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HomeMy WebLinkAboutSWG2024-00341 - SWG Application / Design - 8/12/2024 I 415 N BTH STREET,SHELTON,WA 98584 MASON COUNTY SHELTON:360d27-84 ,EXT 400 BE 380.275d46787,EXT 400 40 ILMA! ELMA'.380d82-52fi9,EXT 400 Public Health & Human services FAX:360427-7787 On-Site Sewage System Tank Only Permit: SWG2024-00341 OWNER Jeremlah Holcomb Phone: Address: 1614 Winfield Ave BREMERTON,WA 98310 APPLICANT Jeremiah Holcomb Phone: Address: 1614 Winfield Ave BREMERTON,WA 98310 SEPTIC INSTALLER DARIN phone: 360-790-3021 133 Address: PO BOX 1336 HOODSPORT,WA 96548 Site Address: 231 N DISCOVERY DR Primary Parcel Number: 423185000143 Permit Description: Replace septic tank Permit Submitted Date: 0811212624 Permit Issued Date: 0811412024 Issued By: Rhonda Thompson Current Permit Fees Paid: $285. (044ulonm ra.,m.y ha r«luraa upon lmmllenond.yaemF Permit Expiration Date: 08114/2025 Ineeoa on&ee 01 Inepeouonl Type of or OSS Repair Components being Replaced: Septic Tank Only _ Surfacing Sewage? No Existing Failure? Yes Shoreline? No Horizontal Setbacks Mel? Yes Number of Bedrooms: 2 Drinking Water Source: Public Water System Additional Details: House Brothers 1250 septic tank Permit Conditions: 1 Horizontal setbacks per WAC246-272A-0210 must be maintained, unless prior approval is obtained 4 proposed development subject to zoning requirements and approval by the planning department staff per Mason County Title 17. 3 Mason County Asbuilt Form, Record Drawing, and Installation fee must be submitted for linal installation approval. 2 permit must be Installed by a Mason County Certified Installer unless prior written authorization from Masan County is obtained. THIS PERMIT MUST BE ONSITE DURING INSTALLATION OF OSS. PROPERTY OWNERS ARE RESPONSIBLE FOR DETERMINING AND MARKING ALL PROPERTY LINE AND EASEMENT LOCATIONS. THIS PERMIT MAY BE REVOKED IF THE SITE CONDITIONS HAVE CHANGED SINCE THE SITE WAS INSPECTED AND/OR DESIGN APPROVED. FINAL INSTALLATION APPROVAL IS REQUIRED PRIOR TO TEMPORARY OR FINAL OCCUPANCY OF ANY RELATED STRUCTURES. For Final Inspection visit:masoncountywa.govlhealthlenvironmentallonsiteloss-Inspection-regmsLphp or call: 360.427-9670,extension 400. UfF1UAL USE ONLY MASON COUNTY g M COMMUNITY SERVICES 5 "� N PuMICNnM ICmuwnlryNN�nWNRINnRA) S��L�yV/� I�� _ o N O xelnwm.vaewwnsxn.w V � a anma-y.i..rwsme. Z Ill Z Y ON-SITE SEWAGE TANK ONLY APPLICATION m m m 36 ` M"lr,A 01 cG b z 11 Ere VA t m NwaDADmfss-efRffECRY. aPccDE Rl A re arts DwonEsa smaT.cm:m ODU S �AY�� 6 231 N , t$CO K✓ ✓ PNOME y Iv N/:ME W OFeIf.IER ��� L. EJ PIIONs O IW MSlNEER 3(�,U O 3nZ w a5k e c c o I TPEOF RI[IrMelaPl dINPoNO WARAGODPGE ❑NEW CONSTlalCllONIUPORP0E8 DRFFAIRIRGP O ENT OPRWATERroA'UUPLW -gDDUCWATERSYSiN1 ,llv 1 Dp,MONFwwmREflEP1AfEdMSMNHI SAS LOT WE p �/� 01 PTGTANK OFUMPTANN Acrf IC, 0 DINER r0 orreRDETASAhewrFwyPM TANY(SISETBAOKCNFAOI4T . Q 6URFACNIO SEWAGE rs--- NO FALNRE �AHDRELRIE �10DFIR PUBLIC CDMMUNILY WFILB �50FTR PRIVATEWELLS.SURFACE WATERS.9TREAMS.WVERS n RR WRTNn �,.,/�"'' 1DFTT DRINKING WATFR SUPPLY LING Il APLOTPIAN(REOUIRED) p-WIrK CR056 SECTION(NEDIIIRED) �,6Ff+PROPERTI'I H�SEMEMLINES.FOUNDATKINS,FOOTINGS DPUMPDETAILS(R APPLICABLE) I3 WANERIS)PFNPPUOASLE) 0 InwI CNECRL9T R UNESANDEASEMENTS ❑E%ISTIHOI PRDPOSEO STRUCTURES RURNGPROPGSEDOSGGOMPONENf8NID 11NE5 C) PROFE ,,, 10NOFSLOPEIGDNTOURS GPENMETEO [3 cuffmomm I M CNORMAPROAW W6l BCALE RARS�WVEII&ETC.., lA) IV�1 wREClwxcro^snEMm BRELONDRKM13 ha,bJrePW) N-111 To PI✓ -3 _af Pd4w ehP✓' /`�' V�1 +U '1/(scG ✓ d V' 2*3 1 N IJI SGO N./'�d✓' ✓14-(:P+�/' ev OFFICIAL USE ONLY BELOW TUTS LINE wDRne I PI uuME m W LL'e 1N �PRM v+Rr> OLUNTARY OMAJNTHNNGFIPUMPING ORNIILINR PERNR OIKIME 9AlE ODDMPIAIIR WpIMf8I00NORICMB �n ��J �` AUG�12 2024 SEYMOETAM'.BMUSi BELISIEO UNDERDDNLST OFREGISTEREDSEWAGETAM(5'.TNM�MJSTMEETCDRREMMWIMUM BQER EGDR�'Wf�N.. NIOLW9TOMINI.CE.NIDIIN!IOEANEfFt1ENT FlLIPR/FMRIPdB1E).RECORD DRAW WGANDRiBTNUTpNRFPORf REWR®fM1fW.LLAP%10YK . M0.IGTNW FIOMMII'MI/MTE MPTLIGTyIIO`N•WP1R-O.TVa�`I(NSD^FD^GY L/ PVE TTNOFORNIMYBEBGANNEOANOAVARABLEFORPUEUCVIEWONTNEMASONCaUMWRWRE pAmam lmnols ' MAOE SY Af / ZZ r Address n6 PropartY Owner ��9/ Paroel(�/ >'��= Seweee Contrecto �/ • A ,NA �,...e_ Date .+ 1. 9oele: 1 Square J CC7$el uue-y- in 2. Drex phyelaal structures to he on lot. 3, Show location of Sell or yet body Of aster. 4. Shox location of eepOfe 9yetelll a r3eEtaernherpg�tllo to tfie other lot corner 2O L 5, kcs..l.'et an elevation Of 300' . elevation- in relation to it. 6. Ues "row- to ehox direeL3on of slaps. 100' C Y..e X�P X° Septic Tank VOL" DraWield length D bdc Yard. gravel used I certify that this syet. Se installed es shown above, and that all- ....kracent. and euncerne of Thuratca--;Weon Sneelth_Drla-.t_r_iat have been satisfied. Signatura�l /` I66 alk Contraator'e u.S..e June, i 1 �m1:01�Vi in 'I Oi',LNIII.�;AIIIi I((T {{ 5tn & Bir.n Thurston-Mason Health District courtnouae Annex • ,/ nn Shelton, . e. .. t on DIVISION DI INVISONMSNTIIL NSAtLtN Phone:a 352a4N¢etOn U ny Phone: 426-4407 �+ J71 ' c 7/ SEWAGE APPLICATION ID ,YD SITE APPLICATION � / Pnone__�i��•_�_-- ��,, ImoI,,, —' Owner r gtate�I.LC _9 7 3,,!/ p� , lynaa CStyrrr�2.dn.�- Mafling Address 3 l /✓ ��� Address Builder (, 1 r}I �' ^� H• k�pp ` vACp Addreee I g.Wage Contractor I / Legal De.orlDtlon SLLeIO N/ j D intended us a of il�ng „ /lem 7r, Direotione W Property „d Water SyStaml No. of Bedroaae 2. N.. of Bathroom._ Baeement_,L_ PRNATE L DRAW SIOMH in blaoX epaoei 1. On-ion- of lot' Property line. and lo.ationa0diapp.11 system in n lot and relation to at".., lakes, we11s, 2. Location of house and se Vag s uatar ty and lines and eseement.. patios, driveways, underground tatdt roa1LY and amount Pine location of dralne. j. Proposed fill, inoluding