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HomeMy WebLinkAboutSWG92-0493 - SWG Application / Design - 8/7/1992 apt$•3 x a.�. E ..`� , MASON COUNTY DEPARTMENT OF HEALTH SEFWIf ES" PERMIT NO. C N SITE EVALUATION DE IGN AND INSTA CATION a m 426 W CEDAR/P.O. BOX 186/SHELTON, WA 98584 Date 7'90� Date W. <: y Receipt No. ` - Receipt No. o w PHONE (206)427-9670 Amount$ Amount$ i.m a, ,4) Del efe ii ! / DATE: f D7�`j CHECK APPLICABLE ITE S ✓ 3 60. MA�,`NG ADDRESS: DAYTIME PHONE: INSTALLING NEW SYSTEM 9 /i/ Q %1YKF CvS�l�'t ?Q REPAIRING OLD SYSTEM STATE: ZIP; EXPANDING SYSTEM v SINGLE FAMILY PROPERTY ADDRESS: L� gr �l I �� OTH SPECIFY: 5 3 SPECIFIC DIRECTIONS FOR LOCATING SITE: PRIVATE WELL x PUBLIC SYSTEM �L i SYSTEM ID NUMBER SYSTEM NAME4.K IN APPLICANT /� NAME Name of Lot x T! ft. MAILING ADD Installer Size: 9 (y acres TELEPHONE K Name of Number o / SIGNAT (20 877-5 45 0 Designer Bedrooms Em rp ee5 X L Q'� PLOT PLAN i Draw a dimensional plot plan, S� including: \ p� ty P o I� ❑Precise location of test �� �i�U ivy holes,showing measured distances to P 9 ��` property boundaries. -9 + 1 •,� r � nt7f' ❑Entry road;other roads, 'C O driveways. ♦� NOTE: DO NOT DRAW IN f," SYSTEM DESIGN OFFICIAL USE ONLY. ONO ITE BELOW DOUBLE LINE. SOIL LOGS j teed- sewe le . ,)2, e r )dk Tit s 5? 144 2ll 1&0G 11e y Depth frorr Original Grade to F estrictive ��22 Layer or ater Table: c 32—In. DESIGNER DESIGNATION SCORES MINIMUM SYS���T///EM REQUIREMENTS r Design:. evel One© �gLevel Two Soil Vertical Separation Septic Tank Daily Capacity: Q Gal. Flow: GPD Slope Appl. Infilt. ept rom ngina Parcel Size : Grad to Bottom of I Rate ®� Gt GPD/FT Area FT' Absoi ption area: D In. Distance to Shoreline r1 Total ` Inspector\ y{ Date COMMENTS/CONDITION FOR APPROVAL Maj -,w UA 1A C��,`�r e�ai i ® WnyL �rench fug ❑Owner/Designer/Installer must meet on site to verity precise system layout ❑Owner must arrange pre-installation conferenceE with health dept.staff ❑Winter observations required ❑Extreme care needed during site preparation to I ireserve existing topsoil Any change from the specified use of the property or any site alteration affecting the system design may invalidate this permit. This Permit expires 3 years from date of issue. Denial of this permit may be appealed to the Health Officer within 10 days of denial date. SITEA: A4 ed tgn Required ❑N DESIGN: ❑Approved ❑Not Approved INSTALLATION:O Ap roved ❑Not Approved BY: DATE BY: DATE: BY: DATE: TOP: Health Dept. Copy MIDDLE: Designer's Copy BOTTOM: Applicant's Copy LFVEF ONE DESIGN FORM - PAGE ONE a.•i.•d 04/22/92 PARCEL IDENTIFICATION Applicant's Name LAKE CUSH SFPTICS Prop. Owner's Namefyfi — jq� anvashL�p�, Address Hoodsport,WA 98548 Mailing R7753At3 Prop. Street Addressn 37 U 4WQ4--w .9 Ci<y �<•_• E1D i=yf Z1v ,{/ Cq7 �rf'Sy� Assessor's Parcel No. / �7'�/.����6 Subdivisio �� � /) �r..•iv-a sai= n.,...n•r> • •/as •/63' noc) A� VL. 7,4 DESIGN PARAMETERS Prosy saw 2� e Z- y • No. Bedrooms 4-51yk Daily Flow 4pd • Soil Type L/ • Septic Tank Capacity Application Rate Y Oro /ft p p y �� gallons 22 d/ft= • Site Character: ZLevel Sloping • Trench/Bed Bottom Area er ft= • Depth from Finished Grade to Top of Septic Tank -------------------------- inches • Depth from Original Grade to Bottom of Absorption Area at aide Edge -- inches • Depth from Original Grade to Bottom of Absorption Area at DaryaRPONWige ---- inches r/ • Depth of Cover over Absorption Area -----------------------------------�2— j< inches • Elevation Difference Between Building Sewer %� ft � (tie r —` Stub-Out and Fixed Reference Point -------x-----tit ------------- inches .� le of T $— • Building Sewer :Stubout is ❑Higher Lower than Fixed Reference Point • Reference Point Location: DESIGNER COMMENTS AND CONDITIONS eCo/Z1�YI6Z f i er .5yr7`� /A) 33 sA-,�S ;eoGK ,-- P,r,pe, Lrive. 7Tf> u. ,7yL S/OPT Aka 77* fq,� kee-lce 4� To tlgr/e j LXWEL ONE DESIGN FORM — PAGE TWO Poised 04/22/92 - -PLOT PLAN . .. . - . . . 1 . \. . OI. a �� . . - - . . . . . . . . . . C � . . . . - 1} �. . �i _ . 0 . . . . . . . . . . . . . 114. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .X . . . . . . . . .y� . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . sI . . . ./ . . . . . . . . . . . b. DESIGNER PLOT PLAN CHECKLIST Scaled plot plan if lot is under } acres Location and dimensions of reserve area Existing and proposed wells, including Buildings, roadways, easements, parking wells within 100 ft of property lines Property lines opographical features, cuts, banks El— Direction and percent of s ope Location and orientation of curtain �-7� drain & all absorption area components 91. Building stub-out LEVEL ONE DESIGN FORM - PAGE THREE Rai& a 04/22/92 DRAINFIELD LAYOUT DETAIL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Z. .. . . . . . . . . . . . . . . . . . . / . : . . . . . . . . . V.. ^,�. . . . . . . . . . . . . . . . . . . . . . - - - - - - - • - . . - - . � . . . . . . . . . . . . . . "t Pe - - - - - - - - - - - - - - - - - - - - • - - - - - - - - - - - - - - - - - • - - - - - - . . . . . . . . . - - - • - • . . . - - - - - • - - - - - - • - - , . L4,+ DRAINFIELD LAYOUT DETAIL CHECKLIST EV-Lateral placement within bed Flow splitting details LWvrEL ONE DESIGN FORM - PAGE FOUR Pwi.ed 04/22/92 SYSTEM CROSS-SECTION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . T� . . . . . . . . . . . . : z . . . . . . . . . . . . - . : . . . . . - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - CONDITIONS AND UNDERSTANDINGS The undersigned agree not to hold Mason county Department of Health responsible in the event the system installed in accordance with this design failoo ooperat a requir d by Mason Coun Ith Code G¢/ a len�aurw et vale .n� alonwsurw er c�.se`w7r Designer waives requirement to be notified of instal a�,d ou pect the prior to final cover: El LL Yes No e len.eur. oc ow.lan.r The undersigned has viewed and approved The undersigned certifies the ystem has this sign on behal Mason County been instaLled in full accordance with this o ea h Serv'c s. r desi Xww Sn.p�o ov Sn.<w11ar