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HomeMy WebLinkAboutSEP1975-00397PROPERTY OWNER MAILING ADDRESS PHONE SYSTEM DESIGNER LEGAL DESCRIPTION: Subdivision Name SITE LOCATION SOURCE OF SEWAGE: TYPE OF WORK: New Expansion Jefferson County Department of Community Development 621 Sheridan St., Port Townsend WA 98368, (360) 379-4450 SEPTIC PERMIT APPLICATION in Area Code ( )% " DEPT. OFCOMMUNITY DEVELOPMENT Section Township I N Range 1 E PARCEL # q77-700-074 01ser"V_&eMlIlan S Division Block Lot(s) .12-91 C—, Ma rl-6 WS' f 0-7-7 e-- Zip Code Residential X Residential ADU Commercial Community Redesign grade Repair Designate Reserve Area PP Conventional Alternative Dr ' ield Length ft. Number of Gallons/day Trench/Bed Depth in. Site Size Water Source: private public Septic Tank size Soil type Previous eval: yes / no SEP 76-0317 Application Rate TYPE OF SYSTEM Partial (tank) (drainfield) Trench Width ft. Number of Lines gal. Pump Chamber size gal. (ATTACH SOIL EVAL.) gal./sq.ft./day By signing the application form, the applicant/owner attests that the information provided herein is true and ccrrect to the best of their knowledge. Any material falsehood or any omission of a material fact made by the applicant/owner with respect to this application packet may result in this permit being null and void. I further agree to save, indemnify and hold harmless Jefferson County against all liabilities, judgments, court costa, reasonable attorney's fees and expenses which may in any way accrue against Jefferson County as a result of or consequence of the granting of this permit. I further agree to provide access and right of entry to Jefferson County and it's employees, representatives or agents for the purpose of application review and any required later inspections. Access and right of entry to t.._ applicant's property or structure shall be requested and shall occur during regular business hours. Appeal - A person aggrieved of a decision of the Health officer may appeal. Appeals shall be submitted to the Heal --h Division in writing within fifteen days after receiving written notice of the decision. DISCLAIMER -This application is for an on-site sewage system that meets the state and county standards in effect on the date of application. This application for an onsite sewage system DOES NOTassure you of any other County approvals. For example, it DOES NOT GUARANTEE that you will later obtain permission to build a permanent residence .or other structure on this parcel. Any future application will be separately judged by the rules and laws in effect at that time. Owner Signature Date FOR OFFICE USE ONLY PARTIAL PRESS/TEST ASBUILT PUD Fire District Planning District School District Zone . FINAL Date (o--2 — Fee 5 5 -' Rec # 45q I I Check # Case # SEP H:\env_health\linda\GD\FORMS\SEPTIC PERMIT APPLICATION.DOC 7/01 a + F 1 tell qa rain k+ n t 'ILI 1 f p� x,^k' "i+ik.i�. truaxr<•A! J40 e a a 4a All MAPS 1 f 1 � g �C I ff j 'a<g 311 {^i`'t = e •'f v i 7-f �+ ;6 vin 01 up p .a t,d is s 7 h t � F Sum LIP 1 u 1 S •�H � '1 I" 1-i a I' �4 M .. . 