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Home My WebLink AboutSWG2023-00038 - SWG Application / Design - 2/10/2023 MASON COUNTY 415 N 6TH STREET,SHELTON,WA 98584 SHELTON:360-427-9670,EXT 400 I. BELFAIR:360-275-4467,EXT 400 Public Health & Human Services ELMA:360-482-5269,EXT 400 FAX:360-427-7787 On-Site Sewage System Permit: SWG2023-00038 APPLICANT TANSEY MARK Phone: Address: 410 NE 103RD ST APT 6B KANSAS CITY, MO 64155 OWNER . TANSEY MARK Phone: Address: 410 NE 103RD ST APT 6B KANSAS CITY, MO 64155 SEPTIC DESIGNER PIONEER DIGGING INC Phone: 360-426-1803 Address: 3083 E MASON BENSON GRAPEVIEW, WA 98546 Site Address: 251 E Emerald Lake Dr W Primary Parcel Number: 321245200031 Permit Description: New SFR-3BR Gravity w/ local waiver Permit Submitted Date: 02/10/2023 Permit Issued Date: 02/21/2023 Issued By: Jeff Wilmoth Current Permit Fees Paid: $525.00 (additional fees may be required upon installation of system). Permit Expiration Date: 02/16/2026 (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 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 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. OFFICIAL USE ONLY MASON COUNTY DATE RECEIVED .el % ' �� x. II. IV COMMUNITY SERVICES AMO , REC•Clin j o Cn Public Health(Community Health/Environmental Health) ' G cn corn 360-427-9670,eat.400 or 360.275 4467,eat.400 SWG 415N.6thStreet Shelton,WA 98584 S`(`/1 ' l `- Z 53 ON-SITE SEWAGE SYSTEM APPLICATION cii › 1- m n APPLICANT PFO\E m r MARK TANSEY z c MAILING ADDRESS-STREET,CITY,STATE,ZIP CODE g 410 NE 103RD ST APT 6B KANSAS CITY MO 64155 m xi SITE ADDRESS-STREET.CITY.ZIP CODE 251 E EMERALD LAKE DR W SHELTON WA 98584 I co NAME OF DESIGNER PHONE I N ROBERT H. PAYSSE 360-426-1803 NAME OF INSTALLER PHONE v PERMIT TYPE(select one) C DRINKING WATER SOURCE - N IW-RESIDENTIAL OSS COMMUNITY OSS 1 I COMMERCIAL OSS El PRIVATE INDIVIDUAL WELL 5 PRIVATE TWO-PARTY WELL z I 1IP l TYPE OF WORK(select one) PUBLIC WATER SYSTEM EMERALD LAKE 1 I NEW CONSTRUCTION/UPGRADES Fl REPAIR/REPLACEMENT OTHER DETAILS(select all that apply) 0 TABLE IX REPAIR I Ul SUBMITTALS CISURFACING SEWAGE 0 EXISTING FAILURE 0 SHORELINE MI Itrt DESIGN FORM(REQUIRED) lir SEPTIC DESIGN(REQUIRED) BEDROOMS LOT SIZE O I N tb WAIVER(S)(IFAPPLICABLE) 3 0.36 0 I 1 DIRECTIONS TO SITE AND SITE CONDITIONS.(ex.locked gate) 0 NORTH HWY 3. LEFT ON MASON LAKE ROAD. FOLLOW TO EMERALD LAKE AND I o TURN RIGHT ON EMERALD LAKE DRIVE. TAKE 1ST RIGHT ONTO EMERALD LAKE r IQ DRIVE WEST. FOLLOW TO SITE ADDRESS 251 ON LEFT. GREEN RIBBONS AND PDI o SIGN POSTED. I w • SITE MUST BE FLAGGED FROM MAIN ROAD AND TEST HOLES MUST BE FLAGGED WITH TEST HOLE NUMBERS. I OFFICIAL USE ONLY BELOW THIS LINE UPGRADE I FAILURE SOURCE(for reporting purposes) ❑VOLUNTARY 0 MAINTENANCE/PUMPING 0 BUILDING PERMIT ['HOME SALE ['COMPLAINT El OTHER: INSPECTOR SOIL LOGS COMMENTS/CONDITIONS _ ( e-2/„. /C., /- O -2L 8 1 Q 2aZ3 2 Y - 6 ZS 6--M- Bv SOIL CODES: RECORD DRAWING AND INSTALLATION REPORT V=VERY G=GRAVELLY S=SAND L=LOAM Si=SILT C=CLAY E=EXTREMELY R=ROOTS REQUIRED FOR FINAL APPROVAL. INSP TOR SIGNATURE // DATE APPLICATION EXPIRATION DATE AP LI TION APPROVED/ISSUED BY DATE r�l' CJ ` 2-4-23 Z- l C�--Z 1Ctillikira2-2( 3 �7-THI FtMAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE REVISED 12/7/2015 