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HomeMy WebLinkAboutSWG2023-00406 - SWG Design - 8/26/2026 MASON COUNTY 415N6THSTREET,SHELTO70,EXT 400 SHELTON:360 59664 EXT 400 Ijq BELFAIR:360-27275-4467,EXT 400 Public Health & Human Services ELMA.360-4925269,EXT 400 FAX'.360-427-7787 On-Site Sewage System Permit: SWG2023-00406 APPLICANT AB Fine Homes Phone: 360.898.0055 Address'. 871 EAST BEACH DR UNION, WA 98592 OWNER ALDERBROOK PROPERTIES LLC Phone: 36O-898-OO55 Address: 871 EAST BEACH DR UNION,WA 98592 SEPTIC DESIGNER PAULA JOHNSON* Phone: 36O-898-2255 Address: 171 E VUECREST DRIVE UNION, WA 98592 Site Address. 331 E Vine Maple Ln Primary Parcel Number: 321045700046 Permit Description: New SFR 3-bedroom OSCAR XO2 system wl OS-50 coils, and permit expiration extension Permit Submitted Date: 09/22/2023 Permit Issued Date: 10110/2023 Issued By. David Anderson Current Permit Fees Paid: $695.00 additional fees may be required upon mstaawn of system). Permit Expiration Date: 09/26/2028 (based on date of inspection) Permit Conditions: 1 Proposed development subject to zoning requirements and approval by the planning department staff per Mason County Title 17. 2 Permit must be installed by a Mason County Certified Installer unless prior written authorization from Mason County is obtained. 3 Drain field installation not to exceed designed upslope and downslope depth specified on design form. 4 Installer is responsible for obtaining Mason County installation approval prior to backfill of system components. 5 Installer is responsible for obtaining Septic Designer/Engineer installation approval prior to backfill of system components. 6 Mason County Asbuilt Form, Record Drawing, and Installation fee must be submitted for final installation approval. THIS PERMIT MUST BE ONSITE DURING INSTALLATION OF O55. 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 DESIGN APPROVED. FINAL INSTALLATION APPROVAL IS REQUIRED PRIOR TO TEMPORARY OR FINAL OCCUPANCY OF ANY RELATED STRUCTURES. For Final Inspection visit: masoncountywa.gov/healthlenvironmentallonsitefoss-inspection-request.php or call: 360-427-9670,extension 400. MASON COUNTY N HE�TON: 36o427960EXTa400 Public Health & Human Services BELFAIR: 360-275-4467, EXT. 400 APPLICATION FOR EXTENSION ' h, nl� AUG 27 L026 Amount Paid: 7lJ "�.. Receipt Number: Instructions: Applicant to complete Parts 1 and 2 and septic designer/engineer to complete Part 3. Submit application with extension permit fee. Make check payable to Mason County Treasurer. Staff will review your application and determine if the extension can be approved. Conditions for approval are outlined in this application. Prior to or after expiration of an approved design, the applicant may apply for a permit extension. The permit extension shall extend the expiration of the design for up to two years, but not exceed five years from the signature date of the Environmental Health Specialist's site inspection{Per WAC 246-272A-200(4)(e)} All approved septic designs may receive one extension. Additional extensions shall not be accepted and would instead require a renewal. PART 1: APPLICANT TfQD AND p PARCEL INFORMATION Name of Applicant: hp rt c- ZY v ! Phone: 3c o- OMB " ©nom Mailing Address of Applicant Ol I E city. L16`n �t State. l_ Pc Zip: 12-digit Tax Parcel Number. .72- 10 4- S-7 0De'4po Site Address: 3�1 E t t ^Y_ Q. L y* Permit Number SWG QD t� PART 2: EXPLAIN WHY YOU NEED AN EXTENSION !n�� tp �. 3cfw� I'�Q eon This form may be scanned and available for public view on the Mason County Web site. 'age 1 of 2 PART 3: ORIGINAL DESIGNERIENGINEER REVIEW AND APPROVAL I, the undersigned original Designer/Engineer, attest that I have reinspected the property and found the following conditions to be true as of the date of my signature below: • NO part of the proposed Drainfield or Reserve area has been altered or disturbed in such a way that may render the proposed design invalid. • NO development has occurred on this parcel or neighboring parcels which would cause the proposed system to no longer meet minimum setbacks. • NO Boundary line adjustments or subdivisions have occurred which would cause the property to fall below the minimum land area requirements of WAG 246-272A. jIrirr : Signature of Desi ner/En ineer Date r PAULA HNSON $1p0"9 \ 9 9 9 g JOY JO �l�l, -' LIc tflh Comments/Conditions: — r *-e-r 7 kAh. \-n t e 4-& 4-- . , . PART 4: HEALTH DEPARTMENT DETERMINATION (staff use only) ❑ Extension Denied /1 /7 7 7 Q di Extension Approved New Expiration Date: V ! L zo`V Comments: Environm alth Specialist Signature: '1 - 9 T orm may be scanned and available for pdIikkyiew ort'the Mason County Web site. .. Page 2 oft Kev: 5 D. 41 ' O1 Control Panel with Audio-Visual �... ( )2 Cleanout 5 O 1,000 Gallon Sepfic/Aeration Tai 21 }�- Zf�PAW1� 2-Compartment with air diffuser 0 1,000 Gallon Clarifier/Pump Tani 2-Compartment o® OS Headworks G 2 q O OSCAR X02 Mound Drainfield ( / �P o ( ss. ç . al �e',� N \ i C + V deg d A � , - 5Mwinu �Ip_ v , vie MaVIi, Lh '` 9� ^fin p t?c m& 2!o4- 1-Um4fa 6 X31 e UGe * o-a9"o�e� Est. 1sw/soMe '�- a ç ( kc i 11 �k mZ 0-12" 5vJIScma roots ; 1?.t%' rcwrJYl.ai" ve 9S1 3 / v Q w � r d W z �c2 ' �_ _ �a�si �i -,vz w �� M O E6Z J N m -.Sol