HomeMy WebLinkAboutSWGG2024-00298 - SWG Application / Design - 7/12/2024 MASON COUNTY 415 NfiTHSTREET.BHET1 WA98584
SHELTON:360427-9670.EXT 400
4 BELFAIR:3a0-275<46467,EXT 400
Public Health & Human Services ELMA:3NA82-5269,EXT 400
FAX 360427-7787
On-Site Sewage System Permit: SWG2024-00298
APPLICANT DOST ANDREW BRYAN&MARIA Phone:
MIURA
Address: 264 CRAFTS PRAIRIE RD BASTROP, TX 78602
OWNER DOST ANDREW BRYAN &MARIA Phone:
MILIRA
Address: 284 CRAFTS PRAIRIE RD BASTROP,TX 78602
SEPTIC DESIGNER ROD LEFT' Phone: 360-698-8488
Address: PO BOX 2954 SILVERDALE,WA 98383
Site Address: 2281 E Harstine Island Rd 8
Primary Parcel Number: 120197500020
Permit Description: 2-bedroom gravity system wl Class B waiver
Permit Submitted Date: 07/12/2024
Permit Issued Date: 08101/2024
Issued By: David Anderson
Current Permit Fees Paid: $540.00 camidenelesm.r be recurred upon rnaaown of eyslomJ.
Permit Expiration Date: 07/29/2027 (based on doe of lnspmmn)
Permit Conditions-
1 Proposed development subject to zoning requirements and approval by the planning
department staff per Mason County Title 17.
2 Permit must be installed by a Mason County Certified Installer unless prior written
authorization from Mason County is obtained.
3 Drainfield installation not to exceed designed upslope and downslope depth specified on
design form.
4 Installer is responsible for obtaining Mason County installation approval prior to backfill of
system components.
5 Installer is responsible for obtaining Septic Designer/Engineer installation approval prior to
backfill of system components.
6 Mason County Asbuift Form, Record Drawing, and Installation fee must be submitted for
final installation approval.
THIS PERMIT MUST BE ONSITE DURING INSTALLATION OF OSS.
PROPERTY OWNERS ARE RESPONSIBLE FOR DETERMINING AND MARKING ALL PROPERTY LINE AND EASEMENT LOCATIONS,
THIS PERMIT MAY BE REVOKED IF THE SITE CONDITIONS HAVE CHANGED SINCE THE SITE WAS INSPECTED AND DESIGN APPROVED.
FINAL INSTALLATION APPROVAL IS REQUIRED PRIOR TO TEMPORARY OR FINAL OCCUPANCY OF ANY RELATED STRUCTURES.
For Final Inspection visit: masoncountywa.gov/hoalthionvironmentaVonsiteloss-inspectionaequest.php or call:
360427-9670,extension 400.
OFFICIAL USE ONLY
DNE xR:ErvED.
MASON COUNTY 1a a y
COMMUNITY SERVICES
rypY[mXrM�(�LfmmunXta'INFnNmnmmd HNMI (/1
SWG _XRU o
z G
ON-SIT TEM APPLICATION 3
MPIN T PMNE m r
Andrew & Maria Do 12 2p2 c
M.aWGADOPEss.sTREEr,cm.ngTEnPc 3
284 Crafts Prairie Rd Bastrop TX 78602 z
SIIER Em-$T ..CRY.VP=E
2281 E. larstine Islan Shelton WA 98584
NOMEDF DESIGIER PipXE I N
Rod Left 360-698-8488
NAE OF IMSTNLER PHLWE O
< I �
PEANLTPE(sNMms) DRINGNGW..TEAS ME N
®RESIDENTIALOSS EDCUMMUNRYOSS BCOMMERCIALOSS ®PWATEINDIVIDUALWELL EDPRIVATETWO-RWIYWEIL Z
TYFEOFYARR(aWtlaxl ®PUBLIC WATER SYSTEM I
JONEWCONSMUCTIONIUPG ES EDREPNRIREPLACEMENT oTYERDETNL9(rYe./S✓epy/f 0}gBLELYREPAIR IV
SUOMITTII3 ❑SURFACINGBEWAGE ❑E STINGFNWRE 13811CRELINE
MDESIGNFCHM(REOUIRM) ®SEPTICDEBIGN(REWIRED) eEMOW9 LOT9RE r I01
OM WAIVERIS)(1FAPPLICABIE) 2 214,800 sq ft c) l O
OIIIEttgH9 TO 9XE NO SIZE CCNdTON3:(¢bct�1 pbf
I �
o to
ti
I N
YrtE MGST BE FfIG6®RMMMAM/IGIG AIID lE4T ROLE9YIRIBEMGG®WRR iNTHGLENUM3FR3.
