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HomeMy WebLinkAboutSWG2024-00328 - SWG Application / Design - 8/2/2024 SHELT ® MASON COUNTY 415NBTH LFAIR, 60_275ON.WA98564 $HELTCN:360427-9670,EXT 400 BELFAIR:360-2]5-0467,EXT 000 Public Health & Human Services ELMA:380i82-5269,EXT 400 FAX 360427-7787 On-Site Sewage System Permit: SWG2024-00328 APPLICANT WALLER THOMAS WILLIAM Phone: 253-223-8461 Address: 3232 S 186TH ST SEATAC,WA 98188 OWNER WALLER THOMAS WILLIAM Phone: 253-223-8461 Address: 3232 S 186TH ST SEATAC,WA 98188 SEPTIC DESIGNER ROD LEFT-Acme Design Phone: 360-698-8488 Address: PO Box 2954 SILVERDALE,WA 98383 Site Address: 427 E Rivendell Rd Primary Parcel Number: 221167590072 Permit Description: 2-bedroom gravity system Permit Submitted Date: 08/02/2024 Permit Issued Date: 08/2812024 Issued By: David Anderson Current Permit Fees Paid: $540.00 Lmimrel lee.m.Y b.rcu..d w.�Imblkdod dr.y mml. Permit Expiration Date: 08127/2027 m...dom.I.mm.d.a.�l Pennit 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 Masan County Certified Installer unless prior written authorization from Mason County is obtained. 3 Dreinfreld 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 backfit of system components. 5 Installer is responsible for obtaining Septic Designer/Engineer installation approval prior to backfill of system components. 6 Mason County Asbuilt 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/oss4nspection-request.php or call: 360427-9670,extension 400. OFFICIAL USE ONLY WRPSENED MASON COUNTY y COMMUNITY SERVICES ° PubINNel I�h lGom uniis HealttW Mnn MBIHMIW -pl MJ Ra D u WMtM \ SWG A004 - o p . ON-SIT POAATa� SLY M APPLICATION a a 3 z MPLIfAN! NpIE m r Tom Waller PAD 253-223-8461 z MAwxDADDPEss-srREEEcm,srATE.zIP cane � 3232 S 186th St SeaTac WA 98188 z SITFADDREss-sTREET,CITYMPGODE 427 E. Rivendell Rd Grapeview WA 98546 I "' NW" DEeWHER PHONE IIV Rod Left 360-698-8488 HPME OF IN-- PHONE Q PEPIM.T7'PE RBMBIwN) OPHONG WATER 901_ O ®RESIDENTIALG.SS �COMMUNITYOSS ®COMMERCIALOSS ®PRIVATEINDIVIDUALWELL PRIVATE TVO PARiY WELL Z I � nPE OF WO0.K(..Ndoy ®PUBLIC WATER SYSTEM ®N:CONSTRUCTION IUPGRAGES Ea OMER OETPIL3(ae4e MSIaIBPPy) ❑TABLE C(REPAIR I V SuSWTTALs ❑SURFACING SEWAGE ❑EXiSTNG FAILURE ❑SHORELINE 11 ®DESIGN FORM(REQUIRED) INSEPTIC DESIGN(REQUIRED) eEG011s LOTSRE 6I , EDWAIVER(S)(IF APPLICABLE) 2 54,450 sq ft x DIRECTICNSTO PREANDSITE CONDTONS:1v.IwWgM1J See Map o I � ti IV MUSTBEFIIOOQOFRONYNN ROAD ANO TEST NOLES NWTSEMGOED INIM LEST NOIENYMBER9. I N OFFICIAL USE ONLY BELOW THIS LINE OPGPPDEIFNLURESOIIRCEIIn,nyNry 10 ❑VOLUNTARY [3MAINTENANCEIPUMPING OBUILDINGPERMIT 0HOMESALE OCOMPLAINT ❑OTHER: WSPECTORSOLLOOsr S COMN ICONDITIONS 7N2'�^f�" vc �5 �s+ u+ s� I-r rno+ a ++r 1 µt:o _JF &tInaf TyPB3 35110 %mil 18.7r V rPWlS v'/ P0WI`S of F(,Mf ao bfftr4 rl SS'.F yrw" pg:U--W G W pGtW of S1 t L I Waf 7�' �- ' 0 Ply RECORD ll DRAWINGANOINSTATONREPORT SOILCODES: V VERY G=GRAVELLY S=9 D L=IMM SI-SILT C=CLAY E=EIIIREMELY 0.=flOOT$ REONNEO FO0.FINALAPPflOVN, IN SPECTCRSIGIMN0.E GTE MPLIG ONRATIXI GTE APPLILFiIONAPFROVEN ISSUED BY TE `6/L /la ( `� l 1a THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE REVISED IWW15 r , DESIGN FORM—PAGE ONE Assessor's Parcel Number: 2 2 1 1 6 — 7 5 — 9 0 0 7 2 A design will be reviewed when 3 copies 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. •Crass-section sketch,including all applicable items on checklist. This form maybe scanned and available for public view on[he Mason county Web site.Maximum a ersize: 11"X 17" Permit Number: SWG 707q7V L Designee Name: Rod Left Applicant's Name: Tom Weller Designer's Phone Number: 360-698-8488 Mailing Address: 3232 S.186th St Designer's Address: PO Box 2954 SeaTse WA 981M SINeNele WA 98380 C1 State Zi Ci State Zi Treatment Device ❑Glendon Biofdter ❑Sand Filter ❑Mound ❑Send Lived Drainfield ❑Rceirec ating Filteq Type: ❑Amobic Unit Make/Model ❑Disinfection Unit Meke/Madel Other Drainfield Type fi(Gravity ❑Pressure ❑Trench ❑Bed ❑Sub Surface Drip Septic Tank/Drainfreld Specifications Laterals Number of Bedrooms 2 Schedule/Class 3034 Daily Flow:Operating Capacity 1$o - gpd Length 45 11 Daily Flow:Design Flow 240 gpd Diameter 4 in Septic Tank Capacity 1000 gal Number 3 Receiving Soil Type(1-6) $ Separation 5 ft Receiving Soil Appl.Rate 0.