9 SY IRA ANY 100 $-V }low ! '4 F, R)j t z � 3 104,11F kzP f+ { d ots r H All 5� T�h J 4 h ¢ low ^f yonp. Q j' Pit y4 afi . e rt yonp. YE �f j' Pit y4 e e 1 a iv �F t" �ait" TAT p 1 YE �f j' Pit y4 jVERSON COUNTY PERMIT CENTER s2,1 SHERIDAN ST SOIL EVALUATION PORT TOWNSEND WA 88388 13801379.4450 D C PROPERTY OWNER Q•e— SYSTEM DESIGNER p ��,®a U ow LEGAL DESCRIPTION: Section Township Ran UEP'LOFC0M-1"'E'm` 6 Subdivision NameDivision oc < o Date Logged; j F — p Logged By:ice °1 ©74 Include soil textural characteristics and the depths at which significant changes occur. Be Sur'� to include depth Where mottling or permaable layers occur. SOIL LOG #1 SO LOG 1 ► m �_to�^In. I ® S7& tori in. to-JQ in._SL0,d„�dV lonrn Ju toin.,�-nn —to—in. Grp""�� b Anticipated water table_Lfg_in, Roots to inches 1 U Health Dept. Comments SOIL LOG to in. --:!5FO in. to- n,__u Anticipated water tat-de—in. Q( Roots tolit Nches'�� Health Dept, Comments SOIL LOG #5 to in. to In. to in. to in. Anticipated water table in. Roots to inches Health Dept. Comments H: WNFOHLTHISOIL.FRM to in. Anticipated water table in. Roots to inches Health Dept. Comments i SOIL LOG #4 to in. to in. to in. to in. Anticipated water table in. Roots to inches Health Dept. Conimonts SOIL LOG #6 to in. to in. to in. to in. Anticipated water table in. Roots to inches Health Dept. Comments ENVIRONMENTALLY SENSITIVE AREAS REVIEW SEP75-00397 Owner. JAMES LADD 12517 S DAVIS LOOP PRINEVILLE OR 97754 Parcel Number. 977700074 ST -R: 4 -29N -01E Site Address: 1291 EAST MARROWSTONE RD NORDLAND WA, 98358 Legal Description OLSON & HAMBLETON'S LOT 48 (S1/2 E1/2 El/2) LESS R OF W Total Acreage: Fire District: 1 Planning Area: 3 Flood Map (FIRM) Panel No 5300690195B Flood District: School Distric 49 WATER SUPPLY UTILITY: Service Area PUD: Assesor's Map Forest Lands: Adjoining Forest Lands: ESA'S Wetlands: Aquifer Recharge Area- Flood. rea:Flood . Erosion: r C Landslide: Seismic: Fish & Wildlife: Stream Type: Shoreline Designation: Flood Certificate: Violations: Require Declaration of Restrictive Covenant to meet minimum land area Recorded Date of Subdivision: <5yrs=Plat Conditions on plat or Old Ordinance PARCEL TAGS: No parcel tags found for this parcel. ssociated CASES status issued finaled description BLD00-00498 F 08/02/20 09/27/20 DETACHED GARAGE DOOR & ROOF BLD99-00833 F 12/28/19 01/03/20 propane tank installation SEP75-00397 F 04/09/19 04/24/19 BF SEP ESA Review mt January 11. 2002 903 E. Caroline OLYMPIC HEALTH DISTRICT Permit No. , Port Angeles SEWAGE DISPOSAL PERMIT APPLICATION Submit in Duplioatg Builder Court. House Port Townsend (IS i'j S DAAJ S L bajO 10jel AJ" t LLr= , 6ft Date ?� OWNR JAmtzs :L MOP, ADDRESS .I OKtDL-�wP- PHONE DIRECTIONS FOR LOCATING SITE 8_q ► MAAS Ad) } APPLICATION IS HEREBY MADE TO: INSTALL Nai SYSTEMLREPAIR EXISTING SYSTEM_ �He iL� �,� �' � �a ►5� � 3 � � S O oaf YPI OF BUILDING N0. E'DROOMS BASEMENT SITE, SIZA NAME OF INSTALLER DRAINFIELD LENGTH ( 2-o'1!IDTH A DEPTH I— #LINES SEPTIC TANK SIZE DRAM A DETAILED PLOT PLAN BELOW. SEE INSTRUCTIONS. SOIL TYPE I♦ 6i rn Wel/ 1 AQEii '� _ _ __CHANGE IN BUILDING OR SD'A,GE.DISPOSAL PLANS, LOCATION OR SITE, INVALIDATES THIS PERMIT UNLESS PRIOR APPROVAL OBTAINED FROM THE HEALTH DEPARTMENT. DATE OF INSTALLATIONSIGNATURE OF APPLICANT(` DATE `-! _ INSPECTED BY �L\ C,Z � DATE SANITARIANS COMMENTS I CERTIFY THAT T YS 'P S I THE MANNER APPROVED BY THE HEALTH DEAPRTMENT ATE STA NAIJE _ NE r SwSIDE W�- 1.:; LtiCAild �. �uP•annrt na'ri• ' hE c S W F RUM IN7E RSEC71ON W RUAU ANL orner soecrbt lacat,On of aanomora LEGAL DESCRIPTION- giocr Lot S '/Z ql'Y7 11. TYPE AND COST OF BUILDING TYPE