HomeMy WebLinkAboutSWG2023-00223 - SWG Application / Design - 6/6/2023 1MASON COUNTY 415 N 6TH STREET,SHELTON,WA 98584
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: SWG2023-00223
APPLICANT SKADAN ET UX RICHARD Phone:
Address: CHERYL D LEE SEATTLE, WA 98177
OWNER SKADAN ET UX RICHARD Phone:
Address: CHERYL D LEE SEATTLE, WA 98177
SEPTIC DESIGNER CINDY WAITE- Septic Designer Phone: 3607010205
Address: 80 E PICKERING LANE SHELTON, WA 98584
Site Address: 21 E Dogwood Ct
Primary Parcel Number: 321045200111
Permit Description: New SFR -3BR Nuwater w/ pressure distribution
Permit Submitted Date: 06/06/2023
Permit Issued Date: 06/27/2023
Issued By: Jeff Wilmoth
Current Permit Fees Paid: $525.00 (additional fees may be required upon installation of system).
Permit Expiration Date: 06/27/2026 (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 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.
Pr
OFFICIAL USE ONLY
DATE RECEIVED: V
0 MASON COUNTYtip
COMMUNITY SERVICES AMO Fin Itt'I IV 3Y CO Cl)
Public Health(Community Health/Environmental Health) Cco
3�..27 9v o.e.t 4�or 1�275�6,...t 400 S W G )C 1- - U 0 a:.3 g °
415 N.6th Street Shelton WA 98584
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ON-SITE SEWAGE SYSTEM APPLICATION
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APPLICANT m
1-
RICHARD SKADENI c
MAILING ADDRESS-STREET.CITY.STATE.ZIP CODE g
361 NW 113TH PLACE SEATLE WA 98177 m
73
SITE ADDRESS-STREET.CITY.ZIP CODE
21 E DOGWOOD CT UNION WA 98584 c"'
NAME OF DESIGNER PHONE N
CINDY WAITE 360-701-0205
NAME OF INSTALLER PHONE
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TBD _<
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PERMIT TYPE(select one) DRINKING WATER SOURCE —
K RESIDENTIAL OSS H COMMUNITY OSS HCOMMERCIAL OSS 6 PRIVATE INDIVIDUAL WELL 17 PRIVATE TWO-PARTY WELL Z I .A
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TYPE OF WORK(select one) PUBLIC WATER SYSTEM ALDERBROOK WS
g'NEW CONSTRUCTION/UPGRADES 6 REPAIR/REPLACEMENT OTHER DETAILS(select all that apply) ❑ TABLE IX REPAIR I C-Jl
SUBMITTALS II�� 0 SURFACING SEWAGE 0 EXISTING FAILURE 0 SHORELINE
RDESIGN FORM(REQUIRED) d1 SEPTIC DESIGN(REQUIRED) BEDROOMS LOT SIZE 5 N to
I
GWAIVER(S)(IF APPLICABLE) 3 121'X143'X137'X70' 0 I I
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DIRECTIONS TO SITE AND SITE CONDITIONS-(ex rocked gate)
GO OUT BROCKDALE ONTO MCREAVY, TURN RIGHT ONTO MANZANITA DR, TURN I o
RIGHT ONTO JACK PINE LANE, TURN LEFT ONTO VINE MAPLE LANE, LEFT ONTO r
DOGWOOD COURT.
( —
SITE MUST BE FLAGGED FROM MAIN ROAD AND TEST HOLES MUST BE FLAGGED WITH TEST HOLE NUMBERS. I
OFFICIAL USE ONLY BELOW THIS LINE
UPGRADE I FAILURE SOURCE(for reporting purposes)
❑VOLUNTARY ❑MAINTENANCE/PUMPING ❑BUILDING PERMIT ['HOME SALE ['COMPLAINT ❑OTHER:
INSPECTOR SOIL LOGS COMMENTS r CONDITIONS
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16 r0 EE M [1 \\_, .
