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HomeMy WebLinkAboutSWG2022-00553 - SWG Application / Design - 11/2/2022 MASON COUNTYIC" 415 N 6TH STREET,SHELTON,WA 98584 SHELTON:360-427-9670,EXT 400 g` BELFAIR:360-275-4467,EXT 400 Public Health & Human Services ELMA:360-482-5269,EXT400 `' FAX:360-427-7787 On-Site Sewage System Permit: SWG2022-00553 APPLICANT LOWE ET AL THOMAS R Phone: Address: 12312 WADDLE CREEK RD OLYMPIA, WA 98513 OWNER LOWE ET AL THOMAS R Phone: Address: 12312 WADDLE CREEK RD OLYMPIA, WA 98513 SEPTIC DESIGNER Jim Henry-septic designer Phone: Address: PO BOX 14531 TUMWATER, WA 98511 Site Address: SE Andrews Circle Dr Primary Parcel Number: 319122290055 Permit Description: New three bdrm-Oscar 2 OS-50 Permit Submitted Date: 11/02/2022 Permit Issued Date: 06/01/2023 Issued By: Jeff Wilmoth Current Permit Fees Paid: $500.00 (additional fees may be required upon installation of system). Permit Expiration Date: 11/10/2025 (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/onsiteloss-inspection-request.php or call: 360-427-9670, extension 400. OFFICIAL USE ONLY MASON COUNTY PUBLIC HEALTH DATE RECEIVED: // 4 2 . 2 z !/ (n D ONSITE SEWAGE SYSTEM APPLICATION AMOUNT RECEIVED: RECEIVED BY: C U) ✓ m 415 N 6th Street,(Bldg 8) Shelton WA,98584 - cn Shelton:360-427-9670 ext 400 Belfair:360-275-4467 ext 400 C,n'G - ' Z Z _� ��s Z 2 APPLICANT PHONE ` > > TOTTEN ESTATE'S LLC 360-791-3854 m m MAILING ADDRESS•STREET.CITY.STATE.ZIP CODE r 1722 HARRISON AVE NW OLYMPIA WA 98502 3 SITE ADDRESS-STREET.CITY,ZIP CODE Cn CO 0 SE ANDREWS CIRCLE DR SHELTON WA 98584 7 m NAME OF DESIGNER PHONE 0 I (A) Jim Henry c�_%_D 360-507-1267 NAME OF INSTALLER DI V�� Q PHONE CHECK ALL APPLICABLE ITEMS ` AIr • ING WATER SOURCE 4 NEW CONSTRUCTION 0 RV HOLBING TANK O 0 PRIVATE INDIVIDUAL WELL (7 ❑ REPLACEMENT SYSTEM 0 INSTAL •1.1841 -e' • T ONLY 0 PRIVATE TWO-PARTY WELL 0 Z ❑ TABLE 9 REPAIR l� SINGLE F• • LY 4 COMMUNITY/PUBLIC WATER SYSTEM I N) ❑ TANK(S)ONLY 0 COMMERCIAL SYSTEM NAME: BAY EAST 1 ❑ UPGRADE TO EXISTING 0 OTHER: BEDROOMS LOT SIZE I N ❑ EXISTING FAILURE "Record Drawing required 3 .81 ACRES W I N for all Installations" DIRECTIONS TO SITE-BE SPECIFIC AND ADVISE OF ANY NEEDED INFORMATION FOR ACCESS(ex locked gate) 0• I From Highway 101 and Lynch Rd, east on Lynch Rd, right on Sells Dr, right on 2nd 7 I � Andrews Circle Dr to site on left. I o 0 r I Ioi 4, SITE MUST BE FLAGGED FROM MAIN ROAD AND TEST HOLES MUST BE FLAGGED WITH TEST HOLE NUMBERS I Ul OFFICIAL USE ONLY BELOW THIS LINE UPGRADE/FAILURE SOURCE(for reporting purposes) ❑VOLUNTARY 0 MAINTENANCE/PUMPING 0 BUILDING PERMIT 0 HOME SALE ❑COMPLAINT 0 OTHER: INSPECTOR SOIL LOGS COMMENTS/CONDITIONS c)- I b(3) GS 1. t.t. •-►-(-_f 00 5z..... ..14,.....- t SOIL CODES: V=VERY G=GRAVELLY S=SAND L=LOAM Sr=SILT C=CLAY E=EXTREMELY R=ROOTS INSPECTOR SIGNATURE DATE APPLICATION EXPIRATION DATE AP I ATION APPROVED BY DATE I I I/Ofrne- I/ (0 )4 LA)L( ..cIP\ 6.-- /-2_ IS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBS! E REVISED 12/7/2015 , DESIGN FORM—PAGE ONE Assessor's Parcel Number: 3 1 9 1 2 — 2 2 — 9 0 0 5 5 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 2� .