HomeMy WebLinkAboutSWG2021-00646 - SWG Application / Design - 11/29/2021 584
MASON COUNTY 415 NBTHELTON: 60427-ON0,EXT 400
SH STREET,
,SHETON, EXT400
4 BELFAIR:360-275J167,EXT 400
Public Health & Human Services ELMA:360482b269,EXT 400
FAX:360427-7787
On-Site Sewage System Permit: SWG2021-00646
APPLICANT CATHRYN WALLZUNDAL Phone:
Address: PO BOX 1186 ELMA,WA 98541
OWNER LEOPPARD GARRICK R&SARAH R Phone:
Address: 8324 48TH CT SE LACEY,WA 98503
SEWAGE DESIGNER CHRIS ELSTROTT' Phone: 360-561-5000
Address: 128 NORTH RIVER STREET MONTESANO,WA 98563
SEWAGE INSTALLER BO RUSSELL-septic installer Phone: 360.589.7957
Address: PO Box 336 MONTESANO,WA 98563
Site Address: 1370 W Satsop Maple Gin
Primary Parcel Number: 619307600110
Permit Description: AG BUILDING-2BR Gravity
Permit Submitted Date: 11130/2021
Permit Issued Date: 12/03/2024
Issued By: Jeff Wilmoth
Current Permit Fees Paid: $705.00 (additional fees may be mulrea upon lnefallabon orsyerem).
Permit Expiration Date: 01/18/2025 maeed an date of lnspeatonl
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 Deinfield 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
back ill of system components.
6 Mason County Asbudt Form, Record Dewing, and Installation fee must be submitted for
final installation approval.
7 According to design, the proposed building for this septic is an exempt storage building.
Plumbing not allowed in exempt sbuctures.
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 15 REQUIRED PRIOR TO TEMPORARY OR FINAL OCCUPANCY OF ANY RELATED STRUCTURES,
For Final Inspection visit: masoncountywa.gov/health/environmental/onsite/oss4nspectiongequest.php or call:
360.427-9670,extension 400.
OFFICIAL USE ONLY
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DESIGN FORM-PAGE ONE Assessor's Parcel Number: 6 I S 3 D -- �, 6 - J o /I 0
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
v Scaled plot plan,including all applicable items on checklist. I Cross-section sketch,including all applicable items on checklist.
This form maybe scanned and available for public view on the Mason County Web site.Marmon paper she: 11"X 17"
PARCEL_IDENTIFICATIO_N
Pemut Number: SWOP • 6()10� Designer's Name: G�i2s . SIR+1T
Applicant's Name: eq "-A- A/ //-Zat d / Designer's Phone Number: .ap6o-S6/-S'000
Mailing Address: P.J. Box //96 Designer's Address: K-S W. /en'.ee sr.
e✓A Z-1- i✓b N?'Ycyw p.9 90r93
City State Zip City _ State Zip
DESIGN PARAMETERS
Treatment Device
❑Glendon Bm6her ❑Sand Filter ❑Mcand ❑Sand Lined Diamfield 0 Reenalating Filter,Type:
0 Acmbic Unit Make/Model ❑Disinfection Unit Make/Model Other: Gir/alI/ )Rbu'a'
//'' DrFBinfreld Type
®'Crravity ❑Pressure ®'branch ❑Bed ❑Sub Surface Drip
Septic Tank/Drainfield Specifications Laterals
Number of Bedrooms .Z Schedule/Class 200
Daily Flow:Operating Capacity 2.V0 glad Length to ft
Daily flow:Design Flow 2yo glad Diameter y'rst< ,we. in
Septic Tank Capacity /2. 0 gal Number 2
Receiving Soil Type(1-6) 3 Separation 9 ft
Receiving Soil Appl.Rate a s gpd/ft' Orifices
Required Primary Area ,Itl0 ft Total Number of Orifices N/4
Designed Primary Area 300 fe Diameter Ay� in
Designed Reserve Area _700 ft° Spacing t2/2 in
Trench/Bed Width .7 ft Manifold
Trench/Bed Length 50 ft Schedule/Class ///q
Elevation Measurements Length ^'/A ft
Original Drainfield Area Slope 0 % Diameter /y/II in
New Slope,If Altered O % Preferred manifold configuration used? 1ya
Depth of Excavation U"[We .?6 'max in Transport Pipe
from Original Grade pawn,,, 76+max in Schedule/Class y,Rpsrra soapy
Designed Vertical Separation 36 - in Length * '/o It
CrmveUcss Chambers Requird? ❑Yes 21ifo0 Optional Diameter rj/" in
Pump Required? ❑Yes Ergo Dosing and Pump Chamber
Pump/Siphon Specifications Number ofdams/day . 119
Difference in Elevation Between Pump Shin'u,f//T N1H and Uppermost Dose quantity gal
Orifice �q4 ft Chamber Capacity a//4 gal
Uppermost Orifice O Higher O Lower than Pump Shumff Pump co . lease c�hoc=those required.
Capacity®Total Pressure Head gpm OTim 0a= u Event C ter
Calculated Total PrcWjdffe;� Alin it If T p on ,Pump off—�-
Comments d
rry
r DESIGN FORM—PAGE TWO Assessor's Parcel Number: 6 LZ 3 0 -- 24— -- 9 ! / O
Permit Number: SWG
.DESIGN CHECKLISTS
Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch
[P'�Tm t hole locations Drainfield orientation and layout Reference depth from original grade:
C�"�Scil logs C3--1'rench/bed dimensions and lqpU-c tank
L1iProperty lines ent ci�al distances within layout Q-Drainfield cover
p/ Existing and proposed wells ❑`SB alve box locations
Reference depth from original grade
within 100 ft of property mrlseptic tiawpump chamber and restrictive trata:
Measurements to cuts,banks,and locations [yL[orals,trench/bed,top and
surface water and critical areas fH O ervation port location /bottom
UIEZ-anon and orientation of an-out location XCurtain drain collector
curtain drain and all absorption M. Manifold placement yap Sand augmentation
en ==is
Orifice placement Other cross-section detail:
CYLacation and dimension of Lateral placement with distance ❑ Observation ports/clean-outs
pn system and reserve area to edge of bed Other Information
Buildings Audible/visual alarm referenced Yes No
Direction of sloye Indi c or �e of drawing shown on scale ❑ LFIIey�staked out
�' Waterlines � r but ❑ f9lLeita ded Notices attached
■Roads,easements,driveways, ❑ U W i er(s)attached
parking ❑ ❑'Fu 'curve attached
6�rth arrow,and scale drawing ❑ val tion of failure
shown on scale bar on-re ential Justification
❑ Waste strength
4'
DESIGN APPROVAL `
The undersigned designer must be notilizii by installer at time of installation es ❑ No
rgnature of Designer Da 6Vq COL',%7v P,,._,_;
The undersigned has reviewed this design on behalf of Mason County Public Health and determined r it to J) ii
compliance with state and local ite regulations:
EAvh#ih&nta1 Health Specta 'st Date
CAUTION: DESIGN APPROVAL IS VALID ONLY TINDER THE FOLLOWING CONDITION:
✓ The design is stamped"Approved"by Mason County Public Health. vv `
✓ 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: 12/7/2015
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