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HomeMy WebLinkAboutSWG2024-00134 - SWG Application / Design - 4/8/2024 ON, MASON COUNTY 415 NB SHELTON: ,SHELT967 ,EXT 400 SHELTON:360<274467,EXT 400 BELFAIR:3fi0-2754487,EXT 400 Public Health & Human Services EUNM 360482-5269,EXT 400 FAX:360-427-7787 On-Site Sewage System Permit: SWG2024-00134 APPLICANT BYERLY MELISSA MAE Phone: Address: 3321 NE OLD BELFAIR HWY BELFAIR, WA 98528 OWNER BYERLY MELISSA MAE Phone: Address: 3321 NE OLD BELFAIR HWY BELFAIR,WA 98528 SEPTIC DESIGNER ROD LEFT-Acme Design Phone: 360-698-8488 Address: PO Box 2954 SILVERDALE,WA 98383 Site Address: 3331 NE Old Belfair Hwy Primary Parcel Number: 123094200070 Permit Description: New SFR-3BR Pressure Gravity Permit Submitted Date: 04/08/2024 Permit Issued Date: 04/2212024 Issued By: Jeff Wilmoth Current Permit Fees Paid: $540.00 (addmonai faaa may be rallied upon malanaron of system). Permit Expiration Date: 04/22/2027 (based on date of inspemen) 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 specked 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 AsbuiH Farm, 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/onsite/oss-inspection-request.php or call: 360427-9670,extension 400. OFFICIALUSEONLY pVE d MD MASON COUNTY 4pDo S �1 COMMUNITY SERVICES _ CUS 1p1 PUMi[nee(M1E(Communm NdMP? NIXURN - O SWG 17*SEWAGE SYSTEM APPLICATION 3 n AFFLIrAxr P11]NE Fn m Melissa B 41y z YNI,IGAOpiE69- E m 3321 NE OkMelfair Hwy Belfair WA 98528 m SIIEADORE6E-STREFT.tlrv.iIPLWE 3331 NE Old Belfair Hwy Belfair WA 98528 I wMEOF DESIcrEn Pn°HE N Rod Left 360-698-8488 coXAME OF IN9THLER PEE v I PENNT IE(MYwnf CRIXpNG WATFASOLWCE z w p NP p mI I RE51OERL OSS I�WMMUNT'OSS ®COMMERCIRLOSS �PRNATE INDMOUPL WELL CU PRNRTETVO-0ARII'WELL 2 � TWEOFxOVK(sbmel LLI C1 ®PUSUC WATER SYBIEM ff NEWCONSTRUCTICNIUPG4ADE5 REPAIRIFEPIACEMEM MNEP OETULS pMW MMtlgYiyJ ❑TABLE a REPAIR IA sUSpN�� pI ❑SURFACING SEWAGE ❑EXISTING FAILURE O SIICRELINE LYLIOESIGNFORM(REWIREO) FWSEPTICDESIGN(REWIREDI BEdiLpxS EOTSISEr rye 0 IN MWANER(5)(IFAITUCABIf) 3 q-_.1 ,/a2 -t 0 I 1 GIRELTIX3TG 9RE.VD SNE 4 MdiTpNS:(n.bnYJpMf I � o to .vlEwareEruae®wan AwNRDADAxa IEiTRCtF8wmBE FuaEP wwIESTNaexuuPRs. I I� OFFICIAL USE ONLY BELOW THIS LINE 11 FGPAOE I FAIL W E 9 W 0.CE Ilv nptiq rygau) ❑V,DI,ARY OMNNIENPNCE IAPING OBUILDIWM MM OHOMESN-E OCWM W DOTHER: ECice^MLLCG4 GOEMENISICOMRgMS 3 © zY ?Y-3c, CGCS 9� �a -55 f MS 5' IFN 6``` 15 c- Y/� zy Cs 2 e�Y �C' yg CC RECARDDA WINGANDINST MNPEPOnF V=VERY G.GPASnUY S=5 L=LD.A1 S�MT C-Q E.EXIFENELY 0.�RODB REWIREDfdi FIWLLPPF0.WIL RE DAE fPRIGiYXI E%PIRAnaN WIE M eFPR'O'VEIlY SSISDB DALE Inh�Ap� c -I l Z C�_* 13 ^2- of U'9.1 -1 THI F YBE SCANNED AND AVAILABLE FOR PUBLk WEW ON THE..COUlI SBSRE R—..�LgxnS DESIGN FORM—PAGE ONE Assessor's Parcel Number: 1 2 3 0 9 — 4 2 — 0 0 0 7- 0 A design will be reviewed when 3 copies of each of the following are submitted: v Completed design form Net has been signed and dated. v Scaled layout sketch,including all applicable items on checklist v Scaled plot plan,including all applicable it.on checklist. a Cross-section sketch,including all applicable sterns on checklist. This torso may he canned and available for public view on the Mason County Web sire.M imum papersizc: 11"X 17" _ PARCEL IDENTIFICATION Permit Number. - SWG 2n zy. 0013�( Designer's Name: Rod Left Applicant's Name: Melissa Byerly Designer's Pbove Number. 