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HomeMy WebLinkAboutSWG2024-00002 - SWG Application / Design - 1/3/2024 SHELTON,WA 584 MASON COUNTY 415NBTHELTON: , 0427-97 .EXT 400 9HELTQN:360i27-9870,EXT 400 BELFAIR:360-275.4467,EXT 400 Public Health & Human Services ELMA 3B 2-5269,EXT 400 FAX:360427-7787 On-Site Sewage System Permit: SWG2024-00002 APPLICANT Buck Carr C/O Mary Carr Phone: Address: PO Box 305 COSMOPOLIS, WA 98537 OWNER TAYLOR ET AL CHLOE M Phone: Address: P O BOX 235 MOCLIPS, WA 98562 SEPTIC DESIGNER Adam Hunter-Jim Hunter and Phone: 360-753-1226 Associates Address: PO Box 162 OLYMPIA, WA 98507 Site Address: 33100 N US HIGHWAY 101 CABIN 1 Pnmary Parcel Number: 323105101016 Permit Description: Table 9 repair ATU to subsurface drip for Cabins 1,7.10 Permit Submitted Date: 01/03/2024 Permit Issued Date: 06/11/2024 Issued By: Rhonda Thompson Current Permit Fees Paid: $2,415.00 (additional fees may tie rNeired uPon mslauanon of system). Permit Expiration Date: 01/0512025 (based on dale of dependent Permit Conditions: 1 Proposed development subject to zoning requirements and approval by the planning department sta%per Mason County Title 17. 2 Permit must be installed by a Mason County Certified Installer unless pnor written authorization from Mason County is obtained. 3 Drainffeld 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 Designer7Engineer installation approval prior to backfill of system components. 6 Mason County AsbuiH 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: mawncountywa.gov/health/environmental/onsiteloss-inspection-request.php or call: 360.427-9670, extension 400. OFFICIAL USE ONLY MASON COUNTY PUBLIC HEALTH • • w D ONSITE SEWAGE SYSTEM APPLICATION E y O N 415Nbih5irzet,(Ndg B) SheltanWg98684 �Shtn:3604U-9670 ex[4W BeNair36GU54967eEI400 SWG _(�A6o�L/ OmA 2 N Z 9 APPLICANT PNLHE D D BUCK CARR 360-300-7111 m m M UNG ADDRESS-STREET CRY.STATE.OR CODE r C/O MARY CARR PO BOX 305 COSMOPOLIS WA 98537 a 61 CODE DO 33100 USEHWYP101 (CABINS 1,7-10) LILLIWAUP WA 98555 z NPME OF DESIGNER PHONE ADAM HUNTER 3607531226 �T NVAE OF INSTALLER I PHONE I y+ CHECRPIIAPlCAS,E MMS IXiMgNG WATER SWRCE NEW CONSTRUCTION 0 RV HOLDING TANK ONLY 0 PRNATE INDIVIDUAL WELL N r Od REPIIMhffNTSYSMM O INSTALIATIONPERMITONLY 0 PRNATETWO-PARTYWEIL 2 u IO TABLED REPAIR SINGLE FAMILY ef COMMUNITYIPUBUC WATER SYSTEM 0 TANK(S)ONLY [3 COMMERCIAL SYSTEMNAME: sTETaoxcrnx I 1 0 UPGRADE TO FASTING O OTHER: BEDROOMS LOTSIIE Yrn` 'RwWtlDmrMy nguHNl 0 EXBiTING FAILURE ANeXNUYlntlam' 10 VARIES � DIRECINWSTO SM-BE 6PEgFICENUAWI6EOFNiY NEEDE➢INFDRM4TWN FORACC.S(az.k[keE 9vle) A I� US HWY 101 TO RIGHT INTO STETSON COVE G 7,Z 116��i o 91TFYUST BEfLA00ED FlMMYAINROADAND TESTRp.ESMOSTBEFIAWED RONTEST NOLENUYBFRS I N OFFICIAL USE ONLY BELOW THIS LINE UPGRADE I FAILURE SWRCE(W�ng WR>✓'w) [3VOLUNTARY [3MNNTENANCE/PUMPING OBUILDINGPERMIT OHOMESALE OCOMPIAINT DOTHE ' \SPECTORSOLLOGS LOMM ICONDRKINS ' \ 0 rh�rnDd rlJ✓1 0 HE It 0 WILCODES: gym V=VERY G-GRAVELLY S=6PN0 L=LOAM G•SILT C-L y E=EXTREMELY II-ROOTS INSPECTOR SIGNATURE DALE MPUCATONE%PIRATIONMTE 1 ` I Izs ]APIRUCATIONAPPROIoIEDBY " 6111zy THIS FORM MY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE REVISED INTrz015 DESIGN FORM—PAGE ONE Assessor's Parcel Number:3 a3La. — E-L — Q-L 01b A design will be reviewed when 3 copies of each of the following are submitted: •Cofnpleted design form that has been signed and dated. 0 Scaled layout sketch,including all applicable items on checklist Scaled plot plan,including all applicable items on checklist. O Cross-section sketch,including all applicable items on checklist. This form maybe scanned and available for public view on the Mason County Web site.Mnrimuso paper size: 11"X I7" PARCEL IDENTIFICATION Permit Number: SWG /.