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HomeMy WebLinkAboutSWG2023-00143 - SWG Application / Design - 4/19/2023 MASON COUNTY 415 N 6TH STREET,SHELTON,WA 98584 M .:. SHELTON:360-427-9670,EXT 400 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: SWG2023-00143 APPLICANT BABCOCK JENNIFER A Phone: Address: 60 NE BEAR CREEK DEWATTO RD BELFAIR, WA 98528 OWNER BABCOCK JENNIFER A Phone: Address: 60 NE BEAR CREEK DEWATTO RD BELFAIR, WA 98528 SEPTIC DESIGNER Richard Bazzell -Caliber Septic Design Phone: 360-509-7900 Address: 165 Tupleo Way POULSBO, WA 98370 Site Address: 60 NE Bear Creek Dewatto Rd Primary Parcel Number: 123094200020 Permit Description: 3-bedroom gravity system repair Permit Submitted Date: 04/19/2023 Permit Issued Date: 04/24/2023 Issued By: David Anderson Current Permit Fees Paid: $780.00 (additional fees may be required upon installation of system). Permit Expiration Date: 04/21/2026 (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 Drainfield 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/environmentallonsiteloss-inspection-request.php or call: 360-427-9670, extension 400. DATE RECEIVED: OFFICIAL USE ONLY MASON COUNTY `-1— [G,- air.3,a3 c N 0417 COMMUNITY SERVICES AMOUNT RECEIVED: M\ RECEIVEDBY v N J Public Health(Community Health/Environmental Health) /� �{^, C N 41SN 6th e 400 orn,W778584 evt.400 SW V —00 t4 3 Q 415 N 61h Street-Shelton.WA 98584 �D�3 7.1 Z ON-SITE SEWAGE SYSTEM APPLICATION 3 -- m C) APPLICANT PHONE m r Jennifer Babcock 407-489-9619 z MAILING ADDRESS-STREET,CITY,STATE,ZIP CODE E 60 NE Bear Creek Dewatto Belfair WA 98528 co SITE ADDRESS-STREET.CITY,ZIP CODE 60 NE Bear Creek Dewatto Belfair WA 98528 I�- NAME OF DESIGNER PHONE I ^, Richard Bazzell 360-509-7900 NAME OF INSTALLER PHONE 0 I` I To Be Determined PERMIT TYPE(select one) DRINKING WATER SOURCE O I c, W RESIDENTIAL OSS I COMMUNITY OSS F COMMERCIAL OSS L PRIVATE INDIVIDUAL WELL 5-PRIVATE TWO-PARTY WELL Z (� TYPE OF WORK(select one) r PUBLIC WATER SYSTEM ,�" R:, I -- -NEW CONSTRUCTION/UPGRADES W.REPAIR/REPLACEMENT OTHER DETAILS(select all that apply) 0 TABLE IX REPAIR SUBMITTALS ® SURFACING SEWAGE 0 EXISTING FAILURE 0 SHORELINE W �WAIVER(S)(IF APPLICABLE) L!I.DESIGN FORM(REQUIRED) SEPTIC DESIGN(REQUIRED) BEDROOMS LOT SIZE r 3 1.23 acres 0 . (� DIRECTIONS TO SITE AND SITE CONDITIONS:(ex.locked gate) I From WA-3 north bound, turn left onto NE Old Clifton•Ln for 500' I Take a right at the intersection and continue onto NE Old'Belfair Hwy for 3.3 miles r Turn left onto NE Bear Creek Dewatto and travel for 325 ` to subject property o I d I0 SITE MUST BE FLAGGED FROM MAIN ROAD AND TEST HOLES MUST BE FLAGGED WITH TEST HOLE NUMBERS. I V OFFICIAL USE ONLY BELOW THIS LINE UPGRADE/FAILURE SOURCE(for reporting purposes) 0 VOLUNTARY 0 MAINTENANCE/PUMPING 0 BUILDING PERMIT ['HOME SALE ❑COMPLAINT 0 OTHER: INSPECTOR SOIL LOGS COMMENTS/CONDITIONS TN z- 0-6' 6cm, co E.,_.-) T4110-68 6015 -< -D g 1 p3•,.4- 6o " 6,c m5 I='l IV O fV W C 1 RECORD DRAWING AND INSTALLATION REPORT SOIL CODES: V=VERY G=GRAVELLY S=SAND L=LOAM Si=SILT C=CLAY E=EXTREMELY R=ROOTS REQUIRED FOR FINAL APPROVAL. INSPECT SIGNATURE DATE APPLICATION EXPIRATION DATE APPLICATION APPROVED!ISSUED BY DATE LI/z(/?oz3 Y/4( l Zo Z 6 THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE REVISED 12n12015 DESIGN FORM-PAGE ONE Assessor's Parcel Number: 1 Z 3 0 l -- Z 0 0 0 2 b 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 ''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: 11"X 17" PARCEL IDENTIFICATION Permit Number: SWG c ZC t ' 00 i Designer's Name: Richard Bazzell Jennifer Babcock Designer's Phone Number: 360-509-7900 Applicant's Name: Mailing Address: Designer's NE Bear Creek Dewatto Desi ner's Address: 165 NW Tupelo Way Belfair WA 98528 Poulsbo WA 98370 City State Zip City State Zip DESIGN 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 0 Trench 0 Bed 0 Sub Surface Drip Septic Tank/Drainfield Specifications Laterals Number of Bedrooms 3 ✓ Schedule/Class 