OFFICIAL USE ONLY BELOW THI5 LINE
DPCl/ADE/FNLURE SODRCE(Iw�atIYq WR<m^)
❑VOLUNTARY ❑MAINTENANCePUMPING OBUIW(NGPEWIT OHOMESAIE CICOMPWNT ❑OTHER:
�S�LCGG CUMIENrsI WNortUN9
TNtb-96Afc {�6ot�h I
Trri:qq 45/S3` S4 r
R(}+ di 4 515 3 ' "/ 0'*
�N3:p- /�5'I �fS bEotfc'A
RECCRDO NGMOIWTP Tp WR RT
SpLCODO:
V�VE0.Y G=GRPYELLY S=.MHO L=LOIM 91.9LT C�GAY E=E%TPFIAELY 0.=R00T9 0.EWIPED FORFIN4AWRGVAL
SIGIMTVRE WR MRIGTCNEWMTpH MTE M PRGYFA'IS .BY DATE
l l y/I aL
TNIS FORM MY BE SCANNED MD AVAILABLE FOR PUBLIC VIEW ON THE WSON COUIMWEBSRE REVISEDiwmt5
t
i DESIGN FORM—PAGE ONE Assessor's Parcel Number: 1 2 0 1 9 — 7 5 — 0 0 0 2 0
A design will be reviewed when 3 copies of each of the following are submitted:
•Completed design farm that has been signed and dated. r 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.Maximum a rrae: 11"X17"
PARCELIDENTIFI
Permit Number: -y. SWG -MZ r Rod Leg
Applicant's Name: Andrew 6 Maria DOW 'g�Phon mber: 3fi0E9g-g48g
Mailing Address: 2M Crafts Prairie Rd 11 es1 �gdr PO Bon 2954
Baxtep T% 7 Jae 1 SMordala WA 983e3
City State City State Zip
DESIGN
torment Device
❑Glendon Biofilter ❑Send Filter ❑Mmmd ❑Sand Lined Ihuinfield ❑Recirculating Filter,Type:
❑Amobic Unit MakadModel ❑Disinfection Unit Make/Model Other:
Draintield Type
RfGravity ❑Press.. ❑Trench ❑Bed ❑Sub Surface Drip
Septic Tank/Draiufreld Specifications Laterals
Number of Bedrooms 2 Schedule/Class 3034
Daily Flow:Operating Capacity 240 gpd Length 45 ft
Daily Flow:Design Flow 240 gpd Diameter 4 in
Septic Tank Capacity 'I'G$0— gal Number 3 '
Receiving Soil Type(14) 4 1 Separation 5 ft
Receiving Soil Appl.Raze .6 gpd/fe Orifices
Required Primary Area 400 ' ftr Total Number of Orifices NA
Designed Primary Area 400 fit Diameter NA iu
Designed Reserve Area 400 _ IF Spacing NA in
Trench/Bed Width 3 ft Manifold
Trench/Bed Length 135 ft Schedule/Clms NA
Elevation Measurements Length NA ti
Original Dminfield Area Slope 9 % Diameter NA in
New Slope,If Altered S % Preferred manifold configuration used? 0 Yes O No
Depth of Excavation Up-elope ai in Transport Pipe
from Original Grade Oowa-elope aI in Schedule/Class 3034 -
Designed Vertical Separation I% in Length ,Is ft
Gravelless Chambers Required? ❑Yes []No S(Optional Diameter 4 in
Pump Required? ❑Yes 56No Dosing and Pump Chambu
Pump/Siphon Specifications Number ofdoses/day NA
Difference in Elevation Between Pump Shutoff and Uppermost Dose quantity NA gal
Orifice NA ft Chamber Capacity NA gal
Uppermost Orifice 0 Higher 0 Lower than Pump Shutoff Pump controls:Please check those required.