% gpd/R2 Orifices Required Primary Area Soo ( ft' Total Number of Orifices NA Designed Primary Area 300 1 ft Diameter NA in Designed Reserve Area 30o r R2 Spacing NA in Trench/Bed Width 3 ft Manifold Trench/Bed Length 100 ft Schedule/Cless NA Elevation Measurements Length NA It Original Drainfield Area Slope 10-15 /o Diameter NA in New Slope,If Altered 10-15 a/ Preferred manifold configuration used? O Yes O No Depth of Excavation on-slope 18 in Transport Pipe from Original Grade Down-elope 14 in Schedule/Cless 3034 Designed Vertical Separation 36 in Length 20 ft Graveness Chambers Required? ❑Yes 0 No 90ptional Diameter 4 in Pump Required? ❑Yes R1No Dosing and Pump Chamber Pump/Siphon Specifications Number of doses/day NA Difference in Elevation Between Pump Shutoff and Uppermost Dose quantity NA gal Orifice ft Chamber Capacity NA gal Uppermost Orifice❑Higher 0 Lower than Pump Shutoff Pump controls:Please check those required. Capacity Q Total Pressure Head gpm OTimer DElapse Meter ❑Event Counter Calculated Total Pressure Head R If Timer: Pump on Pump Off Comments DESIGN FORM—PAGE TWO Assessor's Parcel Number:2 2 1 1 6 — 7 5 -- 9 0 0 7 2 Permit Number: SWG _DESIGN CHECKLISTS Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch 66 Test hole locations 69 Drainfield orientation and layout Reference depth from original grade: 5d Soil logs Rf Trenchlbed dimensions and 17) Septic tank 66 Property lines critical distances within layout gd Drainfield cover 91 Existing and proposed wells 66 D-Box/Valve box locations Reference depth from original grade within 100 ft of property Rf Septic tank/pump chamber and restrictive strata: m Measurements to cuts,banks,and locations X Laterals,trench/bed,top and surface water and critical areas 66 Observation port location bottom ❑ Location and orientation of 19 Clean-out location ❑ Curtain drain collector curtain drain and all absorption ❑ Manifold placement ❑ Sand augmentation components ❑ Orifice placement Other cross-section detail 19 Location and dimension of Ef Lateral placement with distance Pf Observation ports/clean-outs primary system and reserve area to edge of bed Other Information m Buildings ❑ Audiblelvisual alarm referenced Yes No 6d Direction of slope indicator Rf Scale of drawing shown on scale ❑ fff Design staked out m Waterlines bar ❑ Rf Recorded Notices attached 21 Roads,easements,driveways, ❑ if Waiver(s)attached parking ❑ GG Pump curve attached IM North arrow,and scale drawing ❑ 9 Evaluation of failure shown on scale but Non-residential justification ❑ Rf Waste strung[, ❑ R1 Flow DESIGN APPROVAL The undersigned designer must be notified by04� his ller at ti e o ' t 'on 5d Yes ❑ No '31 zoZtf Si lure of Designer Date /{A The undersigned has reviewed this design on behalf of Mason County Public Health and determine n trp( V a O� compliance with state and local on-sit bons: �/ � lJ�Z9770 M°S0A1cooA,,.i, 4 En mal Health Specialist Date 1Y�ppry���_ CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CONDITIl9N AI NEgI ✓ The design is stamped"Approved"by Mason County Public Health. �llo ✓ The Onsite Sewage Permit has not expired,the Permit Expiration Date is: l ✓ 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 an the Mason County web site. Updated Date: 12/7/2015 Mason County WA GIS Web Map zF l ITE ^Y �J6Ctill4 oN c01'*ryf"�' xEkT�ti�TH 4/9/2024, 10:20:37AM 1:12,264 0 0.1 0.2 0.4 mi 13 County Boundary I o 0.15 0.3o, I No Filled El Tax Parcels (Zoom in to 1:30,000) E��Gam]. m P.Mvxmnl P G�GG,WO-. 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