HomeMy WebLinkAboutSWG2025-00192 TANK ONLY - SWG Application - 5/21/2025 •FASO 415 N 6TH STREET,SHELTON,967 WA 98584
SHELTON:360-427-9670,EXT 400
BELFAIR:360-275-4467,EXT 400
Public. Health&:Human Services ELMA:360-482-5269,EXT 400
FAX:360-427-7787
On-Site Sewage System Tank Only Permit: SWG2025-00192
OWNER FISHER ROYCE&LIZA Phone: 1.360.463.2852
Address: 4991 NW EL CAMINO BLVD BREMERTON, WA 98312
APPLICANT FISHER ROYCE&LIZA Phone: 1.360.463.2852
Address: 4991 NW EL CAMINO BLVD BREMERTON, WA 98312
APPLICANT Kitsap Septic Pumping Phone: 3608715258
Address: P.O. Box 809 Manchester,WA 98353
SEPTIC INSTALLER DARREN MILLER* Phone: 360-871-5258
Address: PO BOX 809 MANCHESTER,WA 98353
Site Address: 17010 E State Route 106
Primary Parcel Number: 222115000008
Permit Description: New 2-bedroom SFR septic tank to connect to the existing 3-
bedroom septic system shared with the existing 1-bedroom ADU
Permit Submitted Date: 05/21/2025
Permit Issued Date: 05/30/2025
Issued By: David Anderson
Current Permit Fees Paid: $270.00 (additional fees may be required upon installation of system).
Permit Expiration Date: 05/21/2028 (based on date of inspection)
Type of Work OSS New Construction
Components being Replaced: Septic Tank Only
Surfacing Sewage? No Existing Failure? No
Shoreline? No Horizontal Setbacks Met? Yes
Number of Bedrooms: 2 Drinking Water Source: Public Water System
Additional Details: Roth 1060
Permit Conditions:
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.
I Horizontal setbacks per WAC246-272A-0210 must be maintained, unless prior approval is
obtained
4 Proposed development subject to zoning requirements and approval by the planning
department staff per Mason County Title 17.
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/onsite/oss-inspection-request.php or call:
360-427-9670, extension 400.