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Home My WebLink AboutCRT2025-00003 - CRT Application - 10/27/2025 L*t! VIO NOV 0 3 2025 . BY: 415 N 6TH STREET, SHELTON WA 98584 r., MASON COUNTY SHELTON: 360-427-9670, EXT.400 - COMMUNITY SERVICES BELFAIR: 360-275-4467, EXT. 400 ' •'I• ELMA: 360-482-5269, EXT.400 ` •�-- - - FAX: 360-427-7798 \';. •/ Building,Planning,Environmental Health,Community Health _i APPLICATION FOR ENVIRONMENTAL HEALTH REVIEW / ;/� Permit Number Payment Information Type of Review4 PRI QV r Septic and Water $405 . 03 2425 8 CRT Receipt Number C Septic $240 Elyva� J Cash (6 3l(� L Water $240 (Individual and Two Party o� A" Check I Group B WS$90.00 (+$90.00/hour beyond 1 ho 0WO3 Property Evaluation $ 3 7p -� Date of Payment/47�LS j i Resample $30 lab fee 112 Ja.oa0�k'c Instructions: Complete Parts 1, 2,a d 3 c mpletely and accurately. With the application form, please submit the appropriate fee and the necessary documents such as a septic system maintenance report. If the application is for a property evaluation for septic, be sure the test holes have been dug and the location is clearly marked at the site. i7V UT E: iQl--eiSe Cci// 3 60 _g>Oy_ AS-co 4ticele S ' ' V15'1 4 PART 1. APPLICANT AND PARCEL IDENTIFICATION p2A D L Ptafg 1 Name of Applicant L ZA ekre /4/v/16..02 M,g-.,•r' z L c Phoned 60-Q0/-/s0O Mailing Address of Applicant a ax 6 5/ City 713/YUY/1, State Li-)4. Zip 9�S-K� 12-digit Tax Parcel No. .-3 2-2-Z 7 —S y— o 00s-0 Site Address 2 II N' S P/ A 7-72- g d/L, T/9IY'Y.g. ti4 Brief Legal Description G-d T Sr) G t= -S a 2 e f3 i2 en At. /3 ge p ,�7)1eS. Driving Directions /`'2GM /3 .6 -----/1-i 42' D /2 t w /S^ #11/ies O .47— wog_ril '1/ v2 29 . in&.E /s . /2.;,9Ar y• A/re_ .S Tft% rcN , Q /t-Lv<= ,rQlD a'i Page 1 oflic This form may be scanned and available for public view on the Mason County Web site.Revised 1/2/18 PART 2: TYPE OF REVIEW Septic System • Age of system • Age of house Jt///f • Number of bedrooms • Name of last owner / /`1 Es Cti • Is house currently occupied? i-. YES SG NO• l If not occupied, how long has it been vacant? AN//`f Water System • Number of service connections on the water system? / • If a public water system, name of system -.5/210 2 d 8 4"`' 1,,/19 rE 2 • WFI number Property Evaluation (soil logs) Property evaluations provide, in general terms, the suitability for a parcel for septic system placement. THIS DOES 4 NOT GUARANTEE FUTURE SEPTIC SYSTEM APPROVAL. • Describe the intended use of the property and the reason for requesting the review.•s" �PSt r' P r z e S yS %4t — /=0 P- .3 t;) 4L u,M /`>T0/14 PART 3: PLOT PLAN Use the space below to draw a detailed plot plan, or attach a detailed plot plan to this application. The plot plan should include the following: North Arrow, Location of Test Holes, Location of Existing Septic System, Dimensions of Property, Location of any Drinking Water Sources(wells, springs, etc.) Roads, Easements, Surface Water, and Buildings on the property. (skip Part 3 for Group B water system review) / —7 S-/ rJ i LOT SIZE ri:/;e1 7e X Z.s-0 8 rd ra :m 3 Acres COMPASS N 7S a4 1 M v/t f�.,/ Date I oh 6/L-S- Applicant's Signature:/� Page 2 of\ This form may be scanned and available for public view on the Mason County Web site. Revised 1/2/18 `;H PART 4: HEALTH DEPARTMENT FINDINGS — OFFICIAL USE ONLY Septic System elf(fA Yes No "f The septic system was inspected by an appropriate maintenance provider and the submitted report n ❑ is current. ❑ ❑ Records for this property contain a septic permit, design,final approval and as as-built drawing. ❑ ❑ The site was inspected and the system location appears to be consistent with recorded documents. ❑ ❑ The area of the