OF IMPROVEMENT ® New budding p Addition p Alteration Repair, replacement O Vrrecking ❑Moving (relocation) ❑ Foundation only Tar• Numpr• OWNERSHIP Private lindividual, corporation. - nonprofit institution, etc.) t ✓til ❑Public (Federal. State or loco 90 COST • Cost of improvement... - - - • • - To be installed but not ancluded in the above cost a. Electrical ---------------- b. Plumping --------------- - --- c- Heating, air conditioning ...... d. Other lelevator, etc.).. - - . - .. . • TOTAL COST OF IMPROVEMENT FOAL - 91 IlE7 ROAD /T.lownsn,p r hanpr ___-- Section BUILDING TYPE (DSinple Family Multi -Family number of unats _-1 Hotel, Motel, Eiormiiory number of units D Mobile Home Other - Specify UBC OCCUPANCY GROUP: MOBILITY ❑ New County Resident Is In,, strucuare to serve the residential o+ cUmmercial needs of thuse employed at either the US. Navy's Tilden' or Indian Island Fer,iiries7 G YES ONO USE ❑ Full-time Residence ❑ Second Home- Recrtallon Cabin, etc. ❑ second manentiresidence talon to toms, eena) Nonresidential - pesnibe rn detail proposed use o1 buildi^gs• e.g., food processing Plant, machine shop, laundry building at hospital. elementary school, secondary school, college. Parochial school, parking garage for department store, rental office building. office building at industria; plant. 11 use of existing building is being changed• enter proposed use. _j/ - "727,e) 4- J5 �Gv III. SELECTED CHARACTERISTICS OF BUILDING - PRINCIPAL TYPE OF FRAME O Masonry (wall bearing) Wood Frarne Structural steel Reinforced concrete p Other - Specify PRINCIPAL TYPE OF HEATING FUEL ❑ Gas ❑oil V tic Ln (,pal ❑Other - Spec-fy IV_ IDENTIFICATION - _ Name 2 TYPE OF SEWAGE DISPOSAL a&dcl,=�.-k, '- etc.) TYPE OF WATER SUPPLY �J 1Z he iii e e Pa ^Y ell, is n) TYPE OF FIREPLACE TYPE OF MECHANICAL -------------- Il DIMENSIONS • Number ofStories .---------- •Total square feet of floor area, all floors, based on exterior dimensions--_------ • Total land area, sq- ft.. _ - - - - - - - - NUMBER OF OFF-STREET PARKING SPACES Enclosed ---....._--•-.._-... Outdoors-..._------•-.._..... RESIDENTIAL BUILDINGS ONLY Number of bedrooms ------ Mailing -••-• Mailing Address - Number, street, city and State reense 3. Architect - ve The owner of this building and the undersigned agree so conform to all applicable la Address S,Pmlure of appi.cani Panial.. L! ZIP code I Tet. No. PLANNING AREA --3 FIRE DISTRICT SCHOOL DISTRICT WATER APPROVED BY t/Z.1/ �i'/ Jersc"SC Gour+r" MEJ►t T�' n"" - PE RMIT NUMBER APPROVED BY; urest.on date - -1-/_D BUILOthiG OFFICIAL CP/E _RM IIT F/ WS -0— E`E �J �fJ J _ ISSUE DATE I'EC' 171 NOV Z 7'85 - HEALTH DEPT. 5 S c--3Ct --, BUILDING PERMIT APPLICATION Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD00-00498 Received Date: 7/31/2000 SITE ADDRESS: 1291 EAST MARROWSTONE RD NORDLAND, 98358 APPLICANT: JOE FORE PHONE: (360)379-1434 1291 E MARROWSTONE NORDLAND WA 98358 SUBDIVISION: OLSON & HAMBLETON'S Block: Lot: 48 PARCEL NUMBER: 977700074 Section: 04 Township: 29 N Range: 01 E CONTRACTOR: ARCHITECT/ ENGINEER: OWNER KIRK BOIKE 789 QUINCY PORT TOWNSEND WA 98368 : DETACHED PHONE: TYPE OF WORK GAR SQUARE FOOTAGE: 1 d TYPE OF IMP ALT Total: Total: VALUATION 3,000.00 MAIN: Landslide CODE EDITION: 1997 ADD'L: HEAT TYPE: UH OCCUPANCY: HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: # OF STORIES: CONST TYPE: OTHER: