HomeMy WebLinkAboutSWG2022-00411 TANK ONLY - SWG Application / Design - 7/19/2022 r
415 N 6TH STREET,SHELTON,WA 98584
�, MASON COUNTY SHELTON:360-427-9670,EXT 400
I I
COMMUNITY SERVICES BELFAIR:360-275-4467,EXT 400
ELMA:360-482-5269,EXT 400
j Building,Planning,Emr"raimenWl Health Communily Heal th FAX:360-427-7787
On-Site Sewage System Tank Only Permit: SWG2022-00411
OWNER PLATT J DANIEL Phone:
Address: 4328 MURPHY DR GIG HARBOR, WA 98335
APPLICANT PLATT J DANIEL Phone:
Address: 4328 MURPHY DR GIG HARBOR, WA 98335
SEPTIC INSTALLER DON WOOLLISCROFT B-Line Phone: 360-426-4221
construction
Address: 2971 E PHILLIPS LAKE LOOP ROAD SHELTON, WA 98584
Site Address: 180 E GRAPEVIEW POINT RD
Primary Parcel Number: 121055117005
Permit Description: Replace septic & pump tanks
Permit Submitted Date: 07/19/2022
Permit Issued Date: 08/04/2022
Issued By: Luke Cencula
Current Permit Fees Paid: $240.00 (additional fees may be required upon installation of system).
Permit Expiration Date: 08/04/2023 (based on date of inspection)
Type of Work Other
Components being Replaced: Septic and Pump Tanks
Surfacing Sewage? No Existing Failure? No
Shoreline? No Horizontal Setbacks Met? Yes
Number of Bedrooms: 2 Drinking Water Source: Private Well/Spring
Additional Details: Septic & pump tanks
Permit Conditions:
2 Permit must be installed by a Mason County Certified Installer unless prior written
authorization from Mason County is obtained.
4 Proposed development subject to zoning requirements and approval by the planning
department staff per Mason County Title 17.
3 Mason County Asbuilt Form, Record Drawing, and Installation fee must be submitted for
final installation approval.
1 Horizontal setbacks per WAC246-272A-0210 must be maintained, unless prior approval is
obtained
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 CONDITIONSAPPROVED.
CHANGED SINCE THE SITE WAS INSPECTED AND/OR DESIGN
FINAL INSTALLATION APPROVAL IS REQUIRED PRIOR TO TEMPORARY OR FINAL OCCUPANCY OF ANY RELATED STRUCTURES.
For Final Inspection visit: www.co.mason.wa.uslhealth/environmental/onsite/oss-inspection-request.php or call:
360-427-9670, extension 400.
OFFICIAL USE ONLY -
� Q DATE RECEIVED:
��- I. . MASON COUNTY • U . 2 g
'r., COMMUNITY SERVICES I AMO v: : r OF. co 0
O • ..�' to m
y Public Health(Community Health/Environmental Health) C
e' naoazr•oazo.e=t.a000.aao-z7saaaz,ext.aoo 09
:' SWG - f
' U)
415 N.ath Street ShMtort WA 98584 I
z di
ON-SITE SEWAGE TANK ONLY APPLICATION > en
E AP
APPLICANT PHONE m m
DANIEL PLATT 253-227-0133 z
MAILING ADDRESS-STREET.CITY.STATE,ZIP CODE C
E
4328 MURPHY DR NW, GIG HARBOR, WA. 98335 m
SITE ADDRESS-STREET.CITY,ZIP CODE73
180 E GRAPEVIEW POINT RD, ALLYN, WA. 98524 I �'
NAME OF DESIGNER PHONE I k)
NAME OF INSTALLER PHONE I''''
D
B-LINE CONSTRUCTION, INC. 360-426-4221
TYPE OF WORK(select one) DRINKING WATER SOURCE co Ia
B NEW CONSTRUCTION/UPGRADES ElREPAIR/REPLACEMENT 0 PRIVATE INDIVIDUAL WELL 0 PRIVATE TWO-PARTY WELL 5
Iitp1
COMPONENT(S)TO BE REPLACED/INSTALLED 0 PUBLIC WATER SYSTEM
t
1 SEPTIC TANK IR PUMP TANK CIRV HOLDING TANK BEDROOMS LOT SIZE
❑ OTHER 2 30'X396'X847'X477'
co
OTHER DETAILS(select all that apply) TANK(S)SETBACK CHECKLIST
n
❑ SURFACING SEWAGE 0 EXISTING FAILURE 0 SHORELINE ❑ 100FT+PUBLIC/COMMUNITY WELLS
SUBMITTALS ❑ SOFT+PRIVATE WELLS,SURFACE WATERS,STREAMS,RIVERS
❑ PLOT PLAN(REQUIRED) 0 TANK CROSS SECTION(REQUIRED) 0 10FT+DRINKING WATER SUPPLY LINES leNJ
❑ PUMP DETAILS(IF APPLICABLE) 0 WAIVER(S)(IF APPLICABLE) 0 5FT+PROPERTY/EASEMENT LINES,FOUNDATIONS,FOOTINGS
PLOT PLAN CHECKLIST o I O
❑ PROPERTY LINES AND EASEMENTS 0 EXISTING!PROPOSED STRUCTURES ❑ EXISTING/PROPOSED OSS COMPONENTS AND LINES -I
❑ WELLS WITHIN 100F7 0 WATER SUPPLY LINES 0 DRIVEWAYS/PARKING ❑ SURFACE WATERS,STREAMS,RIVERS.ETC... I C.
