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HomeMy WebLinkAboutSWG2024-00302 - SWG Application / Design - 7/16/2024 584 MASON COUNTY d15N6THELTON: 60H27-O70,EXT 400 SHELTON:360d27-98T0.EXT 400 BELFAIR:360-275-4467,EXT 400 Public Health & Human Services ELMA:360482-5269,EXT 400 FAX 360427-7787 On-Site Sewage System Permit: SWG2024-00302 APPLICANT GOLDWATER PROPERTIES LLC Phone: 425.941.3684 Address: 15322 B St E TACOMA, WA 98445 OWNER GOLDWATER PROPERTIES LLC Phone: 425.941.3684 Address: 15322 B St E TACOMA, WA 98445 SEPTIC DESIGNER MICAH HALVERSON• Phone: 360490-6365 Address: PO BOX 1519 SHELTON, WA 98584 Site Address: XXX W Bear Grass Ln Primary Parcel Number: 421323100070 Permit Description: New 4-bedroom pressure system wl sand lined bed Permit Submitted Date: 0711612024 Permit Issued Date: 12/09/2024 Issued By: David Anderson Current Permit Fees Paid: $540.00 (eddmonm lees nu,,oe neound upon msmll.non or syswrn). Permit Expiration Date: 07/1712027 (oasedondslemmspwion) 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 Drainfleld installation not to exceed designed upslope and downslope depth specked 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 DesignerlEngineer installation approval prior to backfill ofsystem components. 6 Mason County Asbuilt 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/environmental/onsite/oss•inspection•mquest.php or call: 360-427.9670,extension 400. OFFICIAL USE ONLY MASON COUNTY D TBB�ND — (�- 2 y D COMMUNITY SERVICES Ua O N T4MexNM lcommun5vHeaBHIDM,u+memal HealMl < y SWG A Z y ON-SITE SEWAGE SYSTEM APPLICATION 3 A n APPLIC4NT PHONE m M GOLDWATER PROPERTIES LLC 425-941-3684 (Ted Dahm) z- MMLNG ADDRESS-STREET,QTY,STATE,zP CGDE 3 PO BOX 3356 SHELTON WA 98584 DR sREADDREss-STREET cm.nP coDE Undeveloped - LandZ _ of K/ Iv W f NAME OF OESIONER PHONE I_ Micah Halverson 360-490-6365 NAME OF INSTALLER PxONE Undetermined H �W PERGMRNPE(wM .) C c DRINKING VMTER SgMI£ O WRESIDENTIALOSS ISCOMMUNITYOSS ILJ COMMERCLLL OS8 EEF PRIVATE INDNIDUALWELL �PRNATE TWOfARTY WELL = I� TYPEOF WORK µetc me) Cr PUBLIC WATER SYSTEM WNEWCONSTRUCTIONIUPGRADES t7REPAIR/REPLACEMENT OTHER CETMLS(vktee'meK eppp9 OTABLE IX REPAIR IK� SUBMT7&S OSURFACINGSEWAGE DEMSTNGFAILURE 08HORELINE BM p Ln DESIGN FORM(REQUIRED) p SEPTIC DESIGN(REQUIRED) BEDROOMS LOTSRE ECWANER(S)(IF APPLICABLE) 4 5 AC x DIRECTIONS TO SITE AND SITE CONDITIONS:(UK kcYe ) From W Dayton Airport Rd (HWY102)turn onto W Eells Hill Rd, turn left onto W Honeysuckle Ln, turn right onto W Bear Grass Ln. Drainfeld is staked, test holes are r lO marked with pink ribbon. o SITE wIFTBEFLAGDEDPROMMAINRGADAxP TEST HOLES w WFL4GSEDxTTHTEBENDIE...FA OFFICIAL USE ONLY BELOW THIS LINE - UPGRgOElFA0.URESWPCE IM repvGip OUV) OVOLUNTARY OMAINTENANCENUMPWG OBUILDINGPERMIT [3HOMESALE OCOMPIAINT r]OTHER: INSPECTOR 601E LOGS CpALEN(S/CGNMRIXI'u T#Z," 6Coa5 }e'btice►t yow rov, T* 1 . JUL ] 6 2024 � iFll:p-�l"�iCcvS {� .>7 aglLfiOGGB. REwRD puwwGAHorvsAUAnoN REFGRT V=VERY G-GRAVELLY S=SAND L-LOAM 3-SILT C•CLAY E=EXTREMELY R•ROOTS REWIRED Fqi FINaLAWROVN. INSPECTORSIGNATIHE DATE APPLICM1TON E TION GAFFAPPLI IBBUED BY OAT' �/13/?r71 ll 7 :7 1 ? THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSME REVISED IWaD15 DESIGN FORM—PAGE ONE Assessor's Parcel Ntmtber4 l 3 Z- — 3 I _ O_C O,Z O A design will be reviewed when 33 c�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. °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 paper size: 11"X 17" 7 PARCEL IDENTIFICATION Permit Number SWG ZQ ti -do3az Designer's Name: Micah Ha verson_ 1 Applicant's Name: GOLDWATER PROPERTIES LLC Designer's Phone Number: 3604906365 Mailing Address: PO BOX 3356 Designer's Address: PO BOX 1519 SHELTON WA Saw Shelton Wa 98584 city State Zi2 city Statc Zi DESIGN PARAMETERS. -- Treatment Device 0 Glendon Biofiltw ❑Said Filter ❑Memo MrSand Lined Dreintield ❑Recirculating Filter,Type: ❑Aerobic Unit Mskem.del ❑Disinfection Unit Make/Model Other: Septic Tank Drainfield Type O Gravity ifPressure 0 Trench IrBed ❑ Sub Surface Drip Septic Tank/Dramileld Specifications Laterals Number