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HomeMy WebLinkAboutSWG2023-00256 - SWG Application / Design - 6/14/2023 MASON COUNTY 415 N 6TH STREET,SHELTON,WA 98584 SHELTON:360-427-9670,EXT 400 (14: BELFAIR:360-275-4467,EXT 400 Public Health & Human Services ELMA:360 FAX5269,EXT 400 360-427 7787 On-Site Sewage System Permit: SWG2023-00256 APPLICANT SMITH ET AL MARK D Phone: Address: KRISTI S WAITE SHELTON, WA 98584 OWNER SMITH ET AL MARK D Phone: Address: KRISTI S WAITE SHELTON, WA 98584 SEPTIC DESIGNER MICAH HALVERSON-M. Halverson Phone: 360-490-6365 Design LLC Address: PO BOX 1519 SHELTON, WA 98584 Site Address: 741 E Camden Way Primary Parcel Number: 120311290040 Permit Description: New SFR - 3BR Gravity Permit Submitted Date: 06/20/2023 Permit Issued Date: 07/05/2023 Issued By: Jeff Wilmoth Current Permit Fees Paid: $525.00 (additional fees may be required upon installation of system). Permit Expiration Date: 02/26/2029 (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/environmental/onsiteloss-inspection-request.php or call: 360-427-9670, extension 400. OFFICIAL USE ONLY DATE RECEIVED. / a O ` a 5— MASON COUNTY COMMUNITY SERVICES AMOUNT IVE ,! RECE YCO Cn f1z 1T_ l v m Public Health(Community Health/Environmental Health) (p 415 417.h Street et.400 or Shelton. A 98584 ext.aoo S W G '2.cs A. -5- 0 0 LCC ' 2 475 N 6th Street.Shelton.WA 985840 Z ui ON-SITE SEWAGE SYSTEM APPLICATION m n APPLICANT PHONE m Mark Smith 971-764-5856 z MAILING ADDRESS-STREET,CITY,STATE,ZIP CODE -1S: 3 741 E Camden Way Shelton Wa 98584 SITE ADDRESS-STREET,CITY,ZIP CODE I Undeveloped Land NAME OF DESIGNER PHONE I N Micah Halverson 360-490-6365 (� NAME OF INSTALLER PHONE I �� Logan Spear 360-239-1541 <_ NIu, PERMIT TYPE(select ono) DRINKING WATER SOURCE Pt.eFt;>� Q M.RESIDENTIAL OSS COMMUNITY OSS COMMERCIAL OSS ❑ PRIVATE INDIVIDUAL WELL WI PRIVATE TWO-PARTY WELL Z I— TYPE OF WORK(select one) 0 PUBLIC WATER SYSTEM , M.NEW CONSTRUCTION/UPGRADES rl REPAIR/REPLACEMENT OTHER DETAILS(select all that appy) 0 TABLE IX REPAIR I- SUBMITTALS ❑ SURFACING SEWAGE 0 EXISTING FAILURE 0 SHORELINE CO W.DESIGN FORM(REQUIRED) ilit SEPTIC DESIGN(REQUIRED) BEDROOMS LOT SIZE r I N n WAIVER(S)(IF APPLICABLE) 3 1 .26Ac 0 , L DIRECTIONS TO SITE AND SITE CONDITIONS:(ex.locked gate) After Harstine Island Bridge turn right (south), at stop sign turn right again continuing south, I© turn left on E Camden Way. Contact Designer or Applicant for Gate code to enter Camden r Way. Perk holes are marked with pink rib•on drainfield is staked out o I s - , I i r ,erred I .��.' -C SITE MUST BE FLAGGED FROM MAIN R••• -ND TEST HOLES MUST BE FLAGGED WITH TEST HOLE NUMBERS. IO OFFICIAL USE ONLY BELOW THIS LINE - UPGRADE I FAILURE SOURCE(for reporting purposes) 0 VOLUNTARY 0 MAINTENANCE/PUMPING ❑BUILDING PERMIT ['HOME SALE ❑CO PLAINT ['OTHER: INSPECTOR SOIL LOGS �p� JCOOMMMENTS/CONDITIONS to `III\ L„,,, d/O 5 rJUN 20ZIJZ3\_.... 0 - M� i /v,-) 6C 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. 2N EXPIRATION DATE PLIC ION APPROVED!ISSUED BY DATE I CTOR SIGNATURE I_�I[/_. 5 DATE APPLICATION(� � �j� A "7 .. e! — 26 tffije .--7_, THI F MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE REVISED 12/7/2015 DESIGN FORM—PAGE ONE Assessor's Parcel Number:Lz 0 3 r -- t Z -- l c o A_v A design will be reviewed when 3 conies of each of the following are submitted: 0 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: II"X/7" PARCEL IDENTIFICATION Permit Number: SWG .d23` d'D01.510 Designer's Name: Micah Halverson Applicant's Name: Mark Smith Designer's Phone Number: 360-490-6365 Mailing Address: 741 E Camden Way Designer's Address: PO Box 1519 Shelton Wa 98584 Shelton Wa 98584 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 ElDisinfection Unit Make/Model Other: Septic Tank Drainfield Type FifGravity 0 Pressure 0 Trench 0 Bed 0 Sub Surface Drip Septic Tank/Drainfield Specifications Laterals Number of Bedrooms 3 Schedule/Class ASTM 2729 Daily Flow:Operating Capacity 360 