on-site system appears to be maintained in an acceptable manner. ❑ ❑ Was Operation and Maintenance a condition of permit approval? ❑ ❑ Is a copy of a current Operation and Maintenance report attached? Water System Af(q CI Individual Water System Yes No A water sample was taken by Public Health staff. Total coliform bacteria were determined to be ❑ ❑ absent. Laboratory results are attached to this report. ❑ n The well cap was inspected. The sanitary seal appears satisfactory. The well casing was inspected.The casing projected above ground and the ground sloped away ❑ ❑ from the casing. ies, manure le, The well site othe Sobv ous sours es off contam nation appeared wit a 11 t hina100-foot ad uslof the lwell. ❑ � feedlots o Yes No V � 4 Public Water System ❑ ❑ Records indicate water-sampling requirements are being satisfied. ❑ ❑ Records indicate the Water Facility Inventory form is current. ❑ 0 Department files contain water system design and letter of approval. Soil Conditions Test Hole #3 Test Hole #1 Test Hole #2 ,5. e _50(ki (Us Uri rfPO/ Soil Type: Soil Type: Soil Type: Restrictive layer: Restrictive layer: Restrictive layer Slope: Slope: Slope: Distance to Shoreline: Distance to Shoreline: Distance to Shoreline: Page 3 of\$ This form may be scanned and available for public view on the Mason County Web R tesed 12/8/2022 11 / 13 / on- Part 3: Health Department Review (Official Use4Only) Soil Logs and Site Characteristics Parcel: 322275400050 (211#NE Spar Tree Rd) Lot Parcel: 322223300000 Lot# Lot# Test Pit A Test Pit A Test Pit A Test Pit A TH1: (322275400050) TH2: (322275400050) TH1: (322223300000) TH2: (322223300000) 0-35" EGLCoaS (Type 1) fill 0-14" L (Type 4)fill comp 0-9" LFS (Type 4) 0-11"LFS (Type 4) 35-43" SL (Type 4) 14-32" GSL (Type 4) fill 9-32" GMedS (Type 3) 11-33" GMedS (Type 3) Rest at 35"w/comp & mot 32-48" EGLCoaS (Type 1) Rest at 32"w!water Rest at 33"w/water Rest at 32"w/comp& mot 44;37.Lt6W `i -3�S61� -(z3. US 6YS -123 .05663 Depth of Mottling Depth of MottlingDe th of Mottling De th of Mottling , ?�, ep th to Rest. Layer D pth to Rest. Layer ��th to Rest. Layer f to Rest. Layer �— Soil T e (USDA) Soil T pe (USDA) Soil pe (USDA) ITT pe (USDA) / P u ti II `t Test Pit B Test Pit B Test Pit B Test it B TH3: (322275400050) TH4: (322275400050) TH3: (322223300000) TH4: (322223300000) 0-36" VGLCoaS (Type 1) fill 0-22" L (Type 4) fill 0-8" LFS (Type 4) 0-7" LFS (Type 4) 4) 22-27" EGLCoaS (Type 1)fill 8-47" GMedS (Type 3) 7-37" GMedS (Type 3) 36-48' GLFS (Type Rest at 36"w/ mot 27-50" GLFS (Type 4) Rest at 47"w,,water Rest at 37"w/mot& water Rest at 50" w/mot Depth of Mottling Dep h of Mottling Dept) of Mottling 7ptr of Mottling Depth to Rest. Layer Depth to Rest. Layer De t1i to Rest. Layer De-ptj to Rest. Layer 36 5Q . �7 Soi Type (USDA) `oll,` pe (USDA) Y it Type (USDA) Soil Type (USDA) 1 � i- (( � Curtainlljj Drain Curtain Drain Curtain Drain Curtain Drain Needed? ��/ Needed? Needed? 4 Needed? Sloe % Slope % Slope % Slope Shoreline? (YIN) Shoreline? (Y/N) Shoreline? (Y/N) Shoreline? (Y/N) Minimum Lot Size* Minimum Lot Si e* Minimum Lot Size* Minimum Lot Size* Iwo +� - 4► r�►TO ff c-itbtir heibilUditt-Pt' (1c(4 4/ 11.tv/ffyvbit 144, Parcel: 322275400050 (211 NE Spar Tree Rd) Parcel: 322223300000 This form may be scanned and available for pub view on the Mason County Web site. J:\EH Forms\ONSITE FORMS\Current Misc. Forms\2017 Land Use Evaluation Application.doc Updated:12/23/2016 1:32:00 PM Revised 12/30/2016 l)y (( o' s PART 5: HEALTH DEPARTMENT OBSERVATIONS - FOR OFFICIAL USE ONLY Primary Drainfield Yes No The system appears to be functioning adequately at the time of the inspection. (Only applicable if ❑ ❑ system has been in use on a