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Home My WebLink AboutSWG2022-00131 TANK ONLY - SWG Application / Design - 3/18/2022 ""'�i':• 415 N 6TH STREET,SHELTON,WA 98584 .s. MASON COUNTY SHELTON:360-427-9670,EXT 400 VI I. COMMUNITY SERVICES BELFAIR:360-275-4467,EXT 400 ELMA:360-482-5269,EXT 400 Budding,Planning,Ennnonmental Health,Community Health FAX:360-427-7787 On-Site Sewage System Tank Only Permit: SWG2022-00131 OWNER KRUGER RONALD E Phone: 206.786.5713 Address: 15689 YOKEKO DR ANACORTES, WA 98221 APPLICANT KRUGER RONALD E Phone: 206.786.5713 Address: 15689 YOKEKO DR ANACORTES, WA 98221 SEPTIC INSTALLER TJ Goos-TJ's Excavating Phone: 360-490-0217 Address: 150 E MARISA PL SHELTON, WA 98584 SEPTIC DESIGNER DALE TAHJA-Septic Designer Phone: 360-426-5940 Address: 2450 W DEEGAN ROAD WEST SHELTON, WA 98584 Site Address: 10 N POTLATCH DR Primary Parcel Number: 423075000049 Permit Description: Tanks for SWG2020-00670 Permit Submitted Date: 03/18/2022 Permit Issued Date: 03/22/2022 Issued By: Luke Cencula Current Permit Fees Paid: $240.00 (additional fees may be required upon installation of system). Permit Expiration Date: 03/22/2023 (based on date of inspection) Type of Work OSS New Construction 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: Public Water System Additional Details: Septic and pump tanks Permit Conditions: 2 Permit must be installed by a Mason County Certified Installer unless prior written authorization from Mason County is obtained. 3 Mason County Asbuilt Form and Record Drawing must be submitted for final installation approval. 1 Horizontal setbacks per WAC246-272A-0210 must be maintained, unless prior approval is obtained 4 Proposed development subject to zoning requirements and approval by the planning department staff per Mason County Title 17. 5 1,200 gal septic tank & 1,000 gal pump tank per SWG2020-00670. 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/OR DESIGN APPROVED. FINAL INSTALLATION APPROVAL IS REQUIRED PRIOR TO TEMPORARY OR FINAL OCCUPANCY OF ANY RELATED STRUCTURES. For Final Inspection visit: www.co.mason.wa.us/health/environmental/onsiteloss-inspection-request.php or call: 360-427-9670, extension 400. OFFICIAL USE ONLY MASON COUNTY DATE RECEIVED3 I .. \ 1 u� D COMMUNITY SERVICES ^� RECEIVE • C ✓ m Public Health(Community Health/Environmental Health)0 ' C N 360-427-967D.ext.400 or 3G0-2754/67,tort 400 SWG /� �\ Ei5415 N.6lh Street•Shelton,WA 98584 —) ,.J ) O ) '3 0 73 1`�I` /� Z di ON-SITE SEWAGE TANK ONLY APPLICATION 3 m n APPLICANT PHONE m r Ronald E. Kruger (206) 786-5713 r c MAILING ADDRESS-STREET,CITY,STATE,ZIP CODE . 