HomeMy WebLinkAboutSWG2023-00481 - SWG Application - 11/6/2024 MASON COUNTY 415NBTHSTREET SHELT967 ,E98584
SHELFAIR 360-2754470,E%T 400
BELFAIR:360-2]5-048],E%T 400
Public Health & Human Services ELMA:360482-5269,EXT 400
FAX:360-427-7787
OnSite Sewage System Permit: SWG2023-00481
APPLICANT MCCONNELL, BRIAN &MARY Phone:
Address: 9872 W BELFAIR VALLEY RD BREMERTON,WA 98312
OWNER MCCONNELL, BRIAN &MARY Phone:
Address: 9872 W BELFAIR VALLEY RD BREMERTON,WA 98312
SEPTIC DESIGNER ROD LEFT-Acme Design Phone: 360-698-8488
Address: PO Box 2954 SILVERDALE,WA 98383
Site Address: 441 NE Ranch Dr
+ Primary Parcel Number: 223297500050
1 Permit Description: New 5-bedroom Dosing Gravity Drainfield System: REVISION
Permit Submitted Date: 11/13/2023
Permit Issued Date: 1112712024
Issued By: David Anderson
Current Permit Fees Paid: $690.00 (eddid.nal rasa may ba reymred upon msmaadun ofapdra).
Permit Expiration Date: 11/21/2026 (baaea an dale a inp ian)
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 "The septic system may be located within the buffer(75) of the seasonal stream as long
as no native vegetation is removed during the installation.
7 Mason County Asbuitt 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/environmentallonsite/oss-inspection-request.php or call:
360-427-9670,extension 400.
OFFICIAL USE ONLY
MASON COUNTY II' b - 2'/ N >
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Brian McConnell
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9872 W. Belfair Valley Rd Bremerton WA 98312 z
srrEADOREss-sTREEE cm.mmDE
441 NE Ranch Dr Tahuya WA 98588 I ^'
NMIE OF DESIGNER PHONE I N
Rod Left 360-08—SqV
NAMEOFINST. PHONE O I W
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SUB.. Q SURFACING SEWAGE CIE)GSTINGFAILURE OSHORELINE
®DESIGN FORM(REQUIRED) ®SNE EPTICDESIGN(REWIRED) SEMiGIXAs LOT SME r I �
EUWAR(S)(IFAPPLICASLE 3+2 218671 sq ft x I o
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OFFICIAL USE ONLY BELOW THIS LINE
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p VMUNTARY [3mNTENANCENUMPING 13BUILDING PERMIT OWMESALE OCOMPWNT ❑OTHER:
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INS IGNATURE DATE APPIS('TTON E%pIMTION WE APP_. PROJR)/ISSUEDBY OATE
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THIS FORM MAYBE SCANNED AMD AVAILABLE FOR PMBUCWEW ON THE MASON COUNTYWEBSRE REVISW IMNDIS
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DESIGN FORM-PAGE ONE Assessor's Parcel Number: 2 2 3 2 9 - 7 5 - 0 0 0 5 0
A design will be reviewed when 3 copies of each of the following arc submitted:
r Completed design form that has been signed and dated. v Scaled layout sketch,including all applicable items on checklist
•Scaled plot plan,including all applicable items on checklist. a Cross-section sketch,including all applicable items on checklist.
This form may be scanned and avallable far public view on the Mason Cou Web SIM.Aarimum ,size: 11"X17"
PermttNumber: SWG ZOa3-00`12 Designer's Name: Rod left
Applicant's Name: Brian McConnell Designer's Phone Number: 360-698-8488
Mailing Address: 9872 W Beffair Valley Rd Designer's Address: P.O.Box 2954
S...fton We 9B312 Siverdate Wa sa
cityState ZipC' State ZA
_`.. ESI[GN-VARAMETERB
Treatment Device yU
❑Glendon Biofilter ❑Sand Filter ❑Mound ❑Sand Lined Drai.116d O RedreuiaSng Filter,Type:
❑Aerobic Unit Maka/Madd 13 Disinfection Unit Maka Model Other: R
Draiufield Type F�
Iu GraviTy ❑Pressure ❑Trench 13 Bed ❑Sub Surface Ddp
Septic Tank/Drainfield Specifications Laterals
Number of Bedrooms 3+2=5 Schedule/Class 3034
Daily Flow:Operating Capacity 6d Length 50 ft
Daily Flaw:Design Flow 600 gpd Diameter 4 in
Septic Tank Capacity VA Z X 1250 - gal Number 5 -
Receiving Soil Type(1-6) 3 f Separation 5 it
—�
Receiving Soil Appl.Rate .8 gpd/ftr Orifices '.