Capacity Q Total Pressure Head NA gpm OTimm OElapse Meter ❑Event Counter
Calculated Total Pressure Head NA ft If Timm: Pump on Pam?off
Comments
i
DESIGN FORM—PAGE TWO Assessor's Pmcel Numrber: 1 2 0 1 9 — 7 5 — 0 0 0 2 0
Permit Number: SWG
DESIGN CHECKLISTS.
Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch
Id Test hole locations 19 Drainfield orientation and layout Reference depth from original grade:
la Soil logs 21 Trench/bed dimensions and 56 Septic tank
m Property lines critical distances within layout 69 Drainfield cover
19 Existing and proposed wells Ef D-BoxfValve box locations Reference depth from original grade
within 100 it of property E9 Septic tank/pump chamber and restrictive strata:
m Measurements to cuts,banks,and locations IZ Laterals,tmnch/bed,top and
surface water and critical areas 9 Observation port location bottom
❑ Location and orientation of Ea Clean-out location ❑ Curtain drain collector
curtain drain and all absorption ❑ Manifold placement ❑ Sand augmentation
components ❑ Orifice placement Other cross-section detail:
m Location and dimension of if Lateral placement with distance Ed Observation ports/clean-outs
primary system and reserve area to edge of bed Other Information
Buildings ❑ Audible/visual alarm referenced Yes No
lb Direction of slope indicator 1f Scale of drawing shown on state ❑ E(Design staked out
m Waterlines bar ❑ Rf Recorded Notices attached
16 Roads,easements,driveways, Ed ❑Waiver(s)attached
pig ❑ 19 Pump curve attached
21 North mow and scale drawing ❑ 9 Evaluation of failure
shown on scale bar Non-residential justification
❑ HI Waste strength
❑ Ed Flow
DESIGN APPROVAL.
The undersigned designer must be notified by inst t e of pnu, ation Ed Yes ❑ No
7 /L•ZZY
Signs ire of Designer Date /q w
The undersigned has reviewed this design on behalf of Mason County Public Health and d�eteePRO gin
compliance with state and local on-site re ns: �,/,, AZO
%M yll
Envir tat Health Speciahat �� Ds y�1YF/�G��� lpzy
CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CONUITLODij
✓ The design is stamped"Approved"by Mason County Public Health. O /
✓ 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 Date: 12/72015
Mason County WA GIS Web Map
----------
Er land vJcat r
Lei
L
y
A Mlfr
y
—T
7111/2024, 9i16:69 AM 16,144
4�
AUG 0 0.05 0.1 0.2 rni
County Boundary 41ASONCOUN1yENyRCN20Zy o 0.15 oaken
No Filled Doll ENrALNEAtrp
Tax Parcels (Zoom in to 1:30,000) Sawea'. Esri, HERE, Garmn.USGS, Imennap, INCREMENT P. NRCan,
Ea l Japan. METI. Ean Mina(Nag Kopf, Eatl Korea, Eeri Uhl
Ni I,UpaSbaerMap opera ors,e11 bee GIS U.Commwll
MuonC ,oA GIS N§b Map Ap n
Cploil
Mown roodrolam ,,a—a relief or Tmelb of dsa aabsXa Info,not l liable for from reliance on it M1MooRrfw mamntantyna.90v/Eisclamec orp
am DTp 0 0 0 z 1 000 >
III III > > r x 5 m c o A III z z
r 0 o M I M , 0 0
> 0 M 0 Z M < 11 o I J > >
I z 9 z o c wZ z z I' r
ti 46
u L r r III �,F!L
> 4
o z Q l200 am r z
w
c o M� F 6 " , , - .; ?
> 0 Cr 1 0 M� - 1. w I , YA
2 0 z c m r I ; o xM02 I c -Z
1 0 0 j 0 M z > -> - 1 0 0
0 Z 0 0 A Z 0 Z 0 Z q rn
IM I c �m M M T �o Q 0 X 0 <
Z z M 0 o Mz 0 > > > E - R 19.