DESIGN FORM—PAGE ONE Assessor's Parcel Number: 3 2 1 2 4 — 5 2 — 0 0 0 3 1 A design will be reviewed when 3 copies of each of the following are submitted: Completed design form that has been signed and dated. '°Scaled layout sketch,including all applicable items on checklist '0 Scaled plot plan,including all applicable items on checklist. '"Cross-section sketch,including all applicable items on checklist. This form may be scanned and available for public view on the Mason County Web site.Maximum paper size: /i"X i?" PARCEL IDENTIFICATION Permit Number: SWG 20,2-3' 00°3$ Designer's Name: ROBERT H.PAYSSE Applicant's Name: MARK TANSEY Designer's Phone Number: 360-426-1803 Mailing Address: 410 NE 103RD ST APT 6B Designer's Address: 3083 E MASON BENSON RD KANSAS CITY MO 64155 GRAPEVIEW WA 98546 City State Zip City State Zip DFSIGN..PARAMETERS . Treatment Device ❑Glendon Biofilter 0 Sand Filter 0 Mound 0 Sand Lined Drainfield 0 Recirculating Filter,Type: ❑Aerobic Unit Make/Model 0 Disinfection Unit Make/Model Other: Drainfield Type 'Gravity 0 Pressure G 'Trench 0 Bed 0 Sub Surface Drip Septic Tank/Drainfield Specifications Laterals Number of Bedrooms THREE Schedule/Class 2729 Daily Flow:Operating Capacity 270 gpd Length 50 ft Daily Flow:Design Flow 360 gpd Diameter 4 in 1 Septic Tank Capacity(working) 1500 gal Number 3 Receiving Soil Type(1-6) 3 Separation 9+ ft Receiving Soil Appl.Rate 0.8 gpd/ft2 Orifices Required Primary Area 450 ft2 Total Number of Orifices - Designed Primary Area 450 ft2 Diameter - in Designed Reserve Area 450 ft2 Spacing - in Trench/Bed Width 3 ft Manifold Trench/Bed Length 150 ft Schedule/Class 3034 Elevation Measurements Length 18 ft Original Drainfield Area Slope 15 % i et 4 in New Slope,If Altered 15 % tor ranijfo c I: i n used? 171Yes 0 No , Depth of Excavation Up-slope 17 i B 2D23 sport Pipe from Original Grade Down_slope 11 i Sc a3 ule lass 3034 Designed Vertical Separation 48-53+ ;t{NASON cagag ENVIRONMENTAL HEALTI I <50 ft Gravelless Chambers Required? ❑Yes No 0 Optional Diametd 4 in Pump Required? Ei0.1 Yes 0 No Dosing and Pump Chamber Pump/Siphon Specifications Number of doses/day - Diff.in Elevation Between Pump&Uppermost Orifice - ft Dose quantity - gal Drainfield Squirt Height/Selected Residual(head) - ft Chamber Capacity(flood) - gal Uppermost Orifice 0 Higher 0 Lower than Pump Shutoff Pump controls:Please check those required. Capacity @ Total Pressure Head - gpm ❑Timer ❑Elapse Meter 0 Event Counter Calculated Total Pressure Head - ft If Timer: Pump on - ,Pump off - Comments DESIGN FORM—PAGE TWO Assessor's Parcel Number: 3 2 1 2 4 -- 5 2 -- 0 0 0 3 1 Permit Number: SWG DESIGN CHECKLISTS Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch liti Test hole locations g Drainfield orientation and layout Reference depth from original grade: B1 Soil logs Lif Trench/bed dimensions and lig Septic tank Eg Property lines critical distances within layout 12f Drainfield cover iti Existing and proposed wells lif D-Box/Valve box locations Reference depth from original grade within 100 ft of property Eif Septic tank/pump chamber and restrictive strata: 0 Measurements to cuts,banks,and locations lif Laterals,trench bed,top and surface water and critical areas 0 Observation port location bottom 1 