depth, area, P° ORAA'PITAN SI rIO ' SEPTIC TANK IMEE A (' �1 T>ID/H �l//aI 1 /7. yaCf 4 20A HuMf���•�� �V! ---aA;44l F. �, I L HPALTII The esptta system La So approved temporary method of .".go diepoaal Dot ;r ameieary sever, are available, SITg APPLICATION - O.APPLICANC S SIGNATURE eceipt No. gY Sit. impaction fe NOt Approvod 11 Approved Date S tsrian Date SEWAGE APPLICATION New Al APPLICANT � IONATHRE DATE10- ' pas Reeelpt No. Y Approved y Permit No. Date �� I.-G. TTP IN HEIGHT . H r--------- u wa- L UaUK)LL Cl I § I I � 1 0 e I, r-s_� i 4 CA T � v+ 1 I I Z 1 I o a r Lill N � � _ OUfllf HEIGM fr H �i 0 = N P $g �g I II N .n I I = oo I 11 I 1 II - N I p# II L aPPR0tIS ". (.' AUG 1 'I 20A MASON COUN1T f:NVIRONMUTAL NEAUH ■p g[�p� p�T���1 1250 GAL HID PRECAST ��I' [Cfl'e N1O[ S41 Wwt M 1Y3WN IILIpLLIS" IILI�JI M''�H WA n331 9EPIIG TANK 136G+n�lx MASON COUNTY 415NBSHELTON: , &427-9 N, EXT404 SHELTON:360-42TA670,EXT 400 BELFAIR:380-215448],E%T 400 Public Health & Human Services EWA,38U4B2-5269,EXT 100 4 FAX 36"27-7787 On-Site Sewage System Permit: SWG2024-00355 APPLICANT Hunter,Adam Phone: 360 753-1226 Address: 2201 93rd Ave SW Olympia,WA 98512 OWNER OLSON AARON&ELIZABETH Phone: 206-604.6660 Address: 613 21 OTH ST SW LYNNWOOD,WA 98036 SEPTIC DESIGNER ADAM HUNTER' Phone: 360-753-1226 Address: PO Box 162 OLYMPIA,WA 98507 SEPTIC INSTALLER DARIN OGG` Phone: 360-7903021 Address: PO BOX 1336 HOODSPORT,WA 98548 Site Address: 201 N RAINBOW WAY WEST Primary Parcel Number. 422165300091 Permit Description: New 2bd pressure subsurface drip Permit Submitted Date: 08/22/2024 Permit Issued Date: 09109/2024 Issued By: Rhonda Thompson Current Permit Fees Paid: $805.00 IaddNonal fame mW a mound up°^Instarmon M snmml Permit Expiration Date: 08130/2027 Im,ed°^^�M ImPaLdO^I Permit Conditions: 1 Proposed development subject to zoning requirements and approval by the planning department staflper Mason County Title 17. 2 Permit must be installed by a Mason County Certified Installer unless prior written authorization from Mason County is obtained. 3 Drainfield installation not to exceed designed upslope and downslope depth specified on design form. 4 Installer is responsible for obtaining Mason County installation approval prior to backfill of system components. 5 Installer is responsible for obtaining Septic DesignevEngineer installation approval prior to backfill of system components. 6 Mason County Asbuflt Form, Recortf Drawing, and Installation fae must be submitted for final installation approval. THIS PERMIT MUST BE ONSITE DURING INSTALLATION OF OSS. PROPERTY OWNERS ARE RESPONSIBLE FOR DETERMINING AND MARKING ALL PROPERTY LINE AND EASEMENT LOCATIONS. THIS PERMIT MAY BE REVOKED IF THE SITE CONDITIONS HAVE CHANGED SINCE THE SITE WAS INSPECTED AND DESIGN APPROVED. FINAL INSTALLATION APPROVAL IS REQUIRED PRIOR TO TEMPORARY OR FINAL OCCUPANCY OF ANY RELATED STRUCTURES. For