HomeMy WebLinkAboutSWG2024-00128 - SWG Application / Design - 4/2/2024 MASON COUNTY 415N6TH SHELTON:
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FAX:360-427-7787
On-Site Sewage System Permit: SWG2024-00128
APPLICANT BAKKEN TODD R& BRENDA L Phone: 253.355.0440
Address: 221 E BALLANTRAE DR SHELTON, WA 98584
OWNER BAKKEN TODD R&BRENDA L Phone: 253.355.0440
Address: 221 E BALLANTRAE DR SHELTON,WA 98584
SEPTIC DESIGNER ADAM HUNTER' Phone: 360-753-1226
Address: PO Box 162 OLYMPIA,WA 98507
Site Address: 221 E BALLANTRAE DR
Primary Parcel Number: 321275000057
Permit Description: Non-conforming repair 2bd subsurface drip
Permit Submitted Date: 04/0 212 0 24
Permit Issued Date: 0411112024
Issued By: Rhonda Thompson
Current Permit Fees Paid: $805.00 (addmmnal lee.n,,bs reamrad coon Ina silawn of ry.ta.).
Permit Expiration Date: 04/05/2025 (based on dale of asoemmn)
Permit Conditions:
1 Proposed development subject to zoning requirements and approval by the planning
department staffper 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 o/system components.
6 Mason County Asbuilf 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/healthlenvironmentallonsite/oss4nspection-request.php or call:
360.427-9670, extension 400.
OFFICIAL USE ONLY
MASON COUNTY PUBLIC HEALTH
L.
ONSITE SEWAGE SYSTEM APPLICATION BFD ED BH N DB c m
415N6th5treM,(Bldg B) Shelton Wq 9B504 • 7� 00
Shelton:360-427-9670 oft 400 BelhiT.360-275-M67W400 SWG _ A
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BRENDA BAKKEN 3604010140 m m
MAILING ADDRESS-STREET.CITY.STATE,ZIP CODE r
221 E BALLANTRAE DR SHELTON WA 98584 3
SITEADORESS-STREEL CRT.LP CGDE W
221 E BALLANTRAE DR SHELTONG WA 98584 m
NAME OF DESIGNER PI10NE
ADAM HUNTER 3607531226
NAME OFINSTAILER PHONE
TBD TBD
CHELKALLAPPLIGBLE REMS DRINKING WTER SWRCE
5 pp''
E3 NEW CONSTRUCTION 13 RVHOLDINGTANKONLY E3 PRIVATE INDIVIDUMWELL DO ly
REPLACEMENTSYSTEM [3 INSTALLATION PERMIT ONLY 0 PRIVATETWO-PARTYWELL =
0 TABLE REPAIR 0 SINGLE FAMILY Elf COMMUNITY/PUBLIC WATER SYSTEM
0 TANKS)ONLY [3 COMMERCIAL SYSTEMNAME: LwEu.Mucx
E3 UPGRADE TO EXISTING O OTHER: BEDROOMS lOTSRE
Of EXISTING FAILURE "Fawn OnwmB repulreJ /1 024 Ip Is1
W s11 MSYlgtlonY" �/ O lJ
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MASON LAKE RD TO A LEFT ON BALLANTRAE TO SITE ON THE LEFT. Ix �C
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2 2024 °
SIMWSTME AGGEDFROMMAINROAGAN MSTNOLESMUSTMFLAGGEOWI iNOLE NUMBERS
OFFICIAL USE ONLY BELOW THIS LINE
UPGRME/FANUIE SWRCE IblreFUNlM OMWseal
QVOLUNTARY OMAINMNMICOPUMPING 13BUILDINGPEWIT [311OMESALE OCOMPLAINT 130THER:
INSPECTCRSOLLOGS WMMENTSICONDRONS
SOLLDOBB:
V=VERY G+GMVELLY 5=&V10 L+LOPM $I+ELT L=CIAY E=E%TREMELY R+HOOTS
INSPEFTP SIGNATURE WlE 'C"N+c'(pIRAT10 ATE APRICATINI APPROVED BY DATE
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THIS FORM MAY BE SCAhNED AND AVAILABLE FOR PUBLIC VMW ON THE MASON COUNTY WEBSITE REVISED1NR015
DESK-N FORM—PAGE ONE Assessor's Parcel Number.3C �. I -- gQ — Qy U �
'A design will be reviewed when 3 copies of each of the following are submitted:
v Completed design form that has been signed and dated. v Scaled layout sketch,including all applicable items on checklist
v Scaled plot plan,including at[applicable items on checklist. v Cross-section sketch,including all applicable items on checklist.