of Bedrooms 4 - Schedule/Class 40 Daily Flow:Operating Capacity 360 gad Length 46 ft Daily Flow:Design Flow 480 gpd Diameter 1 1/4 in Septic Tank Capacity(working) 1500 gal Number 5 Receiving Soil Type(1.6) 1 Separation 2 ft Receiving Soil Appl.Rate 1 gpd/ttr Orifices Required Primary Area 480 - ft' Total Number of Orifices 80 Designed Primary Alta 480 ft Diameter 1/8 in Designed Reserve Area 480 ftr Spacing 36 in Trench/Bed Width 10 ft Manifold Trench/Bed Length 48 ft Schedulc/Class 40 Elevation Measurements - Length 8 It Original Drainfield Area Slope <1 % Diameter 2 1/2 in New Slope,If Altered same % Preferred manifold configuration used? 0 Yes ff No Depth of Excavation Up-anpe 48 in Transport Pipe from Original Grade Duwa-dnpe 48 in Schedule/Class 40 Designed Vertical Separation 24 in Length <100 ft Graveness Chambers Required? ❑Yes Ef No 0 Optional Diameter 2 in Pump Required? fff Yes 0 No Dosing and Pump Chamber Pump/Siphon Specifications Number ofdoses/day 18 Diff.in Elevation Between Pump&Uppcanost Orifice 10 ft Dose quantity 20 gal Drainfield Squirt Height/Selected Residual(head) 5 it Chamber Capacity(flood) 1500 gal Uppermost Orifice Id Higher 0 Lower than Pump Shutoff Amp controls:Please check those required. Capacity Q Total Pressure Head 34•7 gpm &imer ®'Elapse Meter IrEvert Counter Calculated Total Press=Head 19.6 It If Timer: Pump on TBD pump off 1:19 hr Comments DESIGN FORM-PAGE TWO Assessor's Parcel Number: Z ( 3 Z -- 9 1 D 0 7 Petmit Number: SWG DESIGN CHECKLISTS - Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch 0 Test hole locations 0 Drainfield orientation and layout Reference depth from original grade: la Soil logs IY Trench/bed dimensions and If Septic tank * Property lines critical distances within layout 0 Drainfield cover 0 Existingand proposed wells 0 D-Box/Valve box locations IMP Reference depth from original grade within 100 ft of property 0 Septic tank/pump chamber and restrictive strata: 0 Measurements to cuts,banks,and locations 0 Laterals,trench bed,top and surface water and critical areas 0 Observation port location bottom 0 Location and orientation of 0 Clean-cut location 0 Curtain drain collector curtain drain and all absorption el Manifold placement 0 Sand augmentation components 0 Orifice placement Other cross-section detail: 0 Location and dimension of 0 Lateral placement with distance 0 Observation ports/clean-outs primary system and reserve area to edge of bed 0 Buildings Other Information 0 Audible/visual alarm referenced Yes No 0 Direction of slope indicator Lvf Scale of drawing shown on scale Design 0 ❑ staked out 0 Waterlines bar ❑ 0 Recorded Notices attached 0 Roads,easements,driveways, ❑ P1 Waiver(s)attached parking 0 ❑Pump curve attached 0 North arrow and scale drawing ❑ 0 Evaluation of failure shown on scale bar Non-residential justification ❑ ❑ Waste strength ❑ ❑ Flow DESIGN APPROVAL The undersigned designer most be tified by installer at time of installation Rf Yes ❑ No 7��6�r7Azy Signature of Designer ate The undersigned has reviewed this design on behalf of Mason County Public Health an6,determined it to be in compliance with state and local oa ftfeg/ulati/ons: y' 7�J (� MASON ALL''�9 202y L l� / CONNryEhVINON Environmental Health Spec/ialist Date MfN14C HfAIT H CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CONDITION: ✓ The design is stamped"Approved"by Mason County Public Health. ✓ 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 CD 390,H- 0 m o o. L n ma.m I I y o� m o r���Skw o Q u n °' m n Hnn m n I 3 01 � m �o m � z ng oS v C 9 N '$> N<T 17 3 n � � 3 amd mo �v NofDio II I 6 �An j 3 C N 7 0 D r N 9 N 0 C. 3 c I I i 7 F m n 0 4V S / 70 qq o I I { 1 1 m I \ - - I W Bear Grass Lane / I r— I > z I N rn u SXEEfN Ci�lnfo Parcel--- .---31-00070 M.Halverson Design LLC GOL�ER PROPERTIES LLC Undeveloped - Land 56 e�sondlesSnlllC O PO on 98 PO BOX WIOok CofTl SHEI TON WA98584 Hal \\� k | \ � ! � § © ƒ } \ ! } \ | tj tj e - _ k • / ¢ � . / 4 \ , s ; o - wo2� A « «« C# ( \ KiQz \ } � % lob R $ » k\kt * ! 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