rni
A 0 > 0 > 0 0 > Z r r >
I a I r ) A� I j 0 C� r Z r
z r M 0 c - M > 0
of
M 0 0 m > M{ z r Oc Mr x mm 0-1 z 0
0 M 1 0 0 11 A < 1) 111 M Z I I
M
> c 0 1 M > I > C > 1 0
1 0 > > ; < 2 1) -- %
0 9 1 A 0 0 ; z N j I _,j ! i,
0 1 r A o i 1I m III M r - 0 0 - >
w > o 0 r o z m I w i
o x M m 4 rJ
z Im o z I i A > > zz mm r,
1 0 0 j 0 M 0 N 1 > > 0 z
M 0 . < Z 0 > 0 1 Z z
Z > M 0 x A c -i x c 0 OPE
K A 0 J 0 1 z
0 r 0 ) z III M C III M M -jr.
r I
c 0 g r M
l 0 r
Z M > III D
i r > > X M
I M Z M - > I > 2 A M) a z
0 1 111 00 N
OAD �
I A IM o c x I
0 0 50 0 M
o I FM 1; �m E > Z ........
z M Z x 010 001 >0 >
0 K 0 o M > 0 D 9
C 0 K 0 c > 0 c c 9 In AEI
I Z 0 T M - P 1 1 1 M z z
c M 0 2 0 0 M A Z A ) M F z
w z
0 11 Z - 3 z z 0 1 Il
M
o A ; 00 0 >
0 M o C 0 Z I r < r I v ZN
0 K z 0 > 9 111 M 0 0
> c M 0 omo z w M
1 0 z C 5 0 > V < I
r I
0 C Z r <
M M 0
I, z 0 A III r AD a
o o 0 Z Z 7 r
A - 0 _4Q
Z 0 w 0
M M - > Z- 0 1
I > M 0 1 0 > a
0 o 0 A i o a
0
0 > > I < x 10 F 9
0
c
z c 1 0 AI r r
I .
@ Ir C1 >z 0 0) ro
r 0 U 0
0
Z
III OD 0 z 0
0 0 z
C III
z 0
� z
1>
o N 0 0,
CIO
> M
> z r 0 Z 0
I
w 0C: x 0 D o M
M M , P
M > I 0 M c
r N
0
z >
A IIIz
CD Z
ID�D > >
(1) XI
M
cD M
M a
F.�
in
c2 TI
70
cn —C
gas
M 0 -4
M z
90000 958 8 9�0 0
F
Ow, OXT
'MR, Rmm mom
TIC
ME; M TO
W. W, 0,
rr' Fn
. . . . . . .
M M M
wo wo IT
ITT
An (D
c_ I.
r 0)
nm Z, 1-
0
rn I,
411
z z
co
a
y
O
c
a
C/J
CA
den y m 21• C
Zs y4y
z 1 9 s C)
M<yi
Ovm A fT z RP.. rfl
TN O
y (n �Y C-�
r m R =
O c
—0
A � € C�
m !J
C� C
CrJ
m
x z
� Z
O o
O
3
A (n
i m
Z
t=saCEP ` °_
8n $£ gym .Aa° g pp g , ° 9$ g ° m"" ®s� •69g C) —
D-� p =ejg e= 2 a �. g Y2 sm • 1° $".eg
JAI f" ff=F m° gs �� °m$ ��� gg ��a �: � g� l•= gcmi
S1€ y a.^ c sT $ a; 3�c £�� o9 a z o
if °�c sm 1 H. �$§ � P�$ ¢ Eats 115 y g g spa K
€ a 's" §� " a h§ c• a��m ==e §g So $ �$ss� D o
W mo m.a €p11
a a� sA off= 9$ m ° R � � gs$osa �� e o c)
�a s; _$ oust • ig a �_ Rn za s ys
SRI
algl P-iv Ya mo ' � g �s�$ $ ° ° �g �$ 5 z
pg. =008 ' YSCL map ?a € 3 ;' °g €�$ jAlH¢ o
R F " @S n 3 4$' $' g•Sg z
? L P 3&1 Pz 9 : € 7�£ mb = €gs 512E $" m
ass $0 41 (� �g x
W 4 4-1 m Y$ z
gEE E c ° g (n
cn —i y a £ C j.
�
O 00
rn o m m moe €€ € • " � gaomoa _ 000
5 �$ $ 3 Mi m _
m o --j MUq 6 ° x[n ° • s °
O i Q m = m
[N— Nus 2 F$ mg o
1 1 a ' S• ° R q Cga 6 6
r /1 C m eggg p g c
m V J gg r
o
c� w $ €$ z m o 7 i
7W Wl j6I ° z 14
'ccxi m n a R �
0w