HomeMy WebLinkAboutWAI2025-00066 - WAI Health Waiver - 2/13/2026 wT y "( ' ry r r n tiw
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COMMUNITY SERVICES
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415 N 6`h Street,Bldg 8 Shelton WA 98584,
Shelton:(360)427-9670 ext 400 O Belfair (360)275-4467 ext 400 Elma (360)482-5269 ext 400
FAX (360)427-7787
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Application for Waiver/Appeal
Amount Paid Al/0 0 �J^
Receipt Number 1/07,./5"1" 04 7
Instructions
1. Complete Parts 1 and 2.No determination can be made until these parts are fury completed
2. Fees may be billed for waivers and appeals,based on the Environmental Health Fee Schedule
%), Submit completed application with attachments to Mason County Public Health for review
0 PART 1.Applicant/Parcel Identification
, _:;
Name of Applicant LISA KRAMER Telephone 3(P0—79?— L/9/
Mailing Address of Applicant PO BOX 37
City HOODSPORT State WA Zip 98548
?n 12-digit Tax Parcel No 4 2 2 0 9 _ 5 1 _ 0 0 0 1 3
} Site Address 61 N FAIRWAY DRIVE v1/
.! Subdivision Name and Lot c r V 15 I b h } Lat 13
PART 2:Nature of Waiver/Appeal
O Contractor Certification Requirements
❑ Class B Reduction in Vertical (Installer.Pumper,O&M Specialists)
❑ Separation O Food Sanitation Requirements
OJ Building Permit Review Policies O Group B Water System Regulations
¶a Location.WAC 246-272A-0210 O Water Adequacy Requirements
❑ Holding Tank WAC 246-272A-0240 O Enforcement Timelines
❑ Mason County Onsrte Standards O Departmental Determinations
O Other
Descnption of Waiver/Appeal(include)ustilication.additional material may be attached)
REDUCE SETBACK FROM DECK FOOTINGS S HOME FOUNDATION TO EXISTING DRAIµFIELD Si RESERVE AREAS
ALL FOOTINGS/FOUNDATIONS ARE UPGRADIENT PER 246-272A-0210(3)
Applicant Signature Arco- (AGENT) Date 2/7/2026
1:\EH Forms\Waiver-Appeal Mason County Local Revised 1R02017
Page I of 2
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PART 3: Public Health Evaluation (Staff Use Only)
1. Type of Determination Required: Type of Onsite Waiver (if applicable)
❑ Appeal pA/aiver ❑ None required ❑ Class A ❑ Class B ❑ Class C Local
2. Identification of Specific Code/ Standard/ Determination (include date of determination or
latest Code/ Standard revision): N\i 6-Z?Zs(--O?� O
3. Nature of Appeal*
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4. Hearing Official:
❑ Board of Health 0 Health Officer
❑ Pollution Control hearing Board 0 Public Health Director
❑ Certified Contractor Review Board Environmental Health Manager
5. Mitigating Factors:
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6. I have received this waiver/appeal request. It is complete and mitigation required by the
state and local policy has been submitted.
Staff Signature: Date: t t 12_Q
PART 4: Determination of the Hearing Official
4- The hearing official has determined that approval of this request will not adversely affect public
health and is hereby granted. This decision is based on the following findings and conditions:
O The hearing official has determined that approval of this request could potentially adversely
effect public health and is hereby denied. This decision is based on the following findings and
conditions:
Health Official Signature: U/7 Date: /J
Q/7/
Revised /29/2025
This form may be scanned and available for public view on the Mason County Web site.
Page 2 of 2
. PROJECT SUMMARY:
CUSTOMER IS LOOKING TO REPLACE EXISTING COVERED DECK W/ NEW&
*DRAINFIELD NEEDS DESIGNATED RESERVE AREA. WAIVER SUBMITTED TO REDUCE
DEPTH IS 30" SETBACK FROM DECK FOOTINGS TO EXISTING DRAINFIELD. ALSO
PER ASBUILT EXISTING HOME FOUNDATION TO NEW RESERVE DRAINFIELD AREAS. ALL
FOUNDATIONS APPEAR TO BE "UP-GRADIENT" PER 246-272A-0210(3).
I I
SLOPE
is-:.,J.t AIRWAY DRIVE
l> ;•.i 4.
; r••••••••• 4..0 OME................. door.
2'+ I
I DRIVEWAY! -.ft-7
MAINTAIN 2'+ FROM DRAINFIELD PARKING
TO NEW DECK FOOTINGS. /
I
EXISTING /
I GARAGE
6'
' 7-
1�9 I
..
4,0,...,1. I
tti 1 N� N
yo- 5110393 '�0 /
02 ALEX L.PAY;;aE
LICENSED DESIGNER /
EXPIRES I 2-EXI TING —_/ 5'
ROOM
HOME no i-trI im-Dg
/ *RESERVE AREA
EXISTING 0 /
SEPTIC TANK I O°
:1)4N-4"41RoP.°44411;SE:8
MAY REQUIRE
PRE-TREATMENT
I
oCOV 6+
2'+ DECK /
/ HAND-DUG HOLE
I EXISTING SHED, TO BE
I 40' ( e REMOVED IF RESERVE
/ SPACE NEEDED
_ RESERVE AREA
APPROXIMATE EXISTING _ / 450 6' x
DRAINFIELD AREA: 120LNFT SQFT/ ELDS
300 LNFT
(RESERVE DOWNSLOPE
(PER OSS RECORDS,OWNER PROVIDED OF HOME FOUNDATION)
INFO,&FIELD OBSERVATIONS)
CUSTOMER: LISA KRAMER TEST HOLE 1 • 1979 OSS PERMIT FOUND 36"+ /N
0-24+GSL • 2007 PERMIT ON NEIGHBORING /
.,."............................I PARCEL: 4 2 2 0 9 - 5 1 - 0 0 0 1 3 TH @ 24 LOT FOUND 40"+OF LOAM A
ALPINE SEPTIC SITE: 61 N FAIRWAY DRIVE NO R/L FOUND
-DESIGN--
ALEX L PAYSSE,DESIGNER SHEET: SITE PLAN SCALE: 1"=20' DISCLAIMER: THIS IS NOT A SURVEY. REFERENCES INCLUDE APPLICANT/COUNTY PROVIDED PLATS OR
3089 E MASON BENSON RD SURVEYS,FIELD MEASUREMENTS AND COUNTY GIS. DESIGN INTENDED FOR SEPTIC PURPOSES ONLY.
GRAPEVIEW WA 98546 PROPOSED DEVELOPMENT MAY BE SUBJECT TO OTHER DEPARTMENT/AGENCY REVIEW, DESIGNER NOT
360-507-1546 I0 10.5 II I2 RESPONSIBLE FOR SETBACKS UNRELATED TO SEPTIC COMPONENTS.