This form maybe sunned and available for public view on the Mason County Web site.Maximum paper sue: 11"XI7"
PARCEL IDENTIFICATION
Permit Number: SWG 7-0Z I— C)C' Designer's Name: ADAM HUNTER
Applicant's Name: BRENDA BAKKEN Designer's Phone Number: 360-753-1226
Mailing Address: 221 E BALLANTRAE DR Designer's Address: PO BOX 162
SHELTON WA 98504 OLYMPIA WA W507
city State zip City State Zip
DESIGN PARAMETERS --
Treatment Device
❑Glendon Biofilter ❑Sand Filter ❑Mound ❑Sand Lined Dminfield 0 Recirculating Filter,Type:
0 Aerobic Unit Make/Model 0 Disinfection Unit Make/Model Other:
Drainfield Type �/
0 Gravity Pressure ❑Trench ElM Bed Sub Surface Drip
Septic Tank/Drainfield Specifications In Laterals
Number of Bedrooms "W1 2 Schedule/Class DRIPTUBE
Daily Flow:Operating Capacity 180 8Pd Length 300 ft
Daily Flow:Design Flow 240 gpd Diameter 0.5 in
Septic Tank Capacity 1630 gal Number 2
Receiving Soil Type(1-6) 3 Separation 1.5 ft
Receiving Soil Appl.Rate 0.8 gpd/ft'' Orifices
Required Primary Area 450 fl? Total Number of Orifices 300
Designed Primary Area 484 f? Diameter DRIP EMITTERS in
Designed Reserve Area N/A 112 Spacing 12 in
TrenclaBed Width 22 It Manifold
TrenchBed Length 22 R Schedule/Class 40
Elevation Measurements Length VARIES ft
Original Drainfield Area Slope 0 % Diameter 1 in
New Slope,If Altered 0 % Preferred manifold configuration used? ErYes 0 No
Depth of Excavation U"ION 33 in Transport Pipe
from Original Grade Down-stops 33 in Schedule/Class 40
Designed Vertical Separation 24 in Length 50 ft
Gravelless Chambers Required? 0 Yes IgNo 0 Optional Diameter 1 r1
Pump Required? &(Yes 0 No Dosing and Pump Chamber
Pump/Siphon Specifications Number of doses/day 12
Difference in Elevation Between Pump Shutoff and Uppermost Dose quantity 20 gal
Orifice ft Chamber Capacity 1006 gal
Uppermost Orifice lidifigher 0 Lower than Pump Shutoff Pump controls:Please check those required.
Capacity(al'folat ssn 61 gpm �l'imer 9$lapse Meter WE vent Counter
Caicu o d1/rslR a 109 t R if Timer: Pump on 9.52 MIN Pump off 2 HRB
Counts APR 11 2024
MASON COUNTY ENVIRONMENTAL NFALTV: Jbh_0ortr y n r'llfla ✓
DESIGN FORM—PAGE TWO Assessor's Parcel NumberZo-3l&Z -- 5& — Aa6&r_1
Permit Number: SWG
DESIGN CHECKLISTS
Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch
Rf Test hole locations 9 Drainfield orientation and layout Reference depth from original grade:
V Soil logs Trench/bed dimensions and Rr Septic tank
19 Property lines critical distances within layout 17 Drainfteld cover
F� Existingandproposed wells 9 D-Box/Valve box locations
Reference depth from original grade
within 100 ft of property Septic tank/pump chamber and restrictive strata:
2 Measurements to cuts,banks,and locations ❑ Laterals,trench/bed,top and
surface water and critical areas Observation port location bottom
13 Location and orientation of V Clea lout location ❑ Curtain drain collector
curtain drain and all absorption 9 Manifold placement ❑ Sand augmentation
components V Orifice placement Other cross-section detail:
M Location and dimension of lid Lateral placement with distance El Observation ports/clean-outs
primary system and reserve area to edge of bed
g Other Information
1Z Buildings
Y Audible/visual alarm referenced Yes No
9 Direction of slope indicator 9 Scale of drawing shown on scale d ❑ Design staked out
19 Waterlines bar ❑ ❑Recorded Notices attached
EX Roads,easements,driveways, ❑ ❑Waiver(s)attached
parking ❑ ❑Pump curve attached
if North arrow and scale drawing ❑ ❑ Evaluation of failure
shown on scale bar Non-residential justification
❑ ❑ Waste strength
❑ ❑ Flow
DESIGN APPROVAL
The undersigned designer t b o red . taller at time of installation R Yes ❑ No
3129/24
Si tature of Designer Date
The undersigned has reviewed esign on behalf of Mason County Public Health and determined it to be in
compliance with state and local on-site regulations:
I��rnaaM.y,X�"l �l (l 112 H
Environmental Health peciahst Date
CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CONDITION:
✓ The design is stamped"Approved"by Mason County Public Health. Lt (Vzs—
✓ The Onsite Sewage Permit has not expired,the Permit Expiration Date is:
✓ 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 Daze: 12/7/2015
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APPROVED
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2024
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