HomeMy WebLinkAboutSWG2024-00141 - SWG Application / Design - 4/9/2024 MASON COUNTY 4I5N6THELTON , 0427-97 ,EXT EXT 400
SHELTON ,SHE SHELTON.
BELFAIR:360-275-0467.EXT 400
Public Health & Human Services ELMA:360482-5269,EXT 400
FAX:360,427-7787
On-Site Sewage System Permit: SWG2024-00M
APPLICANT ENNIS JESS W&MARILYN M Phone:
Address: 90 E VAUGHN PL SHELTON,WA 98584
OWNER ENNIS JESS W&MARILYN M Phone:
Address: 90 E VAUGHN PL SHELTON, WA 98584
SEPTIC DESIGNER MICAH HALVERSONe Phone: 360490-6365
Address: PO BOX 1519 SHELTON, WA 98584
SEPTIC INSTALLER JAMIE WORKMAN' Phone: 360463-9573
Address: 120 E TIMBERLAKE DR SHELTON, WA 98584
Site Address: 90 E VAUGHN PL
Primary Parcel Number: 220185300112
Permit Description: Non-conforming repair 2bd gravity trench
Permit Submitted Date: 04/09/2024
Permit Issued Date: 0 4/1112 0 2 4
Issued By: Rhonda Thompson
Current Permit Fees Paid: $805.00 (addimnai lees noy boroaa�,odwonwewiwnon orayswm).
Permit Expiration Date: 03/27/2025 (booed on dew of inspeolionl
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 Drainffeld installation not to exceed designed upslope and downslope depth specified on
j design form.
11 4 Installer is responsible for obtaining Mason County installation approval prior to bacLfill of
system components.
5 Installer is responsible for obtaining Septic Designer/Engineer installation approval prior to
bacMill of system components.
3 6 Mason County Asbuilt Form, Record Drawing, and Installation fee must be submitted for
lil 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/environmentallonsiteloss-inspection-request.php or call:
360.427-9670, extension 400.
OFFICIAL USE ONLY
gTLNKFTrID:
MASON COUNTY N D
COMMUNITY SERVICES M
[0 N
O N
PuWi<NxhM1l ommuniry XeahhEmiron emal HeahM1l <
0
SWG _aogl O(7141
0
z h
ON-SITE SEWAGE SYSTEM APPLICATION
a z
3 n
MPLICrWT 36 PNONE m r
Jess Ennis 0-229-2453 z
MAILIMF P➢DRE55-STREET,CITY,STATE,2MCOOE �
90 E VAUGHN PLACE Shelton Wa 98584 A z
SITE ADDRESS-STREET,CITY,ZIP CODE
Same as Mailing N
RARE OF DESIGNER PHONE
Micah Halverson 360-490-6365
NAME OF INSTALLER PRONE Q I 0
Jamie Workman 360 463-9573 w
pEtMRrypE(ny[I py) DRINKING WATER SOURCE O
FGRESIDENTIALOSS 6COMMUNIWOGB EiCOMMERCIALOSS EPRIVATEINDIVIDUALWELL t7PRIVATETWO-PARiYWELL z Ili
TYPE OF WORK(weeon.l if PUBLIC WATER SYSTEM IImbwM
ff NEWCONSTRUCTIONIUPGRADES RIEFAIRIREPLACEMENT OIHERDETAILS(PAI& fl tA,,P1 DTABLEIXREPAIR I (/T
sueLllrtnLs D SURFACING SEWAGE CI EXISTING FAILURE D SHOREUNE m
WDESIGNFORM(REDUIRED) ASEPTIC DESIGN(REWIRED) BEDROOMS LOT SME 17
i,-WAIVER(S)(IFAPPLICABLE) 2 .43 ac x I I
DIRECTIg STOSITEANDBRECONORNWS:(ae.k ga )
Meet with Rhonda 3/27/2024 I 10
o I�
ti
&IENWiBEFIAOOFO FRLWWMROADAND LEST HdESYUBTBEFIA[MFOWITNTESTNOtEN11MBEB8. I1�.