3 CD 15689 Yokeko Dr., Anacortes, WA 98221 m SITE ADDRESS-STREET,CITY.ZIP CODE C 10 N. Potlach Dr. N., Hoodsport, WA 98548 NAME OF DESIGNER PHONE 3 I N Dale L. Tahja (360)426-5940 NAME OF INSTALLER PHONE O I CA) T.J. Goos _ (360)490-0217 < TYPE OF WORK(select one) DRINKING WATER SOURCE I O ❑ NEW CONSTRUCTION/UPGRADES III REPAIR/REPLACEMENT 0 PRIVATE INDIVIDUAL WELL 0 PRIVATE TWO-PARTY WELL Z ,v COMPONENT(S)TO BE REPLACED/INSTALLED 0 PUBLIC WATER SYSTEM I © SEPTIC TANK III PUMP TANK 0 RV HOLDING TANK BEDROOMS LOT SIZE N I Cn ❑OTHER OTHER DETAILS(select all that apply) TANK(S)SETBACK CHECKLIST O I Q ❑ SURFACING SEWAGE ❑EXISTING FAILURE IN SHORELINE 0 100FT+PUBLIC/COMMUNITY WELLS 6 1• 0 SUBMITTALS 0 50FT+PRIVATE WELLS,SURFACE WATERS,STREAMS,RIVERS N PLOT PLAN(REQUIRED) ® TANK CROSS SECTION(REQUIRED) 0 10FT+DRINKING WATER SUPPLY LINES III PUMP DETAILS(IF APPLICABLE) 0 WAIVER(S)(IF APPLICABLE) ❑ SFT+PROPERTY/EASEMENT LINES,FOUNDATIONS,FOOTINGS PLOT PLAN CHECKLIST - 6 I 0 EN PROPERTY LINES AND EASEMENTS ® EXISTING/PROPOSED STRUCTURES ■ EXISTING/PROPOSED OSS COMPONENTS AND LINES —I III WELLS WITHIN 100FT III WATER SUPPLY LINES ® DRIVEWAYS/PARKING ® SURFACE WATERS,STREAMS,RIVERS,ETC... I - ® DIRECTION OF SLOPE/CONTOURS M PERIMETER/CURTAIN DRAINS • NORTH ARROW III SCALE BAR CO I DIRECTIONS TO SITE AND SITE CONDITIONS:(ex.locked gate) co North on Hwy 101, left at Lake Cushman Rd., left at Big Creek, left ay Mt. Tebow Way, cross N. Potlach Dr. N., driveway straight ahead. OFFICIAL USE ONLY BELOW THIS LINE UPGRADE I FAILURE SOURCE(for reporting purposes) ❑VOLUNTARY 0 MAINTENANCE/PUMPING ❑BUILDING PERMIT OHOME SALE OCOMPLAINT ❑OTHE n re (z n COMMENTS/CONDITIONS 1 f r h q j5 S�(--- ')-C)?-C - o v�-7 o V BY— SEWAGE TANKS MUST BE LISTED UNDER DOH'LIST OF REGISTERED SEWAGE TANKS'. TANKS MUST MEET CURRENT MINIMUM SIZE REQUIREFTENTS;EQHhPPED Wl- LRI RS 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 1.------------t f--feW CiL ')- )— '70?r-3 .----- ---• -5]).1 1)(::11"14- THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WE REVISED 12/72015 Pumps :r ,(„,, ,,, -..., Pump04. Specifications Jlf�.,u p Ji FL50 Series 1 /2 hp Submersible Effluent Pump �' :AIN l■ Flow(Liters Per Minute) 0 38 76 114 1 189 227 265 303 341 379 .--60 -;----x---+--,---s---t_. i 4 1 -c----�— . i i ; 1 t 18 1 4 I I 1 50 ---- ——---_____— . _ __ 15 i s f f + __ 1 1 __ _ _. 12 "*- I I i .,,, I fr I I i 11 s 1 f II I i 1 20 i T IAFPRCiV II:) 1 1 1 10 -L— 1. 'I L 1; Z ' s . 1 —1 3 MENTp.H J s • SON OUNN ENNA , I ILYC, t 0 _�,_I._. _._.Y.^1 .4 ,.... - 1 I __,_1 —. ! r---1---Ij i-----_..{.,.--/ 0 0 10 20 30 40 50 60 70 80 90 100 Flow(GPM) FLSO PI RSt2r20l7 °Copyright 2017 Liberty Pumps Inc. All rigbts reserved. Specifications subject to change without notice. ! 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