HomeMy WebLinkAboutSWG2022-00235 TANK ONLY - SWG Application / Design - 4/27/2022 415 N 6TH STREET,SHELTON,WA 98584
MASON COUNTY SHELTON:360-427-9670,EXT 400
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COMMUNITY SERVICES BELFAIR:360-275-4467,EXT 400
ELMA:360-482-5269,EXT 400
Budding, E nvironmental Health Community Health
t vx<< FAX:360-427-7787
On-Site Sewage System Tank Only Permit: SWG2022-00235
APPLICANT WEBBER JUSTIN &JEAN Phone: 1.253.229.9581
Address: 2918 N 20TH STREET TACOMA, WA 98406
OWNER WEBBER JUSTIN &JEAN Phone: 1.253.229.9581
Address: 2918 N 20TH STREET TACOMA, WA 98406
SEPTIC INSTALLER Shane Maples- MAPLES EXCAVATING Phone: 360-463-8474
Address: 911 SE Arcadia Road SHELTON, WA 98584
Site Address: 151 N WEBSTER LN
Primary Parcel Number: 224065100005
Permit Description: Add septic tank
Permit Submitted Date: 04/27/2022
Permit Issued Date: 05/02/2022
Issued By: Luke Cencula
Current Permit Fees Paid: $240.00 (additional fees may be required upon installation of system).
Permit Expiration Date: 05/02/2023 (based on date of inspection)
Type of Work OSS New Construction
Components being Replaced: Septic Tank Only
Surfacing Sewage? No Existing Failure? No
Shoreline? Yes Horizontal Setbacks Met? Yes
Number of Bedrooms: 3 Drinking Water Source: Public Water System
Additional Details: Add septic tank
Permit Conditions:
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
2 Permit must be installed by a Mason County Certified Installer unless prior written
authorization from Mason County 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 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 RECENED: q( 7 (0:30
07. COMMUNITY SERVICES AMOU CEIV EED: .O D RECEIVED BY:
Public Health(Community Health/Environmental Health) `�'7 C �
360-427-9670,est400or360-275-4467.ext.400 /— /� /'� ]
415 N.6th Street-Shelton,WA 98564 ``/VG 1�a� _��\,S` N 74
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ON-SITE SEWAGE TANK ONLY APPLICATION 3
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APPLICANT PHONE r
Tustin Webb&r 253-2261- g6gi
MAILING ADDRESS-STREET,CITY,STATE,ZIP CODE 3
161 N. WCbSter IAN " LillivvaUp. WA c1g66-6 m
SITE ADDRESS-STREET,CITY,ZIP CODE ""
151 N" WeibStek I-N - LiItiWaLtp, vIA ag555 I'''
NAME OF DESIGNER PHONE I`
NAME OF INSTALLER PHONE v IX'
Sham maw( 3tp0-4tp5- g Nii �,
TYPE OF WORK(select one) DRINKING WATER SOURCE En
O
❑ NEW CONSTRUCTION/UPGRADES 0 REPAIR/REPLACEMENT ,�❑{/PRIVATE INDIVIDUAL WELL 0 PRIVATE TWO-PARTY WELL Z lq-
COMPONENT(S)TO BE REPLACED/INSTALLED lip PUBLIC WATER SYSTEM
Eh SEPTIC TANK El PUMP TANK 0 RV HOLDING TANK BEDROOMS 3 LOT SIZE I
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❑ OTHER 5-0 - 32x. 03
OTHER DETAILS(select all that apply) TANK(S)SETBACK CHECKLIST r
❑ SURFACING SEWAGE ❑EXISTING FAILURE 0 SHORELINE d 100FT+PUBLIC/COMMUNITY WELLS X Ieo
SUBMITTALS di 50FT+PRIVATE WELLS,SURFACE WATERS,STREAMS,RIVERS
❑ PLOT PLAN(REQUIRED) 6 TANK CROSS SECTION(REQUIRED) ,0,( 10FT+DRINKING WATER SUPPLY LINES
El PUMP DETAILS(IF APPLICABLE) 0 WAIVER(S)(IF APPLICABLE) L:1 5FT+PROPERTY/EASEMENT LINES,FOUNDATIONS,FOOTINGS
PLOT PLAN CHECKLIST r I -
❑ PROPERTY LINES AND EASEMENTS ❑ EXISTING!PROPOSED STRUCTURES ❑ EXISTING/PROPOSED OSS COMPONENTS AND LINES -i
❑ WELLS WITHIN 100FT 0 WATER SUPPLY LINES 0 DRIVEWAYS!PARKING 0 SURFACE WATERS,STREAMS,RIVERS,ETC... 131
