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HomeMy WebLinkAboutSWG2023-00266 - SWG Application / Design - 6/23/2023 MASON COUNTY 415 N 6TH STREET,SHELT967 WA 98584 SHETREE ,S 42TON, ,EXT 400 584 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: SWG2023-00266 APPLICANT AUSTON, RYAN & FALYNN Phone: Address: 2002 45TH ST CT NW GIG HARBOR, WA 98335 OWNER AUSTON, RYAN & FALYNN Phone: Address: 2002 45TH ST CT NW GIG HARBOR, WA 98335 SEPTIC DESIGNER ROD LEFT-Acme Design Phone: 360-698-8488 Address: PO Box 2954 SILVERDALE, WA 98383 Site Address: 101 E LIZZY LN Primary Parcel Number: 320242290011 Permit Description: New 3bd OscarXO2 Permit Submitted Date: 06/23/2023 Permit Issued Date: 09/07/2023 Issued By: Jeff Wilmoth Current Permit Fees Paid: $685.00 (additional fees may be required upon installation of system). Permit Expiration Date: 06/29/2026 (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. 7 No clearing of vegetation or addition of impervious surface is permitted within the wetland buffer. 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/onsite/oss-inspection-request.php or call: 360-427-9670, extension 400. W OFFICIAL USE ONLY --- _ DATE RECEIVED: MASON COUNTY O6 �3 �0 -(c) Cn cn COMMUNITY SERVICES AMOUlIcEnP-5 p� RECEIVED BY: Q] cn W rn Public Health(Community Health/Environmental Health) /�] /� C U) 34115 N.6th treett.•WOan.WA 9584 eat 400 SWG �i 1 0,3 - 0o�b 5 Cl' O CIS N.bth Street•Shelton.WA 9a5a� i!"`� 0 O Z U) -13 ON-SITE SEWAGE SYSTEM APPLICATION z m APPLICANT PHONE r I- Falynn Auston z MAILING ADDRESS-STREET,CITY,STATE,ZIP CODE g 2002 45th St Ct N 1 Gig Harbor WA 98335 co SITE ADDRESS-STREET,CITY,ZIP CODE 101 E. Lizzy Lane 3�P! 2 .5-3 Shelton WA 98584 lW NAME OF DESIGNER PHONE I N Rod Left 360-698-8488 _ J NAME OF INSTALLER el PHONE v I 0 C N PERMITRMp�� TYPE(select one) DRINKING WATER SOURCE 0 li RESIDENTIAL OSS E.COMMUNITY OSS COMMERCIAL OSS E PRIVATE INDIVIDUAL WELL ff PRIVATE TWO-PARTY WELL Z I TYPE OF WORK(select one) 2 PUBLIC WATER SYSTEM Agate Grocery lir NEW CONSTRUCTION/UPGRADES 6 REPAIR/REPLACEMENT OTHER DETAILS(select all that apply) 0 TABLE IX REPAIR I N SUBMITTALS ❑ SURFACING SEWAGE CIEXISTING FAILURE ❑SHORELINE Pr DESIGN FORM(REQUIRED) Iff SEPTIC DESIGN(REQUIRED) BEDROOMS LOT SIZE ..... I M 5WAIVER(S)(IFAPPLICABLE) 3 64,904 0 DIRECTIONS TO SITE AND SITE CONDITIONS:(ex locked gate) I Io -I I --k SITE MUST BE FLAGGED FROM MAIN ROAD AND TEST HOLES MUST BE FLAGGED WITH TEST HOLE NUMBERS. I 1 OFFICIAL USE ONLY BELOW THIS LINE UPGRADE/FAILURE SOURCE(for reporting purposes) 0 VOLUNTARY ❑MAINTENANCE/PUMPING ❑BUILDING PERMIT ❑HOME SALE ❑COMPLAINT ❑OTHER: INSPECTOR SOIL LOGS COMMENTS/CONDITIONS 11_\A .., 0,__HCL I (UtHr‘t01. - ) Mojt. 2 ; 6 - 1 c,Lt 1W- N 5 --tt-\3 e —ALA Q S (fiu-e, \ - r SOIL CODES: RECORD DRAWING AND INSTALLATION REPORT V=VERY G=GRAVELLY S=SAND L=LOAM Si=SILT C=CLAY E=EXTREMELY R:ROOTS REQUIRED FOR FINAL APPROVAL. INSPECTOR SIGNATURE DATE APPLICATION EXPIRATION DATE r ATION APPROVED/ISSUED BY DATE -.- -7A9Jiv‘r-ty\ CD/-7-ctl- 6 (-2_6( 1,z, . _et 7-24' THIS FORM MAY BE S ANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE REVISED 12/7/2015 0 • DESIGN FORM—PAGE ONE Assessor's Parcel Number: 3 2 0 2 4 — 2 2 — 9 0 0 1 1 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 srview notnnt the�Mason County Web site.Maximum paper size: 11"X 17 s y A: -',L`t o e P r ,u«�. ARt:ta"lD �T.��1:i,C OtA a�'`fi.`.,,. 'kd e.. v ' 'f� ' ' 93:r� ��i�p�rtk, fi •a4a� ,a5 r.'X.�n�.'