Location and orientation of 1 Clean-out location 0 Curtain drain collector curtain drain and all absorption Manifold placement 0 Sand augmentation components Eli Orifice placement Other cross-section detail: lid Location and dimension of Lateral placement with distance C>� Observation ports/clean-outs primary system and reserve area to edge of bed Buildings g Other Information lZilif Audible/visual alarm referenced Yes No it Direction of slope indicator Ig Scale of drawing shown on scale d 0 Designstaked out 0 Waterlines bar 0 Er Recorded Notices attached 1 Roads,easements,driveways, lif 0 Waiver(s)attached parking y APPROVED ❑ g Pump curve attached o 0 Evaluation of failure 1 North arrow and scale drawing shown on scale bar FEB 2 1 2023 Non-residential justification MASON COUNTY ENVIRONMENTAL HEALTH ❑ lI Waste strength -Igw ❑ It Flow DESIGN APPROVAL The undersigned designer must be notified by install at time of installation Yes 0 No V-z-4J if otiA4L z( '4v( 23 Signature of Designer Date The undersigned has reviewed this design on behalf of Mason County Public Health and determined it to be in compliance with state and local on- ' e regulations: Env' o ntal Health Specialist Date CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CONDITION: ✓ The design is stamped"Approved"by Mason County Public Health. / The Onsite Sewage Permit has not expired,the Permit Expiration Date is: 2.4 2 61 / Drainfield site conditions have not been altered to adversely affect conditions of design approval. Please Note: The system must be installed by a certified installer, unless prior authorization is obtained from Mason County Public Health. An Installation Fee is required. This form may be scanned and available for public view on the Mason County Web site. Updated Date: 12/7/2015 EMERALD LAKE DRIVE WEST 3--PROPOSED � WATERLINE in tt tt I PROPOSED I I BUIDLING I AREA I ° L - - - - - - - � ° -`�� 10' FOUNDATION PROPOSED -moo SETBACK TO DF SEPTIC TANK odd��d�� d� PROPOSED I DRAIN FIELD lP m PPROVE rn I I > FEB 21 2023 m I`I'4N COUNTY ENVIRONMENTAL HEALTH To \____ Jaw s. APPROX. OHWM —\.... - - - — — — — — E � P•cRO6ERiC07i7 YSSE �� D lAK T - EXPIRES AN ASBUILT/INSTALL SIGNOFF FEE WILL • I 42) BE CHARGED AT TIME OF INSTALLATION PIONEER DIGGING INC. CUSTOMER: MARK TANSEY 0-T64 I TEST I TOLL L PARCEL# 32I2452-00031 0 4 S ROOTS ROOTS TO 64 ROOTS TO 64 SEPTIC DESIGNS ADDRESS: 251 EMERALD LK DR W 3083 E MASON BENSON RD. GRAPEVIEW,WA L 85* DESIGNER: ROBERT H.PAYSSE DISCLAIMER:THIS IS NOT A SURVEY.REFERENCES INCLUDE APPLICANT/COUNTY PROVIDED PUNTS OR SURVEYS.FIELD MEASUREMENTS ATCI COUNTY GIS.DESIGN INTENDED FOR SEPTIC OFFICE•360 426 I803 FAX 360 427 2353 SHEET: SITE PLAN SCALE "=30' PURPEPS ONLY PROPOSED DEVELOPMENT MAY BE SUBJECT TO OIRER o ARTMENT/AGENCY REVIEW ESIGNER NOT RESPONSIBLE FOR SETBACKS UNRELATED TO SEPTIC COMPONENTS CLEANOUT AN ASBUILTI INSTALL SIGNOFF FEE WILL BE CHARGED AT TIME OF INSTALLATIONIn /7- ° SEPTIC TANK NpATION SETBACK - - - - - - - FOU 0 7 t_TI 8 O "Q I O DIsr. BOX i - m i �� - 5, i.;..sri_,..,s _ii re ri i r rim,f00////_//aatiggllA----------.,._---- -."---.----15'-----CL----- ----e ., ,, . . 0 - -gaisiii:01;iviii_irierrovrivasissaiiiiiiii____ ��--.< OB PORT ... A ,......._,... ____.,-,_,, , sot _ ___ -- ------,„ jilli - --7----;-7-'7 -iL- 1 .