❑ DIRECTION OF SLOPE/CONTOURS 0 PERIMETER/CURTAIN DRAINS 0 NORTH ARROW 0 SCALE BAR
DIRECTIONS TO SITE AND SITE CONDITIONS:(ex.locked gate) PI
f p\ p A-0 lr'e bc. lo-ot
OFFICIAL USE ONLY BELOW THIS LINE
UPGRADE/FAILURE SOURCE(for reporting purposes)
❑VOLUNTARY ❑MAINTENANCE/PUMPING UILDING PERMIT 0 HOME SALE OCOMPLAINT 0 OTHER:
COMMENTS/CONDITIONS
SEWAGE TANKS MUST BE LISTED UNDER DOH"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
H. ) w --)-3 , - _ 5[711.0-7-1-
THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE REVISED 12/7/2015
• r MASON COUNTY SEWAGE SYSTEM DESIGN
DEPARTMENT OF GENERAL SERVICES - 54-3-P
• ENVIRONMENTAL HEALTH SECTION f-t t t t �sy '' BACKFILOL
P.O.BOX 186.303 NORTH 4th STREET•SHELTON,WA98584
PHONE(206) 426-5561 _ E�—r
PROPERTY OWNER OATS SUBMITTED �.,' �a' ` '��: STONE
�j/ch4f- Cr PO/ SI e fe 42 rK� x •a - . a�
/per r."6 .{� ,
ADDRESS DESIGNED BY f.'%• ♦�.;•,
y��— l6� �P ry� �t ,� �w OVER TILE
/ U Q� •�,� �� �•.4i,V41 Vy fer.;1 " PIPE SIZE
lr-p✓U _1, . j8'O0 8 • '� .,ate .. ., .� r,•►�1/, .
e SOIL LOG- DATA ,,;.a 1�l!w1.t:��0�. h4%rA'
�/ /G�-P d I t�"'�'-t ►'1'��-ef i.•Ic�i;�laa .L'•-' STONE
LEGAL DESCRIPTION (.�d144", /2_- .5 ` r. �/ •��'•- :, r 'N •'
G L <-1 s. /n F/ �7 �sue, �i14 (,litp� < ZOr g' �� �JNDER TILE
J "'e clC _ f v gc)7e 60 �� CROSS SECTIONt OF TRENCH^ 36 Depth tive
'r'.!_. _ 44, vN' Layer
CALCULAT/IONS: GPO If other SHOW THE FOLLOWING ITEMS IN GRID BELOW:
No. Bedrooms 3 than residence' —�6 O A. Horizontal system plan and, if mound system is proposed or
/ 1Q (3.6 slopes exceeding 15%provide cross section.
Application Rate:gal./sq.ft./day Q �� * B. Scale
Drainfield Sizing: Absorption Area 3 ‘° Ft.2 Total Length 'Z Ft. C. Benchmark A ,stubout elevation, tank outlet elevation, (bot-
tom3 of pipe), elevation at finish grade at center of drainfield.
Pump Specifications: High level alarm yes Elevation Difference .� Ft. D. Property lines,building,trees,slopes in excess of 5%,driveway.
GPM /5-7' z r c' Discharge Volume Z E. All wells or drinking water supplies within 100 ft.,water lines.
Volume of sump 70 6'4( F. Drainage system detail (i.e.curtain drain).
Septic Tank Size and Manufacturer 42.47d i'1r(, '3• Ove c f v'CJ G. Replacement area.
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APP ROV
hA? 2 2022
ENVIRDNMEN1, �� ( /
DE N PR D. NV ter�-e SG'.+!Qe Cl/ry1�C S' 7`
BY: A AN INC fril �JLr t‘ .c)'-q C- .F� ['aP("l-S )
1
DAT
The undersigned agrees not to hold the Mason County Department of General Services, Environmental Health Section,
responsible in the event that the system as proposed by /7• �a / - 7 %1 g_
fails to operate as required by the Mason County Health Code.
Printed From Mason County DMc;
Signature of Owprintted from Mason CountW49MS Signature of D Igner D e
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E K ENGINEERING INC. DATE 6/13f 11 TANK DLTAI S=0R HOGELS
DRAFTED BY: 1000 S, 1000 S-T, m
P.O.BOX 3097 BATTLE GROUND,WA 98604 D.R.N. 1000 P & 1000 P-T
PHONE: (360) 687-7668 FAX: (360) 687-7669 SCALE:
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E K ENGINEERING INC. DATE: 6/13111 TANK CONSTRUCTION 6 RE tYAR SCttEDUiE FOR MODELS2.
DRAFTED BY: 1 000 S, 1000 S-T, m
P.O.BOX 3097 BATTLE GROUND,WA 98604 D.R.N. 1000 P & 1000 P-T
PHONE: (360) 687-7668 FAX: (360) 687-7669 SCALE: CSt
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