system has been approved for 680 services. There
are presently 629 connection(s) in use. This will be the 630 connection.
0 I am the manager of this system. This connection will be to upgrade or change the use of an existing
connection on this system (i.e.: recreational to full time). Please indicate on the following line the nature of
this change:
This water system is able and willing to provide water to this (these) connection(s)without exceeding the
limits of the water system or any limits set by state and local regulation.
Print Name of Water System Manager
Kristie Hutchinson Phone (360)426-0773
to n y ? Date September 9. 2025
Signature of Water System Manager Onto
This form may be scanned and available for public view at www.co.mason.wa.us.
iz•",ra 4-27:202 I
J:\EH Forms\Drinking Water
Individual Water Well
ft.
❑ Water well report(attached to application). Depth
gpm gpd.
ElWell capacity Test(attached to application)
l is
ts from
The well driller often performso he water wellacity reports s at the time the Results from these tlests will be accepted.ed IIthf the water
e ests amnoted o
well report cannot be located by the applicant or if the water well report does not have a capacity test,
a well capacity test, which provides stabilization of draw-down and recovery data, must be performed
by a licensed contractor.
❑ Satisfactory bacteriological test (attach to application).
Water Resource Inventory Area (WRIA)
Development within which WRIA http//qis co mason wa us/planning 14_15 16_22_
Water use or limitation recorded
N/A Yes
Well Drilled Date
Individual Spring/Surface Water
❑ WDOE permit (attach to application)
❑ Method of disinfection
❑ I have reason to believe that this water source can provide at least 800 gallons per day; and/or
provides water at a rate of 2 gallons per minute based on the following observations.
Date
Author of Statement
Relationship to Applicant
•
• Part 3: Mason County Community Services Evaluation (staff use only)
x Satisfactory Determination: e
This determination does not address adequacy of the distribution system.guarantee an WDOE water adequate suppl tions.
ly of
water indefinitely in the future, or guarantee compliance with all applicable of
Recommended approval indicates requirements of Sanitary Code,Title 6, Chapter 6.68.040-Determination
ter
Adequacy for Building Permits are satisfied. Additional Growth Management requirements may app y. P
36.70A RCW.
Unsatisfactory Determination:
Applicant's water supply does not appear adequate to meet the needs of its intended use for the following
reason(s).
Reviewer's Signatures:
10/6/25
Environ. Health: Date
This form may be scanned and available for public view at www.co.mason.wa.us. Page 2 of 2