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Home My WebLink AboutWAI2026-00031 - WAI Health Waiver - 7/28/2026 415 N.6'h STREET,SHELTON WA 98584 MASON COUNTY HELTON:360-427-9670,ext 400 BELFAIR:360-275-4467,est.400Public Health & Human Services Applicationli �7 for Waiver or Appeal ) Amount Paid: 3I O Receipt Number: ,4 4 o�Z / WAI _ 000 �l Please note.all Approved Onsite Waivers have the expiration date as their O55 Pem/b Instructions. 1. Complete Parts 1 and 2. No determination can be made until these parts are fully completed. 2. Fees may be billed for waivers and appeals, based on the Environmental Health Fee Schedule. 3. Submit completed application with attachments to Mason County Public Health for review. PART 1. Applicant& Parcel Information Name of Applicant JOHN DITZLER Telephone (425) 623-6816 Mailing Address 16525 SE 30th Street City Bellevue State Washington Zip 98528 Parcel No. 2 ? 2 0 9 _ 5 0 _ 0 0 0 0 1 Site Address 7151 NE Shore Road / Belfair, Washington 98528 Subdivision Name and Lot Lot 1 of CADY'S PEBBLE BEACH TRACTS PART 2: Nature of Waiver/Appeal Onsite: Class A Waiver ❑ Food Sanitation Requirements Onsite:Class B Waiver 0 Group B Water System Regulations Onsite:Class C Waiver 0 Water Adequacy Requirements Onsite: Location, WAC246-272A-0210 ❑ Building Permit: EH Review Policies ❑ Onsite: Holding Tank, WAC246-272A- O Appeal:Enforcement Time/loss 0240 0 Appeal:Departmental Determinations ❑ Onsite:Contractor Certification ❑ Other Requirements Description of Waiver/Appeal(include justification, additional material may be attac ed.): Waiver to allow Septic System Disposal Component to be installed Feet from the S ncwellne or ridd>f Lanai. /, IIICT1FirATinN ATTACHED / Applicant Signature: / I,,;, t / Date: 7/15/2026 Revised 03/03/2026 This form may be scanned and available for public view on the Mason County Web site. Page I of 2 PART 3: Public Health Evaluation (Staff Use Only) 1. Type of Determination Required: Type of Onsite Waiver(if applicable) ❑Appeal Waiver Class A OClass B ❑Class C Local State ria Number of Bedrooms:? Nitrogen Treatment: gYes O No Soil Type: l Minimum Lot Size: sq.ft. Water Source: Public ❑Private This Lot Size: sq.ft. Is This Lot Eligible for State Waivers: R'y'es ❑ No ❑ NIA Hearing Official: 0 Environmental Health Manager ❑ Public Health Director ❑ Other: 2. Identification of Specific Code/Standard/ etermin tion (include date of determination or latest Code/Standard revision): ( -OZ! O 3. Nature of Appeal: ti) 5. Mitigating Factors: 1' MQ4c 'f-1 6' r P o55 u 6. I have received this waiver/appeal request. It is complete and mitigation required by the state and local policy phas been subbmiitjadd. (7-CStaff Signature:f1'�''' "Y " Date: PART 4: Determination of the Hearing Official 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: ❑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: P "'—'" Date 26 o%u61 Revised 03/032026 This form may be scanned and available for public view on the Mason County Web site. Page 2 of 2 On-Site Sewage Systems (Chapter 246-272A WAC) Request for Waiver from State Regulations ,� HEALTH Section I. I (Completed by applicant) Name:(1) Local Health Jurisdiction Received(2) --J.i2i ZLER_„___-_- _ -_- (Seemstructians) _..._.... Address: 16525 SE 30TH STREET BELLEVUE, WASHINGTON 98008 Telephone: (425) Si23-681 _ Sig rdt FOR: OHN DITZLE Property Identification:(3) PARCEL-#_ 22209 -50 00001 _- ADD.RIESS 7151 J4E. .H.4RERQAD ........ .. ( LOT 1 ; CADY'S PEBBLE BEACH FAIR WASHINGTON Section II. (Completed by applicant) WAC Number:(4) WAC Requirement: (5) Waiver Sought (6) 246-272A- 0210(1) TABLE IV DISPOSAL COMPONENT 100' to SHORELINE REDUCTION TO 69-71 FEET FROM SHORELINE Subsection: Justification(Proposed mitigation measures):(7) ATTACHED - _ ......- Section III. (Completed by local health officer) Review Criteria: (8) Additional Mitigation Measures:(9) Comments/Conditions: (10) Type of Waiver: (11) Class A Class a Class C— Request DOH review before granting? Yes flNo Neighbor Notification: (12) Required?Yes❑No❑ If needed,are agreements, easements,etc.filed? Yes ❑ No❑ Section IV. I (Completed by health officer) This Request for Waiver from State Regulations has been reviewed according to the provisions of Chapter 246-272A WAC On-Site Sewage Systems.The review criteria applied,and the mitigation measures proposed and/or required,have been evaluated for their ability to provide public health protection at least equal to that provided by this chapter WAC. ❑Denied IC—il'Approved/ ted—Subject to all c menu,conditions and requirements noted in Sections II and U. Local Health Off(icceerl I' (13) / V42 Date: 'C ti S�`� DOH 337-175 February 2024 CHARLES H. POLLMAR & ASSOCIATES JOHN DITZLER - SHORELINE WAIVER REQUEST AMENDED JUSTIFICATION: 1.) The Property was created PRIOR to the implementation of the current Setback Requirements. PRIOR to 1974, the Setback from the Shoreline was 50 Feet; Prior to 1970, there was NO Setback to the Shoreline. 2.) There is virtually NO area on the Property that meets(or exceeds) the 100 Foot Setback Requirement from the Shoreline. 3.) There is an Existing Residence and a functioning Septic System ON the Property that is in use and is NOT failing. 4.) The Proposed Disposal Component will maintain a Horizontal Separation in of 69 to 71 Feet from the Shoreline. 5.) The Disposal Component is a Pressure Dosed Gravel Bed that maintains a 30-36"+ Vertical Separation from Seasonal Ground Water Levels, well in excess of the MINIMUM 24" Required. 6.) As the Disposal Component will also be "Time Dosed" the Application of the effluent will be equally Spread over an entire 24 Hour Day, which promotes UNSATURATED Flow Conditions and assures that the Volume of effluent will NEVER exceed the Daily Sewage Volume for which the system was designed. This limitation does NOT exist for the Existing Gravity Septic System. 7.) The effluent is to be Pre-Treated through a NuWATER BNR 500 Aerobic Treatment Unit, which produces Treatment Standard "B" quality effluent WITHOUT Disinfection PRIOR to entering the Disposal Component. 8.) As an"Alternative System" it will be subject to the "Operation& Maintenance Program". As such \it will be inspected on a regularly scheduled basis (TWICE a year) and its performance will be monitored. 9.) The location of the Primary Disposal Component is very specific, meeting the greatest possible distance from the Shoreline; and Maximum Distance from the Road; while maintaining a 10 Foot Setback from the House Foundation and Preserving sufficient room for a 100°ro Reserve Drain Field Area. 10.) Approval of the Waiver will represent a substantial improvement in both effluent quality &Treatment over the Existing Gravity System, which has marginal capacity& limited treatment capability. Approval of the Waiver will bring the Septic System up to current code to the greatest degree possible.