HomeMy WebLinkAboutSWG2023-00298 - SWG Application / Design - 7/14/2023 MASON COUNTY 415N 6TH STREET,SHELTON,WA 98584
SHELTON:360-427-9670,EXT 400
BELFAIR.360-215-4467.EXT 400
Public Health & Human Services ELMA'.360-482-5269,EXT 400
FAX.360-427-7787
On-Site Sewage System Permit: SWG2023-00298
APPLICANT Frank Beckwith Phone:
Address: 18430 Nutmeg St SW ROCHESTER, WA 98579
SEPTIC DESIGNER FRANKLIN CLARK-A+Onsite Phone: 360-830-4765
Address: PO BOX 1954 SILVERDALE, WA 98383
Site Address: 30 E LEXINGTON PL
Primary Parcel Number: 421257690044
Permit Description: New SFR-3BR Pressure w/class b waiver
Permit Submitted Date: 07/14/2023
Permit Issued Date: 10/03/2023
Issued By: Jeff Wilmoth
Current Permit Fees Paid: $780.00 (additional fees may be required upon installation or system/.
Permit Expiration Date: 10/03/2026 (based on date oliinspection)
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 055.
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/environmentallonsiteloss-inspection-request.php or call:
360-427-9670, extension 400.
OFFICIAL USE ONLY
MASON COUNTY UP1kXFCtNkU / 19 /9'ZOa3 in a
COMMUNITY SERVICES AMOUNT�NN RECEIVEDavA ` Tn
0m N
-�. 4CJ1. G y
- PublicHealth(Community Health/EnvironmentalMilHezleM G
415 _ ,..tLtoSWG ata3 - nalQRB 53
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ON-SITE SEWAGE SYSTEM APPLICATION 3 A
APPLICANT PHONE m m
r
Franklin Clark 360-830-4765 z
c
MAILINGADDRESS-STREET,CITY,STATE.ZIP CODE E
P.O.Box 1954,Silverdale,WA,98383
SITE ADDRESS-STREET CITY,ZIP CODE I.
30 E. Lexington PI.,Shelton,WA 98584 IUL 1 4 9021 j
NAME OF DESIGNER PHONE IN)
Franklin Clark 360-830-4765
NAME OF INSTALLER PHONE - ' a HI Franklin Clark 360-830-4765 < IA '
PERMIT TYPE(select one) DRINKING WATER SOURCE y 'V
• RESIDEALOSS 000MMUNITYOSS ❑COMMERCIALOSS 0 PRIVATE 0 PRIVATE TWO-PARTY WELL Z NTI IU1
TYPE OF WORK select ane) • PUBLIC WATER SYSTEM Plln3 nisi 1
• NEW CONSTRUCTION I UPGRADES 0 REPAIR I REPLACEMENT OTHER DETAILS(seect all that apply) 0 TABLE IX REPAIR I
SI
SUBMITTALS 0 SURFACING SEWAGE •EXISTING FAILURE •SHORELINE w Iy
• DESIGN FORM(REQUIRED) •SEPTIC DESIGN(REQUIRED) BEDROOMS LOT SIZE 0 1'N1
❑ VVALVER(S)(IF APPLICABLE) 3 2.14 Acres n W I
DIRECTIONS TO SITE AND SITE CONDITIONS.(ex.Inked gate)6IS 14,Alder St
0Shelton WA90584
Take E arodtlale Rd to E McReavy Rd 09minI54m1) Q
rolmw E McReavy Rd to E Lexington PI
~1 I I A
min 0 5 top 4
so E Lexington R
Shelton.WA 98584 A
SITE MUST BE FLAGGED FROM MAIN ROAD AND TEST HOLES MUST BE FLAGGED WITH TEST HOLE NUMBERS.
- - ------- ------ OFFICIAL USE ONLY BELOW THIS LINE -
UPGRADE/FAILURE SOURCE for reporting PWoses)
❑VOLUNTARY 0 MAINTENANCE/PUMPING O BUILDING PERMIT 0 HOME SALE OCOMPLAINT O OTHER
INSPECTOR SOIL LOGS COMMENTS I CONDITIONS
1245E
SOIL COOESt RECORD DRAM:AGAND INSTALLATION REPORT
V=VERY G=GRAVELLY S=SAND L=LOAM SI=SILT C=CLAY E=EXTREMELY R=ROOTS REQUIRED FOR FINAL APPROVAL.