-- ---- --; .__ _1 e I 1 ow ti ..� FINAL FILTER I FABRIC I 41, D« ,. v ' ORIGINAL .. .._.._..:_..:_..._.. -- Fbrz .fz v / ROBERT7.4 PAYSSE 'N`. r-- '•�_•t� � •=•:•i•i•=,i•; ��' ��. RISER OR VALVE BOX •-_•- -•=�= -• EXPIRES TO FINAL GRADE -� �� 010 �1� � � ,: OB PORT D 1ST. BOX 11.... -.1-11 I ,.I PPROVED co J I ' FEB 2 1 2023 / MASON-COUNTY ENVIRONMENTA.HEALTH SPEED LEVELERS \ / JBW I REST LgYER 1 ADJUST TO # OF LATERALS PIONEER DIGGING INC. CUSTOMER: MARK TANSEY 0-64 HOLE I: TEST HOLE 2 PARCEL# 32124 52 0003I GLS 0 64 GLS ROOTS TO 64 ROOTS TO 64 SEPTIC DESIGNS ADDRESS: 251 EMERALD LK DR W w 3083 E MASON BENSON R.D. GRMEVIEW,WA 98546 DESIGNER: ROBERT H.PAYSSE DISCLAIMER SURVEYS FIELD MT A EURVEY.EASURE�.EMS REFERENCES COUNTY GiS oDEES`GIINTE�NDED FORSEPTITICC PURPOSES ONLY PROPOSED LOPMENT MAY BE SUBJECT TO OTHE OFFICE.-360-426-1803 FAX-360-427-2353 SHEET: DF DETAIL SCALE I"=10' OEFAARTMENTIAGENCY RENEW DESIGNER RNNOT RESPONSIBLE FOR SETBACKS UNRELATED TD SEPTIC COMPONENTS I .1 .2_ . • Z I- 7 I U 41../ . - - Z ezZ kr% an , ._ . • . }- z ,.., ,_ Z I • • - 4 . •. v• 0 . : •• CZ i•-• 0 7 w >1, ,. 16.1/4,, __I Li../ 0 Z li- I- 0 4 w ii vl 2 /7-- Ob L.) tz n ce7. , .. .• .A..:1--, cr) ._.... w — T ... .2 -.1.1 0LLI ._.I (..) 0 ce CI Li I . . ..• 0 `.° 0 ;5_ i- IN- ..•:. I IIT.; 1 j)L..? ... I 'A ,.... U Z !--• LL.1 1± 2 > •:: H < Q Cr; Lu p < < ,•..•••• T cz i_... < 1— z ...... 1- . I-- U cyl•• Cc2 j2 Z 7(' Z - •-:. :. •• i--• (L) < y. Ll) 1-- a ..... .•• o ,e H m ..4 L.L1 zee . 0 ..,. ... • .' immi.. 1 co .., u..! , .. .i..' w . I- . L.1.J a >a • rz4 ... -_I tz < .., < U < ;2 cr_. .: •.: w . 0 CD. u7 co RI .1- cc •.-• .. 0 -.; . r•I CC' L) Fi .A. ce CZ I :_ C-.) U cr) ••..., Lf) 0 ,-,-; ce Z •- - .0-..:' - \-- N • . ,- Upgt ... __tL, I- I as- 3 PRO itt IMI •.‘yuAlry z-,,, 2023 ,- Z c, <en f: . 1‘411ENTAZ Ai (5 Le.ire a •::. ,y •:!•`.•'4.. . .*_; -•:... • • ..- - jaa 14, "EAL 7* •- f :I • 7 < , L./ Z --. < ., }— .... f•• b, 1 --Elf [ . ...____, i z (7 .,..... , - :•: ..-.•.•:. Slii .,..".:....:"...:-. -;. .•r• t. iii p 0 u..I i -• - 2 eq Z LI- < —J < I— - 1....e u 1.-- 61 U6 Z •<., Z.• 0 Z < . ,.. ,. 4' 1.1.-- , Installation & System Notes 1. Installer must contact designer for final inspection of the installation prior to cover. All components, including tanks, lids, transport line,drainfield,and water lines must be open for inspection. A$300.00 fee will be charged for time involved with the inspection of the installation and creation of the record drawing. The designer reserves the right to charge additional fees if multiple visits are needed due to installation errors or inaccessible components. 2.This septic design must be installed by a certified installer with the local health department. All components shall be installed according to state,county, and manufacturer requirements. For Homeowner Installs,the owner must get approval from the designer and local health department prior to attempting installation. 3. Designer is not a surveyor. Installer must familiarize themselves with property line locations prior to installation. Any confusion or conflicts with line locations should be reported to the property owner. A licensed surveyor may be necessary prior to installation to confirm all line locations. Any discrepancies found must be reported to the designer immediately. 