V 16" JUN 06
By (6
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.
I PEC OR SIGNATURE DATE APPLICATION EXPIRATION DATE APP TION APPROVED!ISSUED BY = r
01 vz 0�� ( - 3 --iov.= ( -0.--- 'l1� ,��� C�-� ,��
;
T S FO AY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE REVISED 12/7/2015
I
, DESIGN FORM—PAGE ONE Assessor's Parcel Number: 3 2 1 0 4 — 5 2 — 0 0 1 1 1
A design will be reviewed when 3 conies 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: //"X 17"
PARCEL IDENTIFICATION
Permit Number: SWG 20z 3 - Oa 2-z 3 Designer's Name: CINDY WAITE
Applicant's Name: RICHARD SKADEN Designer's Phone Number: 360-701-0205
Mailing Address: 361 N W 113 PL Designer's Address: 80 E PICKERING LANE
SEATTLE WA 98177
City State Zip City State Zip
DESIGN PARAMETERS
Treatment Device
❑Glendon Biofilter ❑Sand Filter 0 Mound 0 Sand Lined Drainfield 0 Recirculating Filter,Type:
'Aerobic Unit Make/Model BNR 500 0 Disinfection Unit Make/Model Other:
Drainfield Type
❑Gravity lif Pressure rifTrench 0 Bed 0 Sub Surface Drip
Septic Tank/Drainfield Specifications Laterals
Number of Bedrooms 3 Schedule/Class SCHEDULE 40
Daily Flow:Operating Capacity 270 gpd Length 50 ft
Daily Flow: Design Flow 360 gpd Diameter 1.25 in
Septic Tank Capacity(working) 1200 TRASH gal Number 4
Receiving Soil Type(1-6) 4 Separation 5 OC ft
1-
Receiving Soil Appl. Rate .6 gpd/ft2 rM Orifices
Required Primary Area 600 ft2 Iii al P irk T r,,,,,, 52
Designed Primary Area 600 ft2 i eter 3/16 in
Designed Reserve Area 600+ ft2 S. ingJON 2 / 4 48 in
MASON2023
Trench/Bed Width 3 ftCOUNTYENVIRpNM old
Trench/Bed Length 200 ft Schedule/CIJOw ENTq-NEALTI CHEDULE 40
Elevation Measurements Length 2-3 ft
Original Drainfield Area Slope <2 % Diam- . 2 in
New Slope, If Altered % Pre re. anifold configuration used? 0 Yes 0 No
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Depth of Excavation Up-slope 15 in • Q. Alt, Transport Pipe
from Original Grade ��4, r
Down-slope 14 in
or:lleki� !, SCHEDULE 40
Designed Vertical Separation 12 in eta" *'c r P�
-� 40 ft
Gravelless Chambers Required? 0 Yes III No 0 Optio " iai , `pN�l 2 in
Jir Pump Required? I 'Yes 0 No ,, y 5 01• 8 S.
c Y E. AITE(��- •; ng and Pump Chamber
Pump/Siphon Specifications UCENS 'DESIGNER • 4I 6
.��..�....0:•��� ,► ��i.�1,
Diff. in Elevation Between Pump&Uppermost Orifice ft ="Mii eiba ttity 45 gal
Drainfield Squirt Height/Selected Residual(head) 2 ft Chamber Capacity(flood) 1200 gal
Uppermost Orifice EIS Higher ❑ Lower than Pump Shutoff Pump controls: Please check those required.
Capacity @ Total Pressure Head 30.68 gpm E 'Timer
litlapse Meter llEvent Cou elk\
Calculated Total Pressure Head 7.64 ft If Timer: Pump on ,Pump off
Comments
USE EXTREME CARE WHEN CLEARING, DESIGNER TO BE CONTACTED AFTER CLEARING TO
LAY OUT DRAINFIELD, CONCRETE TANKS REQUIRED, GRAVEL BASED DRAINFIELD REQUIRED.
