HomeMy WebLinkAboutSWG2024-00301 - SWG Application / Design - 7/16/2024 WA
584
MASON COUNTY 415N6 SHELTON: ,S427-96, ,EXT 400
SHELTON:36012]-9670,EXT 400
BELFAIR:360-275-4467,EXT 400
Public Health & Human Services ELMA:3604625269,EXT 400
FAX:360-427-7787
On-Site Sewage System Permit: SWG2024-00301
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: 421323100060
Permit Description: New 4-bedroom pressure system wl sand lined bed
Permit Submitted Date: 07/16/2024
Permit Issued Date: 12/09/2024
Issued By: David Anderson
Current Permit Fees Paid: $540.00 (addennel reee may W reawrea anon MsWIIMonmayemm).
Permit Expiration Dale: 07/17/2027 (based on dale ohn.,n.r)
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 DesignerlEngineer installation approval prior to
backfill of system components.
6 Mason County Asbuilf 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 RAVE 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/onsiteloss-inspection-request.php or call:
360.427.9670,extension 400.
OFFICIAL USE ONLY
GM N� n
MASON COUNTY —I a
COMMUNITY SERVICES _ �mS (A
Pubk HeaNM1 Communby HeaMUDr fwmeMal HPaM) ` y
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ON-SITE SEWAGE SYSTEM APPLICATION $
M
APPLICANT PHONE m
GOLDWATER PROPERTIES LLC 425-941-3684 (Ted Dahm) c
"LING ADDRESS-STREET,CNV,STATE,M LWE
PO BOX 3356 SHELTON WA 98584 z
SITE ADDRE6 -STREET,CITY,ZIP CCOE
Undeveloped - Land lS
NAME OF DESIGNER —E
Micah Halverson 360-490-6365
NAME OF INSTALLER PHONE O r—
Undetermined 3
PERMRTYPE(aW .) WTW E La
WATER SOURCE
EIRESIDENTMI-OSS 6COMMUNITYOSS 6CGMMERCXOSS I7 PRNATEINDNIDUALWELL WPRNATETW� U- =
n,R�r OF VIOPX(aebeuoe) t7 PUBLIC WATER SYSTEM
L.JNEWCONSTRUCTION/UPGRADES FREPAIR/REPIACEMENT DTHERDETAILSIM afftk y QTABLE XREPAIR JLZ
SUBMITTALS 0 SURFACING SEWAGE O EXISTING FAILURE [3 SHORELINE
p DESIGN FORM(REQUIRED) C!SEPTIC DESIGN(REOUIRED) BEDROOMS LOT SOE Q
M G
ff WANER(S)(IFAPPLIC I-E) 4 5AC x I '
DIRECTIMSTOSREMOSITECONDGIMS:(u'.AN:e ) I O
From W Dayton Airport Rd (HWY102) turn onto W Eells Hill Rd, turn left onto 10
W Honeysuckle Ln, turn right onto W Bear Grass Ln. Drainfield is staked, test holes are r lO
marked with pink ribbon. S
10,
HITEM STBEMGGEDFROMYAN/ROADANDMSTHOLESMUSTBEMOGUMMTEBTHIXBMYMEIIA I I�
OFFICIAL USE ONLY BELOW THIS LINE
UPGRADE IFAI-URE SOURCE(WNpNftg aP )
OVOWNTARY EIMAINTENANCF-HUMPING [3BUILDINGPERMIT OHOMESALE OOOMPLAINT OOTHER:
IusPI:CTOEn
RsoILLOOS ` EC_It10bo%7McoMTENTSICONDmON6
IIJ
RECDRD DRAwwG AND wsTuunaN REPGRr
SQBLDPB:
V=VE
V=VERY G=GMYELLY S=SPND L=LOPM 9=SILT L=CUV E=EXTREMELY R=ROOTS REWIRED FCfl FINKOPPROVAI
IN6 6W'HRNRE DATE APPMfATION E%PFATION DATE APRILAi APFROVEDII66UEDBY GATE
71/L v . /17 o27 12 /
THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WESSITE REVISED120GOIS
DESIGN FORM—PAGE ONE Assessor's Parcel Number: W 2 I
A design will be reviewed when 3 cooler 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. O Cross-section sketch,including all applicable items on checklist.