ECTOR SIGNATURE DATE APPLICATION EXPIRATION DATE F"LAC lION APPROVED(ISSUED BY DATE
if
I OR I 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: g Z 1 Z 5 - 7 (p - Roo (}4,
A design will be reviewed when 3 copies of each of the following are submitted:
■ Completed design form that has been signed and dated. I Scaled layout sketch,including all applicable items on checklist
■ Scaled plot plan,including all applicable items on checklist. I Cross-section sketch,including all applicable items on checklist
I his 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 2O):-', ` 22115 Designer's Name: Franklin l Clark
Applicant's Name: Frank Beckwith Designer's Phone Number: 360.830.4765
Mailing Address: 18430 NUTMEG ST SW Designer's Address: PO Box 1954
City:RocHESTERState:WA Zip:98579-9115 City:Silverdale State:WA Zip:98383
DE SIGN PARAMETERS
Treatment Device
Si Glendon Biofilter ® Sand Filter ® Mound N Sand Lined Drainfield N Recirculating Filter,Type:
® Aerobic Unit Make/Model ® Disinfection Unit Make/Model Other:
Drainfield Type
N Gravity I Pressure ® Trench U Bed El Sub Surface Drip
Septic Tank/Drainfield Specifications Laterals
Number of Bedrooms 3 Schedule/Class 40
Daily Flow: Operating Capacity 360 gpd Length 50 ft
Daily Flow: Design Flow 360 gpd Diameter 1 in
Septic Tank Capacity 1,200 gal Number 4
Receiving Soil Type(1-6) 4 Separation 70 in
Receiving Soil Appl.Rate .6 gpd/ft 2 Orifices
Required Primary Area 600 ft2 Total Number of Orifices 52
Designed Primary Area 600 ft2 Diameter 1/8 in
Designed Reserve Area 600 ft? Spacing 48 in
Trench/Bed Width 3' ft Manifold
Trench/Bed Length 50' ft Schedule/Class 40
Elevation Measurements Length 2 ft
Original Drainfield Area Slope 4- 10 o/o Diameter 2 in
New Slope,If Altered N/A % Preferred manifold configuration used?® Yes I No
Depth of Excavation up-slope 11 in Transport Pipe
from Original Grade Down-slope 12 in Schedule/Class 40
Designed Vertical Separation 18 in Length 30 ft
Gravelless Chambers Required? 0 Yes 0 No U Optional Diameter 2 in
Pump Required? I Yes IA No Dosing and Pu mp Chamber
Pump/Siphon Specifications Number of doses/day 12
Difference in Elevation Between Pump Shutoff and Uppermost Dose quantity 30 gal
Orifice -10 ft Chamber Capacity 1200 gal
Uppermost Orifice 0 Higher Lower than Pump Shutoff Pump controls:Please check those required.
Capacity @Total Pressure Head 22.7 . pf,,n�1 y�,�L- 11 tt,�,. AkTimer I Elapse Meter U Event Counter
Calculated Total Pressure Head 15.1 r 11 W TSne^P n 00/01/00 Pump off 02/00/00
Comments 7n71
DESIGN FORM-PAGE TWO Assessor's Parcel Number: 4 7. I Ic_ a4,- 900fra
Permit Number: SWG
DESIGN CHECK LISTS
Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch
I Test hole locations I Drainfield orientation and layout Reference depth from original grade:
■ Soil logs I Trench/bed dimensions and I Septic tank
I Property lines critical distances within layout I Drainfield cover
I Existing and proposed wells I D-BoxNalve box locations
Reference depth from original grade
within 100 ft of property I Septic tank/pump chamber and restrictive strata:
■ Measurements to cuts, banks,and locations
I Laterals,trench/bed,top and
surface water and critical areas a Observation port location bottom
I Clean-out location N Curtain drain collector-N/A
0 Location and orientation of I Manifold placement I Sand augmentation
curtain drain and all absorption
I Orifice placement Other cross-section detail:
components _N/A
Location and dimension of I Lateral placement with distance I Observation ports/clean-outs
Ito edge of bed Other Information
primary system and reserve area
Buildings I Audible/visual alarm referenced Yes No
IIl Scale of drawing shown on scale N I Design staked out
I Directionteinof slope indicator P p R 0 V ® Recorded Notices attached
I Waterlines I I Waiver(s)attached
I Roads,easements,driveways, I N Pump curve attached
parking OCT 0 3 2023 N I Evaluation of failure
I North arrow and scale drawing
shown on scale bar MASONCOUNTY ENVIRONMENTAL HEALTH Non-residential totrengthation
JBW N I Waste strength
® I Flow
DESIGN APPROVAL
The undersigned designer must be notified by installer at time of installation I Yes IS No
en
17s'- 24 Aug 2023
Signature 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 local o e re ulations:
hI !„1-cq,„ l0 -3 - z3
Envlron Health Specalist Date
CAUTION: DESIGN APPROVAL I%VALID ONLY UNDER THE FOLLOWING CONDITION:
N The design is stamped"Ap oved"by Mason County Public Health.
N The Onsite Sewage Permit has not expired,the Permit Expiration Date:s: (0 - `c
N 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
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