Required Primary Area 750 _ tit Total Number of Orifices N/A
Designed Primary Area 750 fO Diameter N/A in
Designed Reserve Area 760 - ft2 Spacing NIA in
Trench/Bed Width 3 — ft Manifold
Trench/Bed Length 250 ft Schedule/Class WA
Elevation Measurements Length N/A it
Original Drainfield Area Slope 8 % Diameter N/A in
New Slope,If Altered 8 % Preferred manifold configuration used? 0 Yes Rr No
Depth ofExcevetion Opdwe 9 in Transport Pipe
from Original Grade nay-rtvpe 6 in Schedule/Class 3034
Designed Vertical Separation 36 in Length 385 it
Gravelless Chambers Required? ❑Yes 13 No Optional Diameter 2 in
Pump Required? Ed Yes 0 No Dosing and Pump Chamber j
Pump/Siphon Specifications Number ofdoses/day 12
Difference in Elevation Between Pump Sbutaffend Uppermost Dose quantity 50 gal
Orifice 'a ft Chamber Capacity 1500 gal
Uppermost Orifice 13 Higher O Lower than Pump Shutoff Pump controls:Please check those required.
Capacity B Total Pressor Head 10 Wm RfTimer dElapse Meter W(Event Cmadacr
Calculated Total Pressure Head 15.9 it If Timer: Pump ou SMIN ,pump off 2HR
Comments
PUMP TANK TO HAVE (2)24 INCH RISERS
i
DESIGN FORM—PAGE TWO Assessoi s Parcel Number:2 2 3 2 9 — 7 5 — 0 0 0 5 0
Permit Number: SWO
DESIGN CHECKLISTS'
Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch
E(Test hole locations d Drairdield orientation and layout Reference depth from original grade:
f�Soil logs d Trench/bed dimensions and 9 Septic tank
f�Property lines /critical distances within layout Ur Dminfield cover
fd Existing and proposed wells fh D-Box/Valve box locations Reference depth from original grade
within 100 ft of property d Septic tank/pump chamber and restrictive strata:
Measurements to cuts,banks,and locations 03"Laterals,trench/bed,top and
surface water and critical areas dObservation port location bottom
❑ Location and orientation of Of Clean-out location ❑ Curtain drain collector
curtain drain and all absorption ❑ Manifold placement ❑ Sand augmentation
components ❑ Orifice placement Other cross-section detail:
led'Location and dimension of lA' Lateral placement with distance f� Observation por s/cleanouts
primary system and reserve area to edge of bed Other Information
l( Buildings p/Audible/Asual alarm referenced Yes No
G?r Direction of slope indicator [9 Scale of drawing shown on scale ❑ dDesign staked out
Ed Waterlines bar ❑ dRworded Notices attached
dRoads,easements,driveways, ❑ fr Waiver(s)attached
parking S6 [3,Pump curve attached
G(North arrow and scale drawing ❑ as Evaluation of failure
shown on scale but Non-residential justification
❑ ❑ Waste strength
❑ ❑ Glow
DESIGN APPROVAL /
The undersigned designer must be notified by inst. Icr at tiro 'nstallation 2 Yes ❑ No
//-6 'go25(
Spiatim of Designer Date
The undersigned has reviewed this design on behalf of Mason County Public Health and determine it�Inbe•ir}
compliance with state and local on-site re lions: `�0
g a / Z iv lb z" (�%o *01,1�
Enviro Health Specialist Date UNryFN` ZOZy
CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CONDt�t}jesfydNT
✓ The design is stamped"Approved"by Mason County Public Health. �Hi q(
✓ The Owite Sewage Permit has not expired,the Permit Expiration Date is: J 11711 7,� H��Ty
✓ Dminfield 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 maybe scanned and available for public view on the Mason County Web site.
Updated Date: 12/72015
Pun(p Selection for allon-Pressurized System -MulupleFamiyResidenceProject
MCCON N ELU 22329-75-00050
Parameters
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