regular basis for the last 6 months.) ❑ ❑ Sanitary survey? I Pass Fail L I Suspect Not applicable Water System ti f a Yes No well that appears to be a satisfactory The water source consists of an individual (or a two-party) source of potable water for a single-family (or two single family) residence(s).The water was ❑ ❑ sampled and coliform bacteria were absent. The water source is a public water system that appears to be in compliance with applicable ❑ ❑ regulations. ❑ ] Well Construction Permit LI Pass n Fail PART 6: Comments ?Olaf 3Zaz7-59oCOSO = 5cI1S ( i 1 is a q cola of Ve fie( 11r l �� F-�sar�lNe9(vur7 CoilwJ 1dc (r C1),� _501 � !Dq n�j .lOQrn land o r y r The Sollc do not- rederi Y corc' f�ri t la %i or S cwvv , and �� es• P r � �', a a fa1 iermh ftr1 f not�F1')jr flv�?i itorr� e arnovn f a 71 fli tent / have bed dof?os, fend J1 thew Inspector // ( 7 Date I it 7 ions Important aice: FindingsAbsolutely not claim is this made by this reflect office,observed exprressed orconditions mplied they concerning the future success, evaluation was performed. failure or permit approval of the system and site evaluated. Porta 3 ZZ t Z 33 00d00 tYl thit area cons S71 104 Salim I rare1h►5 (TY�u� and 9�uell� medrvn7 SQn� C�r,c�3) . �n is Cony�2U- i`r1 a eeti res ft i f- `(i{, t O y •Ci7 C U' 3 Z -y 7 This form may be scanned and available for public view on the Mason County WebRsitevised 12/8/2022 P95 0k5 10/26/2.5, 12:43 PM TerraScan TaxSifter-Mason County Washington k. A AilMenttlm i.r...`uuwws . -' . ',.. MASON nO= N ,,. , WASHINGTON TAXSIFTER SIMPLE SEARCH SALES SEARCH REETSIFTER COUNTY HOME PAGE CONTACT DISCLAIMER PAYhiEtJT C;AF.TfGI Patti Mclean Mason County Assessor 411 N 5TH ST Shelton, WA 98584 Assessor Treasurer Appraisal Ma pSifter Parcel Parcel I/. 32227-54-00050 Owner Name: LIBERTY MANAGEMENT LLC DOR Code: 18 - Residential - All other Addressl: 10228 44TH AVE SW Situs; 211 NE SPAR TREE DR,TAHUYA Address2: Map Number: City, State: SEATTLE WA Status: Zip: 98146 Description: SHOREBROOK TR 50 Comment: 2026 Market Value 2026 Taxable Value 2026 Assessment Data Land: $15,470 1-1.-.and: I $15,4701 District: 0259-Tax District 02591 'Improvem ents: $0 I Improvements: $0 Current Use/DFL: No Permanent Crop: $0 Permanent Crop: I $0 Total $15,470 (Total $15,470 Total Acres: 0.39000 Ownership --------- - -------------- i Owner's Name i Ownership% Owner Type --------- ---------- ---- LIBERTY MANAGEMENT LLC 100% Owner Sales History Sale Date Sales Document # Parcels Excise# Grantor Grantee Price 01/09/03 1771936 1 200365070 JAMES L CHRISTEN LIBERTY MANAGEMENT LLC i $0 I07/28/98 671840 1 199845805 STERRETT METHENY JAMES L CHRISTEN $40,000 --------------- Building Permits re'ire' S Permit Date Description Amount No. MH(30-05354)was seg'd from 32220-50-03050 for the 2023 TY. At that time, ending owner stated MH In-House 3/25/2024 will be relocated to 211 NE Spar Tree Dr. However, to date, no move-permit or uilding permjt• 90% 10,644' complete decks being built prNe 1/,� Historical Valuation Info Ski' �� '� Year Billed Owner Land — Impr. PermCrop Value r Exempt Taxable r2026 LIBERTY MANAGEMENT LLC $15,470 $0 $0 $15,470 $0—_$15,470I 2 25 LIBERTY MANAGEMENT LLC $19,825 $0 $0 $19,825 $0 $19,825, , 0 1_2024 LIBERTY MANAGEMENT LLC $24,780 $0 $0 $24,780 $0 $24,780 2023 LIBERTY MANAGEMENT LLC $15,020 $0 $0 $15,020 $0 $15,0201 2022 LIBERTY MANAGEMENT LLC $16,690 $0 $0 $16,690 $0 $16,690 https://property.masoncountywa.gov/TaxSifter/Assessor.aspx?keyld=4331023&parcelNumber=32227-54-000508,typelD=1 1/2 "149: --C....'... .r9 0... f'"•. �► `S rii MI aco ' Q Z iy ~ L.,4 0 � `° n e r b � � p y ci; b,a > 0 lk o z° NhorF• a. 1. 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