Final Inspection visit: mawncountywa.goVihealthlenvironmentallonsiteloss-inspection-request.php or call: 360427-9670, extension 400. OFFICIAL USE ONLY MASON COUNTY PUBLIC HEALTH �T"�NEM 8/22/2024 ONSTTE SEWAGE SYSTEM APPLICATION MWN HEN D. 805 `SGAFDBY online 0 N 415 N 6th Street•(Bldg 8) SheeoR WA,98594 5 N Sheltsle 860427-9678BX14W Belfair,36P275407 M4W SWG 2024-00355 0 °a 2 fA PHONE ; sl APPLICANT 2066046660 E, ELIZABETH OLSON m m r MNuxG ADDRESS-STREET CITY STATE,zlPcoce LYNNWOOD WA 98036 C 613 210TH ST SW STEAWRES6-STREET,CRY ZIFOOLE 201 N RAINBOW WAY WEST HOODSPORT WA 98584 m NAMEOFLESIGeER PHONE I A ADAM HUNTER 3607531226 PHOHE N NAMEOFINSTALLER ROYAL FLUSH c IN WiINKING WATER SOURCE I� CNECKALLAFFUGBLE REM6 D PRIVATE INDIVIDUALWELL N 0 NEW CON$TRUCTION ❑ MHOLDING TANK ONLY PRIVATE M6PARIY HELL C REPLACEMENT SYSTEM D INSTALLATION PERMIT ONLY D Ef COMMUNITYIPUBLIC WATER SYSTEM I L' 0 TABLES REPAIR 0 COMSINGMERCIAL SYSTEMNAME: . D UPGRADE TO 0 COMMERCIAL / 1 ❑ UPGRADE TO EXISTING D OTHER: BEIXNCMIS LOT SIZE D METING FAILURE 2 0.2 ^ TT DRECTIO MSUE-BESPECIFICANDADVISECANYNEEOEDINFOWATIONFORACLEs (.r' b ) I ' CUSHMAN POTLATCH TO A RIGHT ON LOWER LAKE TO A LEFT ON KOKANEE TO A I lO LEFT ON OLYMPIC TO A RIGHT ON RAINBOW TO SITE ON THE RIGHT O LOCKED GATE, LOCKBOX CODE IS: 7854, LOCKBOX TO THE RIGHT OF THE GATE. p �O 511E MU9r BEELAGGEG FROM MAIN ROPGANG IESTMd.ESMI/STBEFIAGBEC BTM TESTIKKERLMERS I I� OFFICIAL U5E ONLY BELOW THIS LINE VPGRAEE/FAILURE SOURCE pr mp WWWI®) DVOLUNTARY DMAINTENANCErPUMPING 0 BUILDING PERMIT OHOMESALE DCOMPIAINT DOTHER: INBPECTCR 9gLLCG6 LDMMENTSICGMNTILNS TH1: 0-36 GSL, 36+ tilITH2: 0-38 GSL, 38+ tiIITH3: 0-20 GSL, 20+till MLLOGES: V=VERY G=GMWUX S=SWD L=LOAM 9=SILT C=CLAY E=EXTREMELY R=ROOTS INSPECTORSIGNATURE 8/30/2024 DATE A➢NGTL'W EWPA"CH DATE PFPLIGTIONAP%iOVFDBV GATE 8/30/2027 R Thom sLM 4.09.09 R Th son P IN. THIS FORM MAYBE SCANNEDANOAWUI.ABLE FOR PUBLIC VIEW ON THE MASON COUNTYWEBSNE RENSED TNRGIS DESIGN FORM—PAGE ONE Assessor's Parcel Number:— 42216-53-00091 ___ A design will be reviewed when 3 copies of each of the following are submitted: a 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 v Cross-section sketch,including all applicable items on checklist. This form may be scanned and available for public view on the Mason County Web si[e. Vo�'imvm �o , sice' /1"X 1' ' ..:PARCEL IDENTIFICATION ADAM HUNTER Permit Number: SWG 2024-00355 Designer's Name: 360753-1226 — Applicant's Name: ELIZABETH OLSON Designer's Phone Number: PO BOX 162 Mailing Address: 613 210TH ST SW Designer's Address: OLYMPIA WA 98507 LYNNWOOD WA 980M Cit State Zi City State Zip DESIGN PARAMETERS -- — --- Treatment Device ❑Glendon Biofilter ❑Sand Filter ❑Mound ❑Sand Lined Drain field Cl Recirculating Fine',Type: ❑Aerobic Unit Make/Model ❑Disinfection Unit Make/Model Other: — Drainfield Type .