gpd Length 50 ft Daily Flow:Design Flow 360 gpd Diameter 4 in Septic Tank Capacity(working) 1200 gal Number 3 Receiving Soil Type(1-6) 3 Separation 9 ft Receiving Soil Appl. Rate 0.8 gpd/ft2 Orifices Required Primary Area 450 ft2otal Number of Orifices Perf. Designed Primary Area 450 ft2 Diameter II in Designed Reserve Area 450 ft2 Spacing in Trench/Bed Width 3 ft Manifold Trench/Bed Length 150 ft Schedule/Class D-Box II Elevation Measurements Length ft Original Drainfield Area Slope 4-5 % Diameter in New Slope,If Altered same % Preferred manifold configuration used? 0 Yes 0 No Depth of Excavation up-slope 16 in Transport Pipe from Original Grade Down-slope 14.2 in Schedule/Class ASTM 3034 Designed Vertical Separation 36+ in Length 5 ft Gravelless Chambers Required? 0 Yes Ri No 0 Optional Diameter 4 in Pump Required? 0 Yes 'No Dosing and Pump Chamber Pump/Siphon Specifications Number of doses/day Gravity 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(flood) N/A gal Uppermost Orifice 0 Higher 0 Lower than Pump Shutoff Pump controls:Please check those required. Capacity @ Total Pressure Head N/A gpm OTimer ❑Elapse Meter ❑Event Counter Calculated Total Pressure Head N/A ft If Timer: Pump on N/A ,Pump off N/A Comments ' DESIGN FORM—PAGE TWO Assessor's Parcel Number: (2- O-T ( -- ( Z -- 0 O g o Permit Number: SWG DESIGN CHECKLISTS Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch EI Test hole locations [ Drainfield orientation and layout Reference depth from original grade: g Soil logs g Trench/bed dimensions and g Septic tank It Property lines critical distances within layout 17i Drainfield cover It Existing and proposed wells g D-Box/Valve box locations Reference depth from original grade within 100 ft of property g Septic tank/pump chamber and restrictive strata: It Measurements to cuts,banks,and locations g Laterals,trench/bed,top and surface water and critical areas g Observation port location bottom 6d Location and orientation of g Clean-out location 0 Curtain )f %•llector curtain drain and all absorption It Manifold placement 0 Sand a : is en components It Orifice placement Other cross-section detail: 121 Location and dimension of g Lateral placement with distance RI Observation ports/clean-outs primary system and reserve area to edge of � "tm Other Information Buildings 0 Audible/v. referenced Yes No It Direction of slope indicator Eg Scale of drawing shown on scale g 0 Design staked out It Waterlines bar ❑ Ef Recorded Notices attached Wi Roads,easements,driveways, 0 g Waiver(s)attached parking 0 l'Pump curve attached It North arrow and scale drawing 0 i 1 Evaluation of failure shown on scale bar Non-residential justification ❑ 12 Waste strength ❑ RI Flow DESIGN APPROVAL The undersigned designer must be no 'fled by installer at time of installation gYes 0 No c..."--- C/S/262...) ignature of 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 to : •i-site regulations: n •� ental Health Specialist Date CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CONDITION: I The design is stamped"Approved"by Mason County Public Health. & ✓ The Onsite Sewage Permit has not expired,the Permit Expiration Date is: ^2C0 Z ✓ 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. Updated Date: 12/7/2015 v Q - � '� c CD a rn O • = t5 C.,..) m y 5• . ,Zc 'a- ' p) g • qaiI NN‘ ifig\ 6 ; Ifli MQ1r `\�• - �� g0 f o o a gi� lime •d�� - W N �AN- .-o 4 OO Sam 0 pCD i 0 - O8OOx 3O QVD 9JN • O v v S O v50 0• om g OOCT �-, • - a- - CC] CD CD N) • 2.2 + = CD -C 8 a 7 m u) O Q cn 2 2 co ��nn N r -� ii g'0 N rn m9 I r — 1 zz•m 5S)g Q uo o o ?5 _ a II s ° •s ao _� E • 52 0°' Z1� cD —i CD cn Qgr cur) w I�KvW = — B4 - � a0 � ET.,_C 0 t CD M Er CL ill CJ n L -J ::1 `'ft 1 a o Cli --1 �,, "ena'' a,�, �N,' .\ 2 N . W U' '+hyn'•;'...... 'e\ 'i"'M.°'•. 6) al rzi s 3 g (D N T- Serve,, z 1 R;U H� \ \ 0 -1,38_� \ ii ) 8 .. a 27�_ N 7 2 p W I O ->I o cn cn o CP w 3:211 Ia:!: I to i Ili Z N.) 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