- 00 55$ Designer's Name: JIM HENRY Applicant's Name: TOTTEN ESTATES LLC Designer's Phone Number: 360-507-1267 Mailing Address: 1722 HARRISON AVE NW Designer's Address: PO BOX 14531 OLYMPIA WA 98502 OLYMPIA WA 98511 City State Zip Cit State Zi' DESIGN PARAME a y - jTreatment Device ❑Glendon Bicinfter 0 Sand Filter 0 Mound 0 Sand Lined Drainfield ❑Recirculating Filter,Type: ❑Aerobic Unit Make/Model 0 Disinfection Unit Make/Model Other: Drainfield Type ()Sc10- 11 F ❑ Gravity 'Pressure 0 Trench 0 Bed '-SolrSurface Drip Septic Tank/Drainfield Specifications Laterals Number of Bedrooms 3 Schedule/Class 0S50 COILS Daily Flow:Operating Capacity 270 gpd Length ft Daily Flow:Design Flow 360 gpd Diameter in Septic Tank Capacity 1500 gal Number Receiving Soil Type(1-6) 4 Separation ft Receiving Soil Appl.Rate .6 gpd/ft2 .044fiees E„ti/ 11-ii3 Required Primary Area 600 ft2 Total Number of Orifices 400 Designed Primary Area 600 ft2 Diameter in Designed Reserve Area 600 ft2 Spacing 12 in Trench/Bed Width 13.5 ft M i€eld I e f•A I--) .( Trench/Bed Length 44.5 ft Schedule/Class 40 Elevation Measurements Length "114( ft Original Drainfield Area Slope 0 % Diameter 1.25 in New Slope,If Altered N/A % Preferred manifold configuration used? IiIi Yes 0 No Depth of Excavation Up-slope N/A in Tr-anspor-t-Pipe rusk Leh e. from Original Grade Down-slope N/A in Schedule/Class 40 Designed Vertical Separation 30 in Length 476 ft Gravelless Chambers Required? 0 Yes It No 0 Optional Diameter 1.25 in Pump Required? El Yes 0 No Dosing and Pump Chamber Pump/Siphon Specifications Number of doses/day PER OSCAR Difference in Elevation Between Pump Shutoff and Uppermost Dose quantity PER OSCAR gal Orifice 33 '23" ft Chamber Capacity 1200 gal Uppermost Orifice Elf Higher 0 Lower than Pump Shutoff Pump controls:Please check those required. Capacity @ Total Pressure Head 2.8 gpm 'Timer L 'Elapse Meter l 'Event Counter Calculated Total Pressure Head 41.98 ft If Timer: Pump on PER OSCAR ,pump off PER OSCAR Comments DESIGN FORM—PAGE TWO Assessor's Parcel Number: 3 1 9 1 2 -- 2 2 -- 9 0 0 5 5 Permit Number: SWG DESIGN CHECKLISTS Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch O Test hole locations g Drainfield orientation and layout Reference depth from original grade: O Soil logs i Trench/bed dimensions and g Septic tank g Property lines critical distances within layout Z Drainfield cover L1 Existing and proposed wells 0 D-Box/Valve box locations Reference depth from original grade within 100 ft of property g Septic tank/pump chamber and restrictive strata: ❑ Measurements to cuts, banks, and locations l?1 Laterals,trench/bed,top and surface water and critical areas 0 Observation port location bottom ❑ Location and orientation of g Clean-out location 0 Curtain drain collector curtain drain and all absorption g Manifold placement G1 Sand augmentation components 0 Orifice placement Other cross-section detail: 0 Location and dimension of 0 Lateral placement with distance E Observation ports/clean-outs primary system and reserve area to edge of bed 0 Buildings Other Information lid Audible/visual alarm referenced Yes No ❑ Direction of slope indicator 0 Scale of drawing shown on scale g 0 Design staked out Waterlines bar 0 0 Recorded Notices attached 10 Roads,easements,driveways, 0 0 Waiver(s)attached parking g 0 0 Pump curve attached g North arrow and scale drawing 0 0 Evaluation of failure shown on scale bar Non-residential justification ❑ ❑ Waste strength ❑ ❑ Flow DESIGN APPROVAL The undersigned designer must be notified by installer at time of installation g Yes 0 No /0-3i - 1.1... Sig nature of igner 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-sit egulations: Env' o tal Health Specialist Date CAUTION: DESIGN APPRO AL 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: I ( la '-2 S ✓ 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. 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