OFFICIAL USE ONLY BELOW THIS LINE ��VV
UP3RAOEIFALUPE 80URCE(brepvLLp WN^ar)
DVOLUNTARY DMAINTENANC MPING OBUILDINGPERMIT OHOMESALE DCOMPLAINT DOWER:
' INSPELTgt 30ALCGB COLYAENTS/CONOITWN9
RECORDdUWINGANDNSTALL VIONREPORT
SOLCODEB:
V•VERY G=GRAVELLY 5=5PND L=LOM1 N=SILT C=LUY E=EXTREMELY R=ROOTS REWIRED FIXi FINKAWROVAI
NSPECTORSIGNATURE GAPE APPLICATICNE%PRATIONDATE APPUCNTIONAPPROVENMSUEDBY GATE
FA'I'M 2 Z 3 lz L(( (I (14
THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEEISBE REVISED IWMR5
DESIGN FORM—PAGE ONE Assessor's Parcel Number: Z 2 ! -- 5 3
A design will be reviewed when 3 conies 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. I Cross-section sketch,including all applicable items on checklist.
This form maybe scanned and available for public view on the Mason County Web site.Maximum paper size: 11"X 17"
PARCEl IFICATION
Permit Number: SW'G_2C22_q—_('t))LA L Designer's Namc: Micah Halverson
Applicant's Name: Jess Ennis Designer's Phone Number: 36DA906365
Mailing Address: 90 E VAUGHN PLACE Designer's Address: PO Box 1519
Shelton Wa 98584 Shelter, Wa 98664
city State Zi city State Zip
DES2GNPARAMETERS -
Treatment Device
❑Glendon Biofilter ❑Sand Filter ❑ Maud ❑ Sand Lined Drainfield ❑Recirculating Filter,Type:
❑Aerobic Unit Make/Model ❑ Disinfection Unit Make/Model Other Septic Tank
Drainfield Type
E1Gravity ❑Pressure Ef Trench ❑Bed ❑Sub Surface Drip
Septic Tank/Drainfield Specifications Laterals
Number of Bedrooms 2 Schedule/Class 2729
Daily Flow: Operating Capacity 240 gpd Length 50 ft
Daily Flow:Design Flow 240 gpd Diameter 4 in
Septic Tank Capacity(working) Existing 1000 gal Number 2
Receiving Soil Type(1-6) 3 Separation 6 ft
Receiving Soil Appl.Rate .8 gpd/ft' Orifices
Required Primary Area 300 ft' Total Number of Orifices Perf
Designed Primary Area 300 ftr Diameter in
Designed Reserve Area N/A ft2 Spacing in
Trench/Bed Width 3 ft Manifold
TreachBed Length 100 ft Schedule/Class D-BOX
Elevation Measurements Length it
Original Drainfield Area Slope 12-15 % Diameter in
New Slope,If Altered same % Preferred manifold configuration used? 0 Yes 1KNo
Depth of Excavation Urrsioac 24 in Transport Pipe
from Original Grade Down-slope 6 -18.6 in Schedule/Class 3034
Designed Vertical Separation 24+ in Length 50 ft
Gravelless Chambers Required? 0 Yes O No E1 Optional Diameter 4 in
Pump Required? ❑Yes E1 No Dosing and Pomp Chamber
Pump/Siphon Specifications Number of doses/day Gravity
Diff.in Elevation Between Pump&Uppermost Orifice ft Dose quantity gal
Drainfield Squirt Height/Selected Residual(head) _ft Chamber Capacity(flood) gal
Uppermost Orifice 0 Higher 0 Lower than Pump Shutoff Pump controls:Please check those required.
Capacity @ Total Pressure Head gpm OTimer [311 se Meter ❑Event Counter
Calculated Total Pressure Head ft If Timer: Pump on AP R
Comments APR 11 2024
MASON COUNTY ENVIRONMENTAL HEALTH
DESIGN FORM—PAGE TWO Assessor's Parcel Number: £ Z O t __ $ 3 _ O D 1 1 Z
Permit Number: SWG
DESIGN CHECKLISTS
Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch
15 Test hole locations 13 Drainfield orientation and layout Reference depth from original grade:
Pd Soil logs Pd Trench/bed dimensions and 9 Septic tank
H Property lines critical distances within layout B Drainfield cover
F1 Existing and proposed wells 19 D-BoxfValve box locations Reference depth from original grade
within 100 ft of property 19 Septic tank/pump chamber and restrictive strata:
H Measurements to cuts,banks,and locations iQ Laterals,trench/bed,top and
surface water and critical areas ® Observation port location bottom
H Location and orientation of H Clean-out location ❑ Curtain drain collector
curtain drain and all absorption 9 Manifold placement ❑ Sand augmentation
components Iff Orifice placement Other cross-section detail:
® Location and dimension of 9 Lateral placement with distance I f Observation ports/cleanouts
primary system and reserve area to edge of bed Other Information
IB Buildings 9 Audible/visual alarm referenced Yes No
H Direction of slope indicator tpd Scale of drawing shown on scale If Design
❑ staked out
F1 Waterlines bar ❑ E1 Recorded Notices attached
9 Roads, easements,driveways, ❑ EI Waiver(s)attached
parking ❑ II7 Pump curve attached
6 North arrow and scale drawing ❑ Iff Evaluation of failure
shown on scale bar Non-residential justification
❑ ❑Waste strength
❑ ❑ Flow
DESIGN APPROVAL
The undersigned designer must b#otified by installer at time of installation 15 es ❑ No
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 on-site regulations:
Environmental Health Specialist Date
CAUTION: DESIGN APPROVAL IS VALID ONLY TINDER THE FOLLOWING CONDITION:
✓ The design is stamped"Approved"by Mason County Public Health. q/
✓ The Onsite Sewage Permit has not expired,the Permit Expiration Date is: /I�/T'�
✓ 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 maybe scanned and available for public view on the Mason County Web site.