❑ DIRECTION OF SLOPE/CONTOURS ❑ PERIMETER/CURTAIN DRAINS ❑ NORTH ARROW ❑SCALE BAR
DIRECTIONS TO SITE AND SITE CONDITIONS:(ex.locked gale) I 1
TAKE HIGHWAY 3, TURN RIGHT ONTO GRAPEVIEW LOOP ROAD, TURN RIGHT ON
TREASURE ISLAND ROAD, TURN LEFT ONTO GRAPEVIEW POINT RD. RESIDENCE
IS ON THE RIGHT SIDE OF THE ROAD.
—� _� OFFICIAL USE ONLY BELOW THIS LINE
UPGRADE/FAILURE SOURCE(for reporting purposes) �-
0 VOLUNTARY ❑MAINTENANCE/PUMPING 0 BUILDING PERMIT CI HOME SALE OCOMPLAINT ❑OTHER: ;-- ,221 r
COMMENTS/CONDITIONS it if- I 9 2022 r
US! .1st. f0'-'po L `
SEWAGE TANKS MUST BE LISTED UNDER DOt- LIST OF REGISTERED SEWAGE TANKS". TANKS MUST MEET CURRENT MINIMUM
SIZE REQUIREMENTS,EQUIPPED WITH RISERS
AND LIDS TO SURFACE,AND INCLUDE AN EFFLUENT FILTER(IF APPLICABLE). RECORD DRAWING AND INSTALLATION REPORT REQUIRED FOR FINAL APPROVAL.
INSPECTOR SIGNATURE DATE APPLICATION EXPIRATION DATE APPLICATION APPROVED!ISSUED BY DATE
THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBS/ REVISED 12/7/2015
vraK.Tv\ Z't. _
.. 0—y Ov 6i-..--*
o {r7 sn,.,:.,� L2 �
A t� I° n 4-i, 0 7`
. a0.,
to . 1C''kik 0
ifr.., 5;k —,- i
• •A,110F
irc,-,-i:. /•``�`h, I. b g
in 0 o m� q h% 01
\ • �1o,rNrq*s .R11, '
\ On••
•
D . i 0I D—�
1 '.
•
• 'n� _.,
u APPROVED
• j AUG 0 4 2022
``� ENVIRONnENTPt��``
11 / - sore COUNTY ,rc
/p.
�-
ci /
o
..-ii rf----- -4 ,< .
av
L._1;\___
P
p f itp14<,c reelf 1, f p4'a'I�
•
r a/
//// %
l',J,u k, t,i. '12012.rd/
v
•
Printed From. Mason County - S
Printed r"rorn Mason County DMS
p.,. ... ., ,
4- - •
1250SR & 1250SR—HW
tE r
,..,:
I
1-`1 116" 4a-1
Fil . 72" 1- a---- 36" ---1-F
I
I I
I I I
_i_ II Ct It I.
TOP VIEW II
t 0 1
1 \s,...........} 68"
4" II 1
3" IAPPROY D
i_
'AS
ON COUNTY ENVIRONNIENIA.k0C%
Sm-e401 i'c / Qdtik,
24 ORENCO TANK ADAPTERS
4' CAST-A-SEAL GASKET
-,, ,,,.,
i - L .
..., 4' PVC BAFFLE 4"
4"
.'
FLOOD CAP. 64
FLOOD CAR 1036 GALS. 504 GALS.
55 1 /2'
11 52- 1 /2"
30"
7
3"
APFROX. WEIGHT 1 1 ,000 LBS.
1500P & 1500P—HIV
,, a
".-..�,;.. 1585 GAL. FLOOD CAP.
v ... .
'IPhfra 110" _,7
i 4
TOP VIEW 24' 18" 72„
i 66„
4" 6"
I jo
IP IP., Rd\l„k
Ok 0•\:
_P'` J
�Nv`P0
3 0,,cool vac
SAS
Puy) 1afruk
6' PV PORT 24' ORENCO TANK ADAPTER MASTIC
4- CAST-A-SEAL GASKET 1\Tr I
\i'
e
4"
27,8 GALS. PER/INCH
52- 1 /2"
64"
J______ 3' 4
v I
APPROX. WEIGHT 12 ,000 L3S.