�/ ❑Gravity ❑Pressure ❑Trench ❑Bed ail Sab Surface Drip Septic Tank/Dralnfreld Specifications Laterals p Schedule/Class PER DRIP Number of Bedrooms 153 It Daily Flow:Operating Capacity 180 gpd Length 240 gild Diameter 1/2 in Daily Flow:Design Flow 2 Septic Tank Capacity 1000 gal Number Receiving Soil Type(1-6) 4 Separation 2 it Orifices Receiving Soil Appl.Rate 0.6 gpd/ft2 Required Primary Area 800 1i2 Total Number of Orifices 006 DRIP in Designed Primary Ar 600 t12 Diameter Arm Designed Reserve Area 400 ft2 Spacing 12 in Trenched Width SEE DESIGN ft Manifold Trench/Bed Length SEE DESIGN ft Schedule/Cims 40 Elevation Measurements Length 25 It Original Dminfield Area Slope 1 % Diameter 1 in New Slope,If Altered 1 % Preferred manifold configuration used? IYes 0 No Depth of Excavation Up-slope 12 in Transport Pipe from Original Grade Down-dope 12 in Schedule/Clam 40 Designed Vertical Separation 24 in Length 25 ft Gm ❑velless Chambers Required? Yes Ef No 0 Optional Diameter i in Pump Required? Yes 0 No Dosing and Pump Chamber Pump/Siphon Specifications Number of doses/day 12 Difference in Elevation Between Pump Shutoff and Uppermost Dose quantity 20 gal Orifice R Chamber Capacity 1o00 gal Uppermost Orifice Higher 0 Lower than Pump Shmoff Pump controls:Please check those required. M Capacity Q Total Pressure Head 6.1 gpm Timer hYElapse Meter CrEvent Counter Calculated Total Pressure Head 112.2 ft If Timer: Pump on 20GAL ,Pump off 2HR Comments EH APPROVED Rhonda Thompson 09/09/2024 DESIGN FORM—PAGE TWO Assessor's Parcel Number:————— — —— ----- Permit Number: SWG DESIGN CHECKLISTS Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch Ef Test hole locations EZ Draintield orientation and layout Reference depth from original grade: 19 Soil logs E9 Trench/bed dimensions and Ed Septic tank 1Z Property lines critical distances within layout la Drainfield cover 91 D-BoxNalve box locations Existing and proposed wells Reference depth from original grade within 100 ft of property EZ Septic tank/pump chamber and restrictive strata: ® Measurements to cuts,banks,and locations ❑ Laterals,trench/bed,top and surface water and critical areas 9 Observation port location bottom IZ Location and orientation of If Clean-out location ❑ Curtin drain collector curtain drain and all absorption Rf Manifold placement ❑ Sand augmentation components EZ Orifice placement other cross-section detail: 19 Location and dimension of Ef Lateral placement with distance 9 Observation ports/clean-outs primary system and reserve area to edge of bed Other Information 19 Buildings 19 Audible/visual alarm referenced Yes No E9 Direction of slope indicator Scale of drawing shown on scale ❑Design staked out IZ Waterlines bar ❑ ❑Recorded Notices attached F9 Roads,easements,driveways, ❑ ❑ Waiver(s)attached parking ❑ ❑Pump curve attached F9 North arrow and scale drawing ❑ ❑ Evaluation of failure shown on scale bar Non-residential justlftcatioa ❑