4. Drainfield area may only be cleared by a licensed installer familiar with sensitive drainfield area preservation. The builder, lot developer, or property owner shall not clear the drainfield area. Any clearing required for drainfield installation shall not remove or disturb any top soil in Primary and Reserve areas. Removal or disturbance to drainfield soils could render design void. S. The property owner and installer are responsible for locating all underground utilities (ex. water,gas, electric) prior to installation. Any utility locations shown within design drawings are likely approximate and may not be exact. 6. All proposed tanks must be installed on original soils or compacted gravels. Extend all tank connection lines out onto original soil to avoid settling issues. Risers and lids must be brought to finished grade and left accessible for future operations and maintenance. Component manufacturers (ex.ATU, Glendons,) may have other requirements not listed within this design. 7. All electrical wiring shall be done by a licensed electrician or homeowner(if allowed) and must be permitted through Labor and Industries. 8.The proposed septic system should be installed in dry weather conditions. Any failed attempts at installation during wet weather conditions may render this design void. 9. Maintain 10ft to waterlines with all septic components. If less than loft is required,sleeving in sch.40 pvc is required. If sewage transport lines and waterlines must cross,waterline must be 18" above sewage line with one of the lines sleeved in sch. 40 pvc loft in each direction of crossing. 10.This design may include waiver applications with specific mitigation measures pertaining to installation,operation and maintenance of the proposed components. 11. Stormwater runoff,footing drains, roof drains must be diverted away from any septic system components. No curtain, foundation, perimeter drains shall be installed 30ft downslope and loft upslope of drainfield areas. 12.This design is site specific and intended to meet state and county requirements that are related to the system components being proposed. Any placement of proposed buildings, proposed wells or other non-related items on these drawings may or may not meet other requirements. 13. All onsite septic systems require regular maintenance to verify satisfactory operation. The system owner/operator is responsible for the continuous operation and maintenance of the system per WAC 246-272A. For operation and maintenance information, refer to Mason County Public Health Homeowner's Manual,which should be received after installation approval. 14. System owner should be cautious of landscaping ar• nd septic components. Root intrusion can cause premature failure of the drainfield area. Ini, h uld be kept 1+ away from lids and other septic maintenance points. FEB2 12023 MASON COUNTY ENVIRO N!MENTAL H JO LTH � v, ;, PIONEER DIGGING • USTOMER: MARK TSEY . � • ; . . • PARCEL# 32124 52-00031 c: EceEn Tr31 e pAissE SEPTIC DESIGNS ADDRESS: 251 EMERALD LK DR W +I >� wi��i 3083 E MASON BENSON RD. GRAPEVIEW,WA 98546 DESIGNER: ROBERT H.PAYSSE EXPIRES OFFICE-360-426-I803 FAX-360-427-2353 SHEET: NOTES SCALE: NA