40/3034 Daily Flow: Operating Capacity 270 gpd/ Length 50 ft Daily Flow:Design Flow 360 gpd l Diameter 4 in Septic Tank Capacity(working) 1250 gal / Number 3 Receiving Soil Type(1-6) / Separation 5 O.0 ft Receiving Soil Appl.Rate sb gpd/ft2' Orifices Required Primary Area a1 : 1 � ft2 ✓J Total Number of Orifices n/a Designed Primary Area ,.7#50 '� ft2 ( Diameter n/a in Designed Reserve Area nra. , ,,2 v Spacing n/a in Trench/Bed Width A.:. c/ Manifold Trench/Bed Length '''_-` 5Q COt; ft4 Schedule/Class n/a NI • 'A �Pri..0 F; Elevation•Me �lurertients,,:n., ,,.,^l i f1 Length n/a ft Original Drainfield Area Slope ',,_, ,,•,;! ' ' '` ' Diameter n/a in New Slope,If Altered n/a % Preferred manifold configuration used? 0 Yes 0 No Depth of Excavation Up-slope 15 - 20 in Transport Pipe from Original Grade Down-slope 1 6.4 - 21.4 in Schedule/Class 40/3034 Designed Vertical Separation 36 in Length 85 ft Gravelless Chambers Required? 0 Yes 0 No 2iOptional Diameter 4 in Pump Required? 0 Yes IF1No Dosing and Pump Chamber Pump/Siphon Specifications Number of doses/day n/a Diff.in Elevation Between Pump&Uppermost Orifice n/a ft Dose quantity n/a gal Drainfield Squirt Height/Selected Residual(head) n/a ft Chamber Capacity(floA �/\ C-a gal Uppermost Orifice 0 Higher CI Lower than Pump Shutoff Pump controls: Please chec those req i . Capacity @ Total Pressure Head n/a gpm ❑Timer ❑Elap eet r202 0 Event Counter n/a ft If Timer: Pumpon n/a A ,1'Jmp o f n/a Calculated Total Pressure Head Comments MASON COUNTY ENVIRONMENTAL HEALTF' Please approach the septic tank(collapsed) and test holes (type 3 soils) with caution. The tank tigAand test holes have been flagged and fenced (temporary) by the homeowner for safety. Please contact the Designer if there are any questions. DESIGN FORM — PAGE TWO Assessor's Parcel Number: -- -- Permit Number: SWG DESIGN CHECKLISTS Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch PI Test hole locations g Drainfield orientation and layout Reference depth from original grade: g Soil logs S Trench/bed dimensions and L( Septic tank S Property lines critical distances within layout g Drainfield cover Ll Existing and proposed wells g D-Box/Valve box locations within 100 ft of property g Septic tank/pump chamber Reference depth from original grade and restrictive strata: PI Measurements to cuts, banks, and locations Cif Laterals,trench/bed, top and surface water and critical areas S Observation port location bottom 0 Location and orientation of S Clean-out location 0 Curtain drain collector curtain drain and all absorption 0 Manifold placement 0 Sand augmentation components ❑ Orifice placement Other cross-section detail: Location and dimension of 0 Lateral placement with distance S Observation ports/clean-outs primary system and reserve area to edge of bed IZ1 Buildings Other Information 0 Audible/visual alarm referenced Yes No g Direction of slope indicator S Scale of drawing shown on scale 5 0 Design staked out S Waterlines bar 0 5 Recorded Notices attached S Roads, easements,driveways, ❑ S Waiver(s)attached parking 0 5 Pump curve attached d North arrow and scale drawing 0 5 Evaluation of failure shown on scale bar Non-residential justification • 0 S Waste strength � . I/1 S Flow DESIGN APPROVAL � , i r � � The undersigned designer must be notifie by install r a i of inst. ." .n� tl ❑ No r ti :• a�' • i I Signature of Designer Da / 21037126 11 RICHARD `, /, The undersigned has reviewed this design on behalf of Mas•. od EI ��; �, R ,�•. •• pRiGIZE ID compliance with state and local o - re ' ns: ��- •% %AAA% ,/ Y(ZI/ZOZ6 APR 2 12023 • vironmental Health Specialist DIM I ON COUNTY ENVIRONMEf,,AL HEALTV CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CONDI'P N: ✓ The design is stamped"Approved"by Mason County Public Health. ✓ The Onsite Sewage Permit has not expired,the Permit Expiration Date is: ✓ 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. 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