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HomeMy WebLinkAboutSWG2023-00535 - SWG Application / Design - 12/29/2023 415 N 6TH STREET,SHELTON,WA 98584 r_ ,.rt%n.4x,. MASON COUNTY SHELTON:360�27-9670,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: SWG2023-00535 APPLICANT FRANKLIN CLARK* Phone: 360-830-4765 Address: PO BOX 1954 SILVERDALE, WA 98383 OWNER MARKS SKY & CHRISTINA Phone: Address: 4461 DEERHORN TRAIL NW BREMERTON, WA 98312 SEPTIC DESIGNER FRANKLIN CLARK* Phone: 360-830-4765 Address: PO BOX 1954 SILVERDALE, WA 98383 SEPTIC INSTALLER FRANKLIN CLARK* Phone: 360-830-4765 Address: PO BOX 1954 SILVERDALE, WA 98383 Site Address: 417 NE DEWATTO HILLS RD Primary Parcel Number: 223187500130 Permit Description: New 4bd gravity Permit Submitted Date: 12/29/2023 Permit Issued Date: 02/15/2024 Issued By: Rhonda Thompson Current Permit Fees Paid: $780.00 (additional fees may be required upon installation of system). Permit Expiration Date: 01/09/2027 (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 4"V DALE RECENED: � MASON COUNTY 2 - cl - 2 111111 N '��� COMMUNITY SERVICES AMO • C.`'O L� Public Health(Community Health/Environmental Health) tom. . 74 C I ; ,27 7o,e.t or z,5,�7.en..� oat SWG y `Z3 —©0 o' 0 415 N.6th Street-Shehon,WA 98564 c O Z1 Z fn ON-SITE SEWAGE SYSTEM APPLICATION 3 m n APPLICANT PHONE m Franklin Clark 360-830-4765 z z c MAILING ADDRESS-STREET,CITY,STATE,ZIP CODE C W P.O.Box 1954,Silverdale,WA,98383 m SITE ADDRESS-STREET.CITY,ZIP CODE z 417 NE Dewatto Hills Rd,Tahuya,WA 98588 IA , NAME OF DESIGNER PHONE II v Franklin Clark 360-830-4765 ) NAME OF INSTALLER PHONE v IW Franklin Clark 360-830-4765 Z (� PERMIT TYPE(select one) DRINKING WATER SOURCE ■ RESIDENTIAL OSS 0 COMMUNITY OSS 0 COMMERCIAL OSS ■ PRIVATE Well 0 PRIVATE TWO-PARTY WELL Z 100 TYPE OF WORK(select one) CI PUBLIC WATER SYSTEM r • NEW CONSTRUCTION/UPGRADES 0 REPAIR/REPLACEMENT OTHER DETAILS(select all that app/y) 0 TABLE IX REPAIR I\1 SUBMITTALS 0 SURFACING SEWAGE 0 EXISTING FAILURE 0 SHORELINE W • DESIGN FORM(REQUIRED) SEPTIC DESIGN(REQUIRED) BEDROOMS LOT SIZE r" ❑ WAIVER(S)(IF APPLICABLE) 4 5.74 Acres o ' DIRECTIONS TO SITE AND SITE CONDITIONS:(ex.locked gate) lO Mason County Community Services-415 N 6th St,Shelton,WA 98584>Take W Alder St to WA-3 N/E Pine St> lO Turn left onto WA-3 N/E Pine St,Continue to follow WA-3 N>Continue on WA-300 W.> Take NE Belfair Tahuya Rd,NE Haven Way and NE Tahuya Blacksmith Rd to NE Dewatto Hills Rd O Iowa 417 NE Dewatto Hills Rd,Tahuya,WA 98588 —I IW SITE MUST BE FLAGGED FROM MAIN ROAD AND TEST HOLES MUST BE FLAGGED WITH TEST HOLE NUMBERS. 10 OFFICIAL USE ONLY BELOW THIS LINE— - UPGRADE/FAILURE SOURCE(for reporting purposes) ❑VOLUNTARY 0 MAINTENANCE/PUMPING 0 BUILDING PERMIT ['HOME SALE ❑COMPLAINT ❑OTHER: INSPECTOR SOIL LOGS COMMENTS/CONDITIONS . . 0-5 Z ,S I.. ,S z +-' 190> P1 0+- 11.4( 644 -to s----? '._ d 0 l' Si-}— W 'l ``� (e/---------- 94Ye 0'.. -C2- Q)Ca All , At cm 5�- r 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. INSPECTOR SIGNATURE DATE APPLICATION EXPIRATION DATE APPLICATION APPROVED/ISSUED BY DATE i\ik w,, \\ 6\ `1 vu. \ 121 �04)C - f(S1-2L( THIS FORM 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: 2231 8 -- 7 5-- 0013 0 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 III Scaled plot plan,including all applicable items on checklist. II 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: 1 1"X 17" PARCEL IDENTIFICATION Permit Number: SWG ?