�7�"TOf7DOZ . Designer's Name: ADAM HUNTER Applicant's Name: BUCK CARR Designer's Phone Number: 360-753-1226 Mailing Address: C/O MARY CARR PO BOX 305 Designer's Address: PO BOX 162 COSMOPOUS WA 98537 OLYMPIA WA 96507 City State zip city State Zip DESIGN PARAMETERS Treatment Device ❑Glendon Biofilter ❑ Sand Filter O Mound 13 Sand fined Drainfield ❑Recirculating Filter,Type: S(Ambic Unit Make/MoM BNR1500 ❑Disinfection Unit Make/Model Other: Drainfield Type �/ ❑Gravity Elal Pressure ❑Trench ❑Bed Sub Surface Drip Septic Tank/Drainfield Specifications Laterals Number of Bedrooms. 10 Schedule/Class DRIP Daily Flow:Operating Capacity 900 gpd Length 250 ft Daily Flow:Design Flow 1200 gpd Diameter DRIP in Septic Tank Capacity 3000(PER aNR 1500) gat Number 6 Receiving Soil Type(1-6) _� Separation 1 ft Receiving Soil Appl.Rate 94 gpd/ft' Orifices Required Primary Area 1500 ft' t/ Total Number of Orifices 1500 Designed Primary Area 1500 ft, Diameter DRIP in Designed Reserve Area NIA W Spacing 12 in Trench/Bed Width VARIES ft Manifold Trench/Bed Length VARIES ft Schedule/Class 40 Elevation Measurements Length 40 ft Original Drainfield Area Slope 0 ova Diameter i in New Slope,If Altered NIA /o Preferred manifold configuration used? 61"Yes O No Depth of Excavation 11 -10 a 12 in Transport Pipe from Original Grade -r(�c 12 in Schedule/Class 40 Designed Vertical Separation 12 in Length 200 ft Gravelless Chambers Required? ❑Yes l2fNo ❑Optional Diameter 1.25 in Pump Required? SdYes 17 No Dosing and Pump Chamber Pump/Siphon Specifications Number of doses/day 12 Difference in Elevation Between Pump Shutoff and Uppermost Dose quantity 100 gal Orifice 1' R Chamber Capacity 3000 gal Uppermost Orifice&(Higher 0 Lower than Plump Shutoff Pump controls:Please check those required. �y Capacity B Total Pressure Head 18.0 gpm �Pimer fikla a Meter fryy,� ar Fvent Counter Calculated Total Pressure Head 113.8 ft If Timer: Pu ^/�rrFF''11 l{DD 1 HR Counts JUN 11 2024 ur 168 RSON COUNTY ENARONMENTA D DESIGN FORM—PAGE TWO Assessor's Parcel Number:3,Z5 _ -- T-L Permit Number: SWG DESIGN CHECKLISTS Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch 1f Test hole locations a Dminfield orientation and layout Reference depth from original grade: 19 Soil logs d Trench/bed dimensions and E� Septic tank 19 Property lines critical distances within layout Ed Drainfield cover [Z Existing and proposed wells 121 D-Box/Valve box locations Reference depth from original grade within 100 ft of property Q( Septic tank/pump chamber and restrictive strata: la Measurements to cuts,banks,and locations ❑ Laterals,trench/bed,top and surface water and critical areas E9 Observation port location bottom Cd Location and orientation of 1Z Clean-out location ❑ Curtain drain collector curtain drain and all absorption 9 Manifold placement ❑ Sand augmentation components Y Orifice placement Other cross-section detail: Sd Location and dimension of 9 Lateral placement with distance ld Observation ports/clean-outs primary system and reserve area to edge of bed Other Information 19 Buildings V Audiblelvisual alarm referenced Yes No 19 Direction of slope indicator 9 Scale of drawing shown on scale Ed ❑ Design staked out 19 Waterlines bar ❑ ❑ Recorded Notices attached E9 Roads,easements,driveways, ❑ ❑Waiver(s)attached parking ❑ ❑Pump curve attached 19 North arrow and scale drawing ❑ ❑Evaluation of failure shown on scale bar Non-residential justification ❑ ❑ Waste strength ❑ ❑ Flow DESIGN APPROVAL The undersigned designer in b notifie mstaller at time of installation lif Yes ❑ No 5/11/24 S ature of Designer Date The undersigned has reviewed ' design on behalf of Mason County Public Health and determined it to be in compliance with state and local on-site regulations: ��W 6.I I� Environmental Health Specialist Date CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CONDITION: ✓ The design is stamped"Approved"by Mason County Public Health. ` i ( S ✓ 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. 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