This form maybe scanned and avallable for public view en the Meson County Web site.M¢ximum paEer size: I1"X 17"
PARCEL IDENTIFICATION
Permit Number: SWG 201l/ ' 6030 1 Designer's Name: Micah Halverson
Applicant's Name: GOLDWATER PROPERTIES LLC Designer's Phone Number: 360490-6365
Mailing Address: PO BOX 3356 Designer's Address: PO BOX 1519
SHELTON WA 98W Sheftw We 98584
city State Zip Ci state Zi
Treatment Device
❑Glendon aiofdtu ❑Sand Filter ❑ Mound 9Smd Lined Drainfield 0 Recirculating Filter,Type:
❑ Aerobic Unit Make/Modd ❑Disinfection Unit Make/Model other: Septic Tank
Drainfield Type
❑ Gravity arPresatre 0 Trench II{Bed ❑Sub Surface Drip
Septic Tank/Drainfield Specifications Laterals
Number of Bedroom 4 Schedule/Class 40
Daily Flow:Operating Capacity 360 gpd 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/iI2 Orifices
Required Primary Area 480 fe Total Number of Orifices 80
Designed Primary Area 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 Schedule/Class 40
Elevation Measurements Length 8 ft
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-91W 48 in Transport Pipe
from Original Grade I)owa,dapa 48 in Schedule/Class 40
Designed vertical Separation 24 in Length <100 ft
Cravelless Chambers Required? ❑Yes 11 No 0 Optional Diameter 2 in
Pump Required? Ff Yes O No Dosing and Pump Chamber
Pomp/Siphon Specifications Number of deses/day 18
Diff.in Elevation Between Pump&Uppermost Orifice t0 B Dose quantity 20 gal
Drainfield Squirt Height/Selected Residual(head) 5 ft Chamber Capacity(flood) 1500 gal
Uppermost Orifice Er Higher O Lower than Pump Shutoff Pump controls:Please check those required
Capacity®Total Pressure Head 34.7 gpm Elfimer I111Elapse Meter lBEvent Counter
Calculated Tonal Pressure Head 19.8 ft If Timer: Pump on TBD Pump off 1:19 hr
Comments
DESIGN FORM—PAGE TWO Assessor's Parcel Number: UZ 3 31 0Q
---3 - -- - ---6—
PermitNumber: SWG
DESIGN CHECKLISTS
Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch
9 Test hole locations 0 Drainfield orientation and layout Reference depth from original grade:
a Soil logs 9 Trench/bed dimensions and 9 Septic tank
Q Property lines critical distances within layout B Dtainfield cover
0 Existing and proposed wells If D-BoxNalve box locations Reference depth from original grade
within 100 ft of property 9 Septic tank/pump chamber and restrictive strata:
13 Measurements to cuts,banks,and locations IB Laterals,trench/bed,top and
surface water and critical areas 0 Observation port location bottom
0 Location and orientation of IN Clean-out location 0 Curtain drain collector
curtain drain and all absorption If Manifold placement 9 Sand augmentation
components 0 Orifice placement Other cross-section detail:
0 Location and dimension of I( Lateral placement with distance If Observation ports/clean-outs
primary system and reserve area to edge of bed
9 Buildings Other Information
B Audible/visual alarm referenced Yes No
0 Direction of slope indicator pi Scale of drawing shown on scale I( ❑ Design staked out
9 Waterlines bar ❑ I Recorded Notices attached
9 Roads, easements,driveways, ❑ 117 Waiver(s)attached
Parking 0 ❑ Pump curve attached
9 North arrow and scale drawing ❑ Il7 Evaluation of failure
shown on scale bar Non-residential justification
❑ ❑ Waste strength
❑ ❑ Flow
DESIGN APPROVAL.
The undersigned designer must b tified by installer at time of installation 9 Yes ❑ No
Signature of Designer DateJOP/�
The undersigned has reviewed this design on behalf of Mason County Public Health and dete�mined4
compliance with state and local on-site lations: !!//
i Z y�tUZY SaN"tklkec�91014 O
Environmental Health Specialist Date NO
0� ,
CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CONDITION F'tZTN
✓ The design is stamped"Approved"by Mason County Public Health. /
✓ The Onsite Sewage Permit has not expired,the Permit Expiration Date is: 1/ 77 7(jZ7
✓ 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 vlew on the Mason County Web site.
Updated DaW 12/7/2015
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