-07i3—00 S3S Designer's Name: Franklin J Clark Applicant's Name: Sky Marks Designer's Phone Number: 360.830.4765 Mailing Address: 4461 Deerhorn Trail NW Designer's Address: P.O. Box 1954 , Bremerton,WA 98312 City: State: Zip: City:Silverdale State:WA Zip:98383 DE SIGN PARAMETERS Treatment Device N Glendon Biofilter N Sand Filter N Mound N Sand Lined Drainfield N Recirculating Filter,Type: N Aerobic Unit Make/Model N Disinfection Unit Make/Model Other: Drainfield Type I Gravity N Pressure N Trench N Bed N Sub Surface Drip Septic Tank/Drainfield Specifications Laterals Number of Bedrooms 4 Schedule/Class '?j 17 t 3 Daily Flow: Operating Capacity 480 gpd Length (01'ft Daily Flow: Design Flow 480 gpd Diameter 4 in Septic Tank Capacity 1,200 _ gal Number , 4 Receiving Soil Typ e(1-6) 4 Separation 5'On Center. ft Receiving Soil Appl.Rate Pri: .6/Res: .6 gpd/ft 2 Orifices - N/A Required Primary Area 800 ft' Total Number of Orifices DesignedPrimary Area 800 ft' Diameter in Designed Reserve Area 800 ft2 Spacing in Trench/Bed Width 3 ft Manifold - N/A Trench/Bed Length 7 U ft Schedule/Class Elevation Measurements Length ft Original Drainfield Area Slope 1 -2 % Diameter in New Slope,If Altered N/A % Preferred manifold configuration used?® Yes ® No Depth of Excavation Up-slope /L 1 in Transport Pipe- N/A from Original Grade Down-slope w in Schedule/Class Designed Vertical Separation 36 in Length ft Gravelless Chambers Required? 0 Yes II No N Optional Diameter in Pump Required? N Yes I No Dosing and Pu mp Chamber Pump/Siphon Specifications Number of doses/day Difference in Elevation Between Pump Shutoff and Uppermost Dose quantity gal Orifice N/A ft Chamber Capacity gal Uppermost Orifice N Higher N Lower than Pump Shutoff Pump controls:Please check those required. Capacity @ Total Pressure Head gpm N Timer N Elapse Meter 0 Event Counter Calculated Total Pressure Head ft If Timer: Pump on , Pump off Comments This is a revision which shows the revised reserve drain field layout and the addition of a Curtain Drain which must be installed as part of the system. DESIGN FORM —PAGE TWO Assessor's Parcel Number: 22318 — 7 5 — QQ13Q Permit Number: SWG DESIGN CHECK LISTS Scaled Plot Plan Scaled Layout Sketch Cross- Section Sketch I Test hole locations Drainfield orientation and layout Reference depth from original grade: Soil logs ITrench/bed dimensions and I Septic tank I Property lines critical distances within layout Drainfield cover Existing and proposed wells ID-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 I Observation port location bottom - N/A III Clean-out location Curtain drain collector 0 Location and orientation of � Manifold placement ® Sand augmentation - N/A curtain drain and all absorption ElOrifice placement - N/A Other cross-section detail: components _N/A Observation ports/clean-outs Lateral placement with distance 1 p I Location and dimension of to edge of bed primary system and reserve area Other Information • Audible/visual alarm referenced Yes No Buildings Scale of drawing shown on scale ® I Design staked out Direction of slope indicator bar ® Recorded Notices attached I Waterlines ® I Waiver(s)attached Roads,easements,driveways, ® I Pump curve attached parking Z I Evaluation of failure I North arrow and scale drawing Non-residential justification shown on scale bar ® I Waste strength Flow DESIGN APPROVAL The undersigned has reviewed this design on behalf of Mason County Public Health and determined it to be in compliance with state and local onsite regulations: 01/23/2024 Signature of Designer Date cL22\-"NA (('Ch'kl Environmental Health Sp calist 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:s: 41 /Z7 • Drainfield site conditions have not been altered to adversely affect conditions of design approval. 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