^�:�+Gn.... r( -r. .. Y ..., ��,. _-.i' ��, Permit Number: SWG 2J 2 3 s ©024 Y Designer's Name: Rod Left Applicant's Name: Falynn Auston Designer's Phone Number: 360 698-8488 Mailing Address: 2002 45th St Ct NW Designer's Address: PO Box 2954 Gig Harbor WA 98335 Silverdale WA 98383 City State Zip Ci State Zip Treatment Device ❑Glendon Biofilter 0 Sand Filter lifMound 0 Sand Lined Drainfield ❑Recirculating Filter,Type: EtAerobic Unit Make/Model OSear X02 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 4 Schedule/Class Daily Flow: Operating Capacity 360 gpd Length ft Daily Flow:Design Flow 480 gpd Diameter in Septic Tank Capacity 1500 gal Number Receiving Soil Type(1-6) 5 Separation ft Receiving Soil Appl.Rate .4 gpd/ft2 Orifices Required Primary Area 1200 ft2 Total Number of Orifices Designed Primary Area 1200 ft2 Diameter in Designed Reserve Area 1200 ft2 Spacing in Trench/Bed Width 18 ft Manifold Trench/Bed Length 66.66 ft Schedule/Class Elevation Measurements Length ft Original Drainfield Area Slope 2 % Diameter in New Slope,If Altered 2 % Preferred manifold configuration used? ❑Yes 0 No Depth of Excavation Up-slope N/A in Transport Pipe from Original Grade Down-slope N/A in Schedule/Class 40 Designed Vertical Separation 12+ in Length 114 ft Gravelless Chambers Required? 0 Yes Ig No 0 Optional Diameter 1 in Pump Required? 6I Yes 0 No Dosing and Pump Chamber Pump/Siphon Specifications Number of doses/day Pre-set Difference in Elevation Between Pump Shutoff and Uppermost Dose quantity gal Orifice i ft Chamber Capacity \pap gal Uppermost Orifice❑Higher 0 Lower than Pump Shutoff Pump controls:Please check those required. Capacity @ Total Pressure Head gpm ❑Timer ❑Elapse Meter 0 Event Counter Calculated Total Pressure Head ft If Timer: Pump on 30 sec ,pump off 3 min Comments PPROVE S073 MASON COt1NTYEP ENVIRONMEN202TAL HEALTH JBW DESIGN FORM—PAGE TWO Assessor's Parcel Number:3 2 0 2 4 -- 2 2 — 9 0 0 1 1 Permit Number: SWG DESIGN CHECKLISTS Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch O Test hole locations 12i Drainfield orientation and layout Reference depth from original grade: O Soil logs lit Trench/bed dimensions and lii Septic tank li Property lines critical distances within layout Drainfield cover ❑ Existing and proposed wells lil D-Box/Valve box locations Reference depth from original grade within 100 ft of property I i Septic tank/pump chamber and restrictive strata: CA Measurements to cuts,banks,and locations 61 Laterals,trench/bed,top and surface water and critical areas 6d Observation port location bottom ❑ Location and orientation of L2f Clean-out location 0 Curtain drain collector curtain drain and all absorption ❑ Manifold placement 0 Sand augmentation components 0 Orifice placement Other cross-section detail: Cti Location and dimension of I Lateral placement with distance 0 Observation ports/clean-outs primary system and reserve area to edge of bed • Buildingsg Other Information Audible/visual alarm referenced Yes No l7i Direction of slope indicator lif Scale of drawing shown on scale 0 El Design staked out lid Waterlines ❑ II Recorded Notices attached ltil Roads,easements,driveways, P P R 0 V E 0 Etif Waiver(s)attached parking o Pump curve attached FA North arrow and scale drawing SEP 0 7 2023 ❑ Evaluation of failure shown on scale bar MASON C(tiNTY ENVIRONMENTAL HEALTH N❑ n❑silent strengthtcation J B W ❑ ❑Flow DESIGN APPROVAL. The undersigned designer must be notified by install • e • lation Ei Yes 0 No Signa o 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 local o ' e regulations: di& Gliciftvoll . E ' comr. Health Specialist Date CAUTION: DESIGN APPROVAL 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: C —Z'cj 2(Y' ✓ 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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