HomeMy WebLinkAboutSWG2024-00129 - SWG Application / Design - 4/3/2024 SHELT
® MASON COUNTY 415N6SHELTON, 60427-O70.EXT40
SHELFAIR 360-2754467.EXT400
BE ELMA 360-2T5-4467.EXT 400
Public Health & Human Services ELMA:360d825269,EXT 400
FAX:360427-7787
On-Site Sewage System Permit: SWG2024-00129
APPLICANT Tim Labatte Phone:
Address: 123 NW 12th Ave PORTLAND, OR 97209
OWNER SWINDLER'S COVE LLC Phone: 253-381-2235
Address: 9815 59TH ST NW GIG HARBOR,WA 98335
Site Address: Anchor View Ln
Primary Parcel Number: 320103150170
Permit Description: New SFR-4BR Gravity
Permit Submitted Date: 04/03/2024
Permit Issued Date: 04/16/2024
Issued By: Jeff Wilmoth
Current Permit Fees Paid: $540.00 (addeonaloess rear,ee required upon installation ofWaa,n).
Permit Expiration Date: 0 4/0 412 0 2 7 (eased on date of mspeceon)
Permit Conditions:
i 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 upslops 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 DesigneriEngineer 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/onvironmental/onsiteloss-inspection-request.php or call:
360.427-9670, extension 400.
OFFICIAL USE NLY
MASON COUNTY PUBLIC HEALTH FSW
�DWD ONSITE SEWAGESYSTEMAPPLICATION 415 N6th StrE46(Bldg 8) Shelton WA,985B4 O •Sheltan:36D-427-9670E#400 BeBair:3%275-4467ext400 � � — y p
y O 0
2 f%a
APPLICANT PHONE
TIM LABATTE 5037057981 m
MWLING ADDRESS-STREET.Cm STATE,LP CODE r
123 NW 12TH AVE PORTLAND OR 97209 c
SUE ADDRESS-STREET Cm.LP CODE
W
XX ANCHOR VIEW LN SHELTON WA 98584 m
NAME OF DESIGNER 36 P Ir AI
ADAM HUNTER 3607531226 V V
NAME OF INSTALLER PHONE
TBD
CHECKALAPPLICANEUEMS DRINKING WATER SOLACE O
0 NEW CONSTRUCTION 0 RVHOLDINGTANK ONLY O PRNATEINDIVIDUALAMIL y r
Of REPLACEMENT SYSTEM E3 INSTALLATION PERMIT ONLY O PRNATETWO-PARTYWELL 0
0 TABLE 9 REPAIR 0 SINGLE FAMILY Ef COMMUNITYIPUBLIC WATER SYSTEM
0 TANK(S)ONLY O COMMERCIAL SYSTEMNAME: smwePA. I I I
0 UPGRADE TO EXISTING 0 OTHER: BEDROOMS LOT SIM V"
0 EXISTING FAILURE 'R^'TINDn+NMre9uirea 4 51 W
b MMFNINtiens" r I^
DIRECTIONS TO SUE-BE SPECIFIC AND ADVISE OF MY NEEDED INFORMATION FOR ACCESS(ax.k yb) n
AGATE LP TO A RIGHT ON DANI�LS RD TO A LEFT INTO SWINDLER'S COVE, STAY Ix
RIGHT TO LOT 7. IC
SUE MAST RE FLAGGED FROM MAIN ROAD AND TESTHOES YUSTBE AAGTiED BTTHIESTHOIENUYBERS I I�
OFFICIAL USE ONLY BELOW THIS LINE
UPGRADE I FAILURE SOURCE(Nr AANUr puTom)
DVOLUNTARY OMAINTERANCEIPUMPING OBUILDINGPERMIT OHOMESALE O00MPL4INT DOTHER:
INSPECTORSOLLOGS COMMENTSICONOIIXNiS
aYf � "72- /W3, CS k
BOLCODEB:
V-VERY O-GRAVELLY S-SAND L-LOAM S-SILT C-CIAY E-EXTREMELY R-ROOTS
INSPECTOR SIGNATURE MTE APPLICATION EXPIRATION DATE APFLIGTbNAPFROVEDBT DATE
T MMAY BE SCANNED AND AVAILABLE MR PUBLIC VIEW ON THE MASON COUNTYWEBSITE REVISED127=15 I
DESIGN FORM—PAGE ONE Assessor's Parcel Number: 34 - f7b LZjD
A design will be reviewed when 3 coides 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. °Cross-section sketch,including all applicable items on checklist.
This form maybe scanned and available for public view on the Mason County Web site.Marimum paper size: 11"X 17"
PARCEL IDENTIFICATION
Pemut Number: SWG Designer's Name: ADAM HUNTER
Applicant's Name: TIM LABATTE Designer's Phone Number: 360-753-1226
Mailing Address: 123 NW 12TH AVE Designer's Address: PO BOX 162
PORTLAND OR 97209 OLYMPIA WA 98507
city state CI Zi state zip
DESIGN PARAMETERS
Treatment Device
❑Glendon Biofilrer ❑Sand Filter ❑Mound ❑Sand Lined Drainfteld ❑Recirculating Filter,Type:
