HomeMy WebLinkAboutUNIT B - BLD Sewer Adequacy - 5/28/2025 vn , il--- g , ,
.,,..soN ,,,,,„0.,„,
.,,k,, .,,,,,, v-?,,,
, . ,,,,,? b..Ac ��1: Heath
Always working for a safer Ot 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/Parcel Information
Applicant: MISHKO, JOHN 3\t VQ, Date: 5/28/25
Mailing Address: PO BOX 381 City,State,Zip: BURLEY WA,98322
Site Address:1090 E Old Ranch Rd. Unit B Allyn WA 98524 Phone: 253-377-6798
Parcel Number: 12217-50-91398 Permit Number:
Email Address: MIKEMISHKO@YAHOO.COM
Part 2: Sewer System Information
Name of Sewer System: NBCI ® Site Plan attached?
Official use only: Sewer System Manager or Designated Employee is to complete.
El New Connection: I have reviewed the applicants Information and have no Issues with Mason County Public Health approving the corresponding
Mason County Permit.
O 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.
[] Please add the following condition(s)it/ on the corresponding Mason ounty Permit:(optional) ��
// c .1P, ;� /./Ct //i:f't �� 'b-r- /fit ckiteiJ..'. 1 VC—/ /('/c%i',/ 4,Di(f/,Y+.
F-;-,-=.7.3 . �j/`6)os e_S'c', lkt• �O6 g /f 5. gi) r' ti✓,'77� rk 7TH' ,-):4 ;,.,a .h
iw,,,
Richard Dickinson .- 60. -:,/4?-6/e.;'Z 1
-20
Printed Name of System Manager/Employee Signature of System Manager!Employee P" Dale 4,
Part 3: Mason County Public Health Review/Approval .1'4`.6:
,` ' ®XSatisfactory ❑ Unsatisfactory 5/1 �'"' 6 J� .
Signature of Environmental Health Specialist &te'6+,r)r„r
This form may be scanned and available for public view on the Mason County Web Site. e,c<q �1
l
REVISED ID/2812015
I
10 UM
f
•
•
*.
_. cy,i
•! 7 ,, gi, s,. ,i...i.„.
•
. . _... • . ,
. 1 k
OLD RANCH D
12.241 .
. 2259OOOO1i22j759OOOO:!
•-•....,.
� ( m j ---'•{{'
�_ - / E °
° K
\_ -'_ - -•-
_- I r
Z
0
_ ----.
B ti
gigi aL A r r r
_ e"sii Ej 7 _ :ir ci a \ `\` `�\
if
\ I
$ F z \e \ I
s€`€ c � • is t`
',P4Z k g \ \ \ 3
t it'£ L �'n/A 8 IJ.�
fill! s e cl ..--,1 'A , 1
of _ _deo ��_ ,� _. I} 1
e '� is eg 1 ` '
l xt'j HI
1 �!
L = =1Z a ;
H di lg i• e II
, ,,
is„„, ‘,, . ..
„ � .._ _
. :,
§ q/ ;�` I
,845-' % i9S al g ' J • �v Ii
An f54 a I• I '£ .I fi RI/� \ � � .i
/� ' e ;I
/ •
\\--\''' 1 .‘..\.4, 0371 u il
5
.xa
N g
\ s , ,� =L.
�: 5' �I
_� ` ;�, r
/L>7.../i 1
ii
s^ � .d - ,-
l
I
J-IAIWL.J • -
e.... 4GHAVs telu n\o nryn»aw ..s-'.at. "" For. Tttlr
16074 V F xexr,wsemi e....-. ,,;,.. WASHINGTON FEDERAL SAVINGS REMAINING IMPROVEMENTS
42- 1- D25)151-5222
, 9 g t(415)231-3782 FAI °-'.-� e-rr CIO RICKA GERSTNAIDI EXHIBIT
,,
yt `, ;� w: + 425 PIKE STREET
Sr..\-x\'-....10.....-..q...--...0*,....”......3,--:.....34....r.,
1 .
Mason County Utilities and Waste
SIDE SEWER REGULATIONS(partial list)
1. Any work, including installation, replacement and repair, on the sanitary side sewer requires a
permit. This must be obtained - in.advance of the work- from the Public Works Department at
100 W. Public Works Drive, Shelton, WA.
2. All costs and expenses incidental to the installation and connection, operation and maintenance
and replacement of the side sewer shall be borne by the owner.
3. For an inspection, call the Public Works Office at (360) 427-9670 ext. 199. Inspections will be
made 8:00 A.M. -Noon and 1:00P.M. - 3:00 P.M.
4. "Side Sewer"refers to the extension from a building sewer beginning two feet outside the outer
foundation wall of the structure to the property line or easement.
• Side sewers shall be no less than 4" diameter from dwelling to property line and 6" from
property line to public sewer.
• All multiple family, commercial and industrial side sewer lines shall be no less than 6"
diameter.
• Each building must have a separate side sewer.
• Pipes acceptable for side sewers: polyvinyl chloride (PVC)ASTM D 3034, SDR 35. Not
acceptable for side sewer: black ABS pipe, glued joint pipes, glued fittings.
• Lines shall be laid on uniform slope not less than 1/4"per foot for 4" pipe and 1/8" per
foot for 6" pipe. Pipe shall be bedded in and covered with suitable fine material.
Alignment of both vertical and horizontal shall be straight and true.
• Side sewer shall be water or air tested for their entire length. Inspection of the test.
must be witnessed by a Public Works Utilities and Waste employee before backfilling.
• No 90° bends allowed.
• Minimum cover for side sewers shall be 18".
• Cleanouts are required at the property line or easement line and within 5' of all
buildings and at intervals of not more than 100 feet.
5. Backwater Valves - The Uniform Plumbing Code requires backwater valves on building sewers
where the finished floor is below the rim of the upstream manhole. Backwater valves, if they are
installed, must be located within the building footprint upstream of the cleanout. The County is
not responsible for their installation, maintenance, or operation.
6. City staff have 24 hours to make inspection.
7. Demolished or removed buildings. The property owner or contractor shall notify the County of
such work, obtain an permit from the Public Works Department at 100 W. Public Works Drive
and shall expose and plug the side sewer connection of such structure at the property line. A
Mason County Utilities Department inspector must observe and document all abandonments.
Any questions regarding the above regulations may be directed to the Public Works Office by
calling (360) 427-9670.