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DESIGN FORM—PAGE TWO Assessor's Parcel Number: 3 2 1 0 4 — 5 2 -- 0 0 1 1 1
Permit Number: SWG
DESIGN CHECKLISTS
Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch
Ei Test hole locations 21 Drainfield orientation and layout Reference depth from original grade:
g Soil logs g Trench/bed dimensions and Q( Septic tank
Property lines critical distances within layout 12f Drainfield cover
Ifpxisting and proposed wells g D-Box/Valve box locations Reference depth from original grade
within 100 ft of property g Septic tank/puipp chamber and restrictive strata:
Pfiyeasurements to cuts, banks,and locations d/ oils
fig Laterals,trench/bed,top and
surface water and critical areas I2' Observation port location bottom
.Location and orientation of rig Clean-out location 0 Curtain drain collector
curtain drain and all absorption lif Manifold placement Id Sand augmentation
components
Gd Orifice placement Other cross-section detail:
1 Location and dimension of Lateral placement with distance 0 Observation ports/clean-outs
primary system and reserve area to edge of bed
10 Buildings Other Information
g Audible/visual alarm referenced Yes No
Q? Direction of slope indicator i f Scale of drawing shown on scale ❑ 0 Design staked out
IZ1 Waterlines bar �❑ 0 Recorded Notices attached
fill Roads,easements,driveways, 0 0 Waiver(s)attached
parking App
# aive_ 0 0 Pump curve attached
North arrow and scale drawing �';,:it. ❑ Evaluation of failure
1°'hG
shown on scale bar ` on-residential justification
MASONiNUN 2 j 2023 • ❑ Waste strength
COUNTY ENVIRON,1eF 0 0 Flow
NTAC freitlH
DESIGN,AdiWVAL
The undersigned designer must be not. by insta er at time of installation I1 Yes 0 No
ea.uti 6�.5720 23
Signatur f Designer Date
The undersigned has reviewed this design on behalf of Mason County Public Health and determined it to be in
compliance with state and loca -site regulations:
(Aj il tvt,(\irTh (0 — 2-7 ''. --3
nvironmental Health Specialist Date
CAUTION: DESIGN A PROVAL IS VALID ONLY UNDER THE FOLLOWING CONDITION:
✓ The design is stamped"Approved"by Mason County Public Health.
V The Onsite Sewage Permit has not expired,the Permit Expiration Date is: CO — (Z 2 /
✓ Drainfield site conditions have not been altered to adversely affect conditions of design approval.
Please Note: The system must be installed bya certified installer, of
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unless prior authorization is obtained from Mason County Public H'alth.
An Installation Fee is required.
This form may be scanned and available for public view on the Mason County Web site.
Updated Date: 12/7/2015
$
1. PROPOSED 3BR RESIDENCE
2. 121200 TRASH TANK
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3. BNR 500 IN CONCRETE TANK
..`'�"" .'.�_-d-.�•��..•- ..�.,�.�.... ..., / ' 1-( 4. 1200 GALLON PUMP TANK
5. AUDIONISUAL ALARM
6. CLEAN OUT
I L '� L 7. VALVE BOX
i 8. TRANSPORT LINE
1 1 9. 20'X50'DRAINFIELD ENVELOPE
PAGE #4
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Lateral # Length Length Orifice # Distance from Distance from end Length #
# (Feet) (Inches) Spacing" Orifices feeder line of end of lateral
1 50 600 48 13 1 1 50
2 50 600 48 13 1 1 50
3 50 600 48 13 1 1 50
4 50 600 48 13 1 1 50
Total 200 32, 200
TRANS LENGTH 40
GPM .112,e'
K (2" SCHEDULEN 40) 284.5
FRICTION LOSS 0.3815518
Squirt 2
Elevation difference 5
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