Updated Date: 12n12015
yet
� " a
��4 x
6 ija � 1
o ffi n
n
Y /
II 1 I
p 1
C
s
2 c Ti
Z C) I
O
` m Z
1] T
Z
7J
x m
@m g D
55
3 c
a`
a
u—�
S!1 b1 >0 > w > m
h o m = Dom ma ax,
L• x c .J.�N O >1
a m — mmx `p nn34m
nb r a 3N
U 3 m W. ym
O
^ 03 coi �m m ° m
m Rz mho= OK@O .
y _ to 'o N
q a m r o r V 2 n
o $ yrp o 0
D^F To -
Ell
o n rn o
+%i It 2 n V al F
e �b Y A
_ ^
m
Abbreviated Description: TIMBERLAKE #5 LOTS: 112-113
=Ha1ve0r'son5desicLnllcC&o
son Design LLC =" �' "�"
Jess Ennis Parcel# 22018-53-00112
9 Shelton Wa 98584 Mailing:g0 E VAUGHN PL 90 E VAUGHN PLACE 1
utlook.com Shelton Wa 98584
oN«
2^
\\
CD
00
2 � . .
( } D 2
)
� |
! O
I se --I --I / 2 CD` 2 0 ?
CD § \ j \ �\ �C
�+ } \# $ ; _
� } 7 \ m \ Ow
- _\*
0. CD
= 3
(
// ® [
ƒ ° % !
�
9.H1 ro DsgnLC - Jess Ennis mcel# 22018#ee
PO Box ,«ss� m �84 22%& mrymmP» 2
«_ond« aoutlookam ®
m
W
O m N O F NO O D m O N yj N N 0 0 p O jai N O 0
N Yl W ..r J W
Allied L
—� �� dmid �tD mr° m �$ H ffcd35d S5-i
• _ JrS f4�i '< 7i ^Im NN dON d_Oi < QO
Z gg gg oa �.a `=ao � 3 �v �cv `mm �5 �n, =
al G 55 itI@e O' G• aC 4'i 0S' ?°< 'N° t°J'TmNO-? 7 (�
If gt _ =� ON n Q d N < J 00 N R^ nS m m m d
m m �� ' mdip° N NCd Ned CcdO' _
W monm.'^ 3d dd 'm
m �. 8 m Rm cn =mE. m N n
S.
y� sr
m' Oo cao � O m $-a7
3 [[ $ >. A. 3w �a
4 °c O o mdm ^ ° nAv ? Qd nnm nm
a $ ,tj .•H s @; ® ' ,O. 003 `o 'wv 3 N0N O omwcc $ m : m
$ 7 �' Yyr 3 i❑ 3a �g e' +. '� m � S n omn3mvPi o' s xd Tm
� 3 7 YS m nm m m� _mmc mmcmn; ip m J
i f 0• 9,YQe 'j d3 m
46wJ J 3 O ' C�
fY fit} yYY In 8 g Y 4 m .2T n a N J =y ° d.d•'N� S
Sl adj$ c3 ��I IL '-JY It S O O til C fG n'2 C J
.M nJm m
t °fin
a *
oy LA o�
3 °m n o� yam. 3n� 0,o
`a I S 3S� $erg wP m � xn; � �' � m J mm $ m
- m ° m aan a.nQ 3
C a! fit B N 0J F.a3m O'NN mm0 S
CDy * g53fl n $ °1aim $
CD N $ mms$ $ $ S nM $ (^
a J m N N N N d N
3 $ wowCr a
3 m 2JJ & 9° � -f
NA 3 G m = $ Oi: c=
T C N a ry N
CD
O. S n m °' m -°y 3'm O T P d O, m
210
m �
= X• t CTi m
mm =
fl
J
O O Z O m
� io ^� m � m `° vmim D (1) v � n� � o� (OD2' v •� � m � m � N
M N N m - . CD (D = M. i/i m S m S 3.