360-698-8488 Mailing Address: M21 NE Old Beaair Hwy Designer's Address: PO Boa 2954 Bodair WA 88528 BMrertleb WA 9ft183 City State zip ClIx State zip '.' DESIGN PARAMETERS_.. . - Treatment Device ❑Glendon Biofiluu ❑Sand Filter ❑Mound ❑Sand Lints Dreinfield ❑Recirculating Filter,Type: ❑Aerobic Unit Makr/MOdel ❑Disinfection Unit Mak,,No l Other. Drainfield Type R(Gravity ❑Pressure ❑Trench ❑Bed ❑Sub Surface Drip Septic Tank/Drainfseld Specifications Laterals Numberofliedrooms 3 Schedule/Class 40 Daily Flow:Operating Capacity a70 gpd Length fill ft Daily Flow:Design Flow 360 gpd Diameter 4 in Septic Tank Capacity 1000 gal Number 4 Receiving Sail Type(1-6) 4 Separation 5 ft Receiving Soil Appl.Rate 0.6 gpd/ft' Orifices Required Primary Area 600 ft Total Number of Orifices Designed Primary Area 600 fe Diameter in Designed Reserve Area 600 ftr Spacing in Trench/Bed Width 3 ft Manifold Trencl Length 200 it Schedule/Cless Elevation Measurements Length it Original Draimbeld Area Slope 2 % Diameter m New Slope,If Altered 2 % Preferred manifold configuration used? 0 Yes 0 No Depth of Excavation U"I� 18 in Transport Pipe from Original Grade Dowaabpe 18 in Schedule/Class 40 Designed vertical Separation 36 in Length 200 tt Graveness Chambers Required? ❑Yes D No EdOpticasial Diameter 4 in Pump Required? ❑Yes RfNo Dosing and Pump Chamber Pump/Siphon Specifications Number of doses/day Difference in Elevation Between Pump Shtrfoff and Uppermost Dose quantity gal Orifice ft Chamber Capacity gal Uppermost Orifice 0 Higher 0 Lower than Pump Shutoff Pump controls:Please check those required. Capacity Q Total Pressure Head gpm OTimer DElapse Metes ❑Event Counter Calculated Total Pressure Head ft If Ticroijiusupe, Pump off Comments W li7 E' icy � 1\ APR 12 2024 1' ENVIRONMENTAL HEA11p Jew ' DESIGN FORM—PAGE TWO Assessor's Parcel Number l 2 3 0 9 — 4 2 — 0 0 0 7 0 Permit Number: SWG ' DESIGN CHECKLISTS. Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch 51 Test hole locations 19 Drainfield orientation and layout Reference depth from original grade: la Soil logs Ed Trench/bed dimensions and Rf Septic tank m Property lines critical distances within layout IX Drainfield cover m Existing and proposed wells Is D-BoxfValve box locations Reference depth from original grade within 100 ft of property R1 Septic tank/pump chamber and restrictive strata: 0 Measurements to cuts,banks,and locations lZ Laterals,trench/bed,top and surface water and critical areas 19 Observation port location bottom ❑ Location and orientation of E9 Clean-out location ❑ Curtain drain collector carbon drain and all absorption ❑ Manifold placement ❑ Sand augmentation components ❑ Orifice placement Other cross-section detail: 16 Location and dimension of 59 Lateral placement with distance 56 Observation ports/clean-outs primary system and reserve area to edge of bed Other Information 19 Buildings ❑ Audible/visual alarm referenced Yes No la Direction of slope indicator Ed Scale of drawing shown on scale ❑ Rf Design staked out 5d Waterlines bar ❑ Rf Recorded Notices attached Ed Roads,easements,driveways, 11 ❑ Rf Waiver(s)attached parking P 0 ® ❑ l7)Pump curve attached 10 North arrow and scale drawing ❑ 61 Evaluation of failure shown on scale bar P Non-residential justification pPR 2 120 ❑ if Waste strength MENTAL NEW ❑ Flow ohoc'lbrsI WLrROVAL The undersigned designer must be notified by ins er at time of majaDation Eil Yes ❑ No I ,82o2v Si of esigner 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: Ev'y6saAatal Health Specralist Date CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CONDITION: ✓ The design is stamped"Approved"by Mason County Public Health. J The Onsite Sewage Permit has not expired,the Permit Expiration Date is: Lt-r7-27 J 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 avaitable for public view on the Mason County Web site. Updated Date: L2n2015 i Mason County WA GIS Web Map A .7 • qp Y'xk�, Fm Y ' O 'i �ri O s �y • 21 Bf yF WR ', t'z NE Ora ti • 312W2023,2:27:30 PM 1:1,528 0 0.01 0.03 0.05 Ga County Boundary 0 OM O.0 0.08km No Filled Site Address (Zoom in to 1:3,000) Fo .N3 fM.N IEAE G",Yn.Inbmmo,men,u�P CaR.GEBco.us FAO. , RGA'. IGN. NL EM Gcflve. IVEetlx QJurn 5+xy. 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