0 Aerobic Unit MakdModel 0 Disinfection Unit Maka/Model Other.
Drainfield Type
5(Gmvity ❑Pressure ❑Trench ❑Bed 0 Sub Surface Drip
Septic Tank/Drainfreld Specifications Laterals
Number of Bedrooms 4 Schedule/Class 40
Daily Flaw:Operating Capacity 360 gpd Length 54 ft
Daily Flow:Design Flow 480 gpd Diameter 4 in
Septic Tank Capacity 1500 gal Number 5
Receiving Soil Type(1-6) 4 Separation 6-9 ft
Receiving Soil Appl.Rate 0.6 gpd/ftt Orifices
Required Primary Area 800 (jt Total Number of Orifices GRAVITY
Designed Primary Area 810 ft, Diameter GRAVITY in
Designed Reserve Area 1200 ftz Spacing GRAVITY in
Trench/Bed Width 3 ft Manifold
Trench/Bed Length 270 ft Schedule/Class 40
Elevation Measurements Length 20 ft
Original Drainfield Area Slope 20 % Diameter 4 in
New Slope,If Altered 20 /a Preferred manifold configuration used? 9Yes 0 No
Depth of Excavation U"IWp 32 in Transport Pipe
from Original Grade Down-slope 24 in Schedule/Class 40
Designed Vertical Separation 36 in Length 15 ft
Crravelless Chambers Required? ❑Yes []No I(Optional Diameter 4 in
Pump Required? ❑Yes IdNo Dosing and Pump Chamber
Pump/Siphon Specifications Number ofdoses/day GRAVITY
Difference in Elevation Between Pump Shutoff and Uppermost Dose quantity GRAVITY gal
Orifice ft Chamber Capacity GRAVITY gal
Uppermost Orifice 0 Higher 0 Lower than Pump Shutoff Pump controls:Please check those required.
Capacity Q Total Pressure Head WA glint OTimer OElapse Meter 0 Event Counter
Calculated Total Pressure Head u/A ft f PnP n PRI Pump off WA
Comments III IR
APR 16 M4 Lf
MASON COUNTY ENVIRONMENTAL HEALTH
DESIGN FORM—PAGE TWO Assessor's Parcel Number.3.CRQ L Q
Permit Number: SWG
DESIGN CHECKLISTS
Scaled Plot Plan Scaled Layout Sketch Cros; Section Sketch
Rf Test hole locations 11 Drainfreld orientation and layout Reference depth from original grade:
19 soil logs Y Trenchlbed dimensions and Ed Septic tank
19 Property lines critical distances within layout IZ Dminfield cover
11 Existing and proposed wells V D-BoxNalve box locations Reference depth from original grade
within 100 ft of property EZ Septic tank/pump chamber and restrictive strata:
• Measurements to cuts,banks,and locations ❑ Laterals,trench/bed,top and
surface water and critical areas E9 Observation port location bottom
• Location and orientation of 9 Clean-out location ❑ Curtain drain collector
curtain drain and all absorption d Manifold placement ❑ Sand augmentation
components 9 orifice placement Other cross-section detail:
99 Location and dimension of hj Lateral placement with distance 9 Observation ports/clesmouts
primary system and reserve area to edge of bed Other Information
9 Buildings Rf Audible/visual alarm referenced Yes No
IZ Direction of slope indicator Scale of drawing shown on scale ❑ Designstaked out
9 Waterlines bar ❑ ❑ Recorded Notices attached
9 Roads,easements,driveways, ❑ ❑Waivers)attached
puking ❑ ❑ Pump curve attached
1f North arrow and scale drawing ❑ ❑ Evaluation of failure
shown on scale but Non-residential justification
❑ ❑ Waste strength
❑ ❑ Flow
DESIGN APPROVAL
The undersigned designer mus otifred by installer at time of installation "Yes ❑ No
3II3/24
ta[ure of Designer Date
The undersigned has reviewed is design on behalf of Mason County Public Health and determined it to be in
compliance with state and local o"'te regulations:
Envfon6&&l Health Specialist Date
CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CONDITION:
✓ The design is stamped"Approved"by Mason County Public Health. t.
✓ The Onsile Sewage Permit has not expired,the Permit Expiration Date is: t`,*2,1
✓ Drainfteld 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 obtain Public Public Health.
An Installation Fee is required. APR 1 6 2024
This form may be scanned and available for public view on Ab site.
JB W Updated hate: 12/72015
PAGE I
MASON COUNTY HEALTH DEPARTMENT
ON-SITE SEWAGE DISPOSAL SYSTEM DESIGN
SITE#: PARCEL#: 32010-31-50170
DATE SUBMITTED: 3/132024 LEGAULOT#: LOT 7
SWINDLERS COVE
SUBMITTED BY: ADAM HUNTER
APPLICANT: TIM LABATTE
ADDRESS: 123 NW 12TH AVE
PORTLAND,OR 97209
I.CALCULATIONS
NUMBER OF BEDROOMS= 4
RESIDENTIAL GPD FLOW= 480
IF NON-RESIDENTIAL-GPD FLOW
WILL BE AS FOLLOWS:
GPD=
APPLICATION RATE= 0.6 GPD/FT2
REDUCTION=LEAVE SLANKIF NO REDUCTION TAKEN
DRAINFIELD SIZING
ABSORPTION AREA= 810 FT2
TRENCH LENGTH OR BED CONFIG.= 5-54FT TRENCHES
II.WATERPROOF SEPTIC TANK
COMPOSITION AND SIZE= 1500GAL.CONCRETE
NEW OR EXISTING= NEW
Ill.DRAINFIELD CROSS SECTION
DEPTH TO DRAINROCK BOTTOM= T-0'
ROCK DEPTH BELOW PIPE= 0'-6'
SEPARATION FROM TRENCH BOTTOM TO IMPERMEABLE
MATERIAUSEASONAL SATURATION= IT-0-
FILL DEPTH= 11.9.
TRENCH WIDTH= T.O.
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