SHORELINE: CONST TYPE: GARAGE: SETBACK: DECK: BANK HEIGHT: SEWAGE DISPOSAL: CON WATER SYSTEM: PWELL BEDROOMS: BATHROOMS: Exist: Exist: Prop: Prop: Total: Total: Routing Date. Flood Plane Permit Plan Check State Building Code Total: PARCEL TAGS: YES NO STORMWATER: YES NO AREA Wetland Erosion Seismic Streams Flood Way Flood Plane F&W Landslide Shoreline Aquifer Forest: Commercial Rural Amount Paid By: Date: 'fedi $83.25 MAM 07/31/00 33396 $24.98 MAM 07/31/00 33396 $4.50 MAM 07/31/00 33396 $112.73 iAF_BLD App_Bld.rpt 10/29/99 IV. f 115' 30S Yell 2' L1> � / Cower p.2t House Ogo c efts i � 99 '�� �`••� s�' (A rtr •.�'' Jr�t2lf tK� • •• a. �Scbr'i � D2o i p Ta K K s► g5' a• S. a `••,:' : .;, ,� •ti : • A51 h2t� 1` ;Agi now s-ror« :i _ "R 0A n ' :' ' :. a �, r '• ,� : R • �• ,f ., a BUILDING PERMIT APPLICATION M ev�025 Type: I BATHROOMS: Jefferson County Department of Community Development Exist: Prop: 2 621 Sheridan Street Port Townsend, WA 98368 Total: 2 PERMIT #: BLD02-00260 Received Date: 5/3/2002 SITE ADDRESS: 1291 E MARROWSTONE RD Forest: Commercial Rural NORDLAND, 98358 MAM OWNER: JOSEPH O FORE JR PHONE: (360)379-1434 1291 E MARROWSTONE RD NORDLAND WA 98358-9678 SUBDIVISION: OLSON & HAMBLETON'S Block: Lot: 48 PARCEL NUMBER: 977700074 Section: 4 Township: 29 N Range: 01 E CONTRACTOR: TERHUNE HOMES INC PHONE: 360-697-7000 PO BOX 97 POULSSO WA 98370 Contractor's License TERHUH1133J7 Expires 4/27/2002 REPRESENTATIVE(SY TERHUNE HOMES PO BOX 97 POULSBO WA 98370 PROJECT DESCRIPTIO? SINGLE FAMILY RESIDENCE TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP NEW VALUATION 143,600.00 MAIN: 1,632 CODE EDITION: 1987 ADD'L: HEAT TYPE: PRO OCCUPANCY: HEAT BASE: HEAT TYPE: R-3 OCCUPANCY: UNHEATED: # OF STORIES: CONST TYPE: OTHER: 5N GARAGE: SHORELINE: CONST TYPE: DECK: 333 SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: OSS WATER SYSTEM: PWELL BEDROOMS: BATHROOMS: Exist: Exist: Prop: 2 Prop: 2 Total: 2 Total: 2 outing Date: Landslide �—L'3 Aquifer Forest: Commercial Rural PARCEL TAGS: YES NO STORMWATER: YES NO AREA Wetland Erosion Seismic Streams Flood Way Floodplain F&W Landslide Shoreline Aquifer Forest: Commercial Rural Type Amount Paid BY: Date: Receipt: Approved/Date Permit $1,240.15 MAM 05/03/02 47609 Plan Check $806.10 MAM 05103/02 47609 C� State Building Code $4.50 MAM 05/03/02 47609 Potable Water Application Total: $50.00 $2,100.75 MAM 05/03/02 47609 io min SITE PLAID` SCALE: 1 " = 20'-0" N" JOSEPH FORE PARCEL # 977-700-074 LOT #48 OLSON & HAMILTON\,SUBDIVISION 1291 E. MARROWSTONE ROAD TERHUNE HOMES LLC 4/21/01 LR V2N, q_ zcl-O2 \ 24'-0„ 3-�y 92'-1" EXISTING 1 20'-0" 24'X30' GARAGE EXISTING li CD z X W i I PROPOSED / 2 BEDROOM RESIDENCE / EXISTING 2 BEDROOM MOBILE TO BE REMOVED � Lrl EXI�fN'� CURTAIN DRAIN — l t TING EXISTING 2 BEDROOM I PRIMARY DRAINFIELD EXISTING RESERVE DRAINFIELD 150' EAST MARROWSTONE ROAD a_ O V) z i va�i3 ri rk 1 Screen: 01 Parcel # 000977700074 Geo Cd 292104203211 OLSON & HAMBLETON'S LOT 48 (S1/2 E1/2 E1/2) LESS R OF W * Taxpayer Cd FORE 0300 FORE JR, JOSEPH 0 * Title Owner Tax Code 0211 Status Tx TAXABLE Affidavit 87970 Vol/Page / Leaal Doc SWD 9/30/99 Taxpayer FOR L Search K � o Mode: INQUIRY Auto Roll' OFF Nbad Cd 3215 UP Chg Dt 10/20/1999 T/P Chg Usr JODI Land Use 1101 MH-REALW/LND C/U Code S/C Cd Amount 75000 IMP JOSEPH 0 FORE JR' 1291 E MARROWSTONE RD NORDLAND WA 98358-9678