v° 3 ° moo m o y^ m o � a� � mo v o CD ° ' � 3 ' y � m o m � (D
'O O 3 v = 'O N O m > y S O D S m N -p n m -•-O
O. m Jmm m IOym = -- m =f? O, NmOn m Cnp 0. CD _ y n -
p a' N . 7 n m ry (D - in 41, O O 0 y "O `Z .1 O p C
O M O f p m a O CD O j p' .'� ry O � O N N m CD O 0 1 ii, 00
W W
CD
y O J d j N w N N = _� y n N Dl p f0 3 .O. C J (p fD �tG
m n m m m m m o. 3 m �i o m ' d m In o m » nCM
N N C a y9 0 S 'p N < 3. O -O m ? F (D S
0 & N N (OD �`< N 2 (D fD O N M O J 'O vl y g y fDn
e � y CD ? N � i; (n 3 f0 < C � 0 D CD Ul C � p 'o m F N 5 CM
>d 7 V n y 'O d f\ 3 Q m N (D UM C 3 R w O � 3 (D N !n ? lD
*6 `Z N CD 0
m J y m y. p j O. (n 00 5 p j C `'z .D. O O- O 2 m m J N. N.-D
CD O' ^ nO- Nn � Ef 9? mmO pCm < 0 `< ap mfDO
m M m O O m N 5 O J N t0 m = M ti a , OT m i.< m v O0 a ? m D O
S O y C 0 O 13 (O a' N = N -.O. n O^ G J �O-. m n �0 m m K w N
D y m 3 0 c CD m m m O F m o y F y o d-D n
s s��rnm pgz 3 m = = m �, m = m m 01 -`" = o a� � c o m
m nm m�� yv � °_ mW oao om41 -D ap � 2 v, cD mCD
� � m
m' m a _. N C m n C n w mm m O -O _i a 0 C m S ] a. m 8 z
m .-. _2 m in m m c0a p v .�
-i33m mmyc N m N m nny �< ' m N .O aN v m w 6 O W O O
Am O < �Jy^ O ,Z < N m 10
fN � N-`gF n� " N NmmO � NN � NSy OS =p0
N -m° R O 900. N.$ -p Q, 5 N y (D S m 0 U1 F a N m 2 0 O O � ? >
m am Z2K m iDti O w _. 7 n 3 3 NtC N m R. j m a � m m OC' p
.m i 8* 2 &ai g ' m N o ' y - tO 0m m = m � D nw O m EF CD m `m< N
J xt� - rm ._o c > > = m p E; m Opp N � m myc 0 -0 w -D
n An NNOamnF N 6; F » F - mm �, �' < >' m JmJ > Op O
� 8O moo NO.ymc D N5 Fr m ' 0 ai m pm 0J (G N. NQ= Vl3m 3m m
8
9 T.A d = N n <D ~S 'O.N a y N C m m •-' m m m N 3 S O
�'•-m w o cy 'm m g`8 p- m m CD CD m a fn < O m lu N � Cr w.
�yy ? 3 m J; 3 Q N O O N N `< .O-.. a O m p m O m m 0 � m G
�oo0 am won m s � � Ufa maD � � 5 5 Rt _3 CD � y3 ° _ _
I � mm m m o o mm
p,- tVp_(p1 n.a $ m 0 �< F �p CD N �p v m f0 vl w M m or
3 .
m7c 'Y.° � pZv3 _ ? fn - N N m m � O
Om
m 0 "p'Y
U3
J
l[i�pHalveor'monde,siqnllc(a)outlook.com
.Haverson Design LLC "-�'° ' ","Jess Ennis Parcel#22018-53-00112
Mailing:gp E VAUGHN PL
O Bx 1519 Shelton Wa 98584 90 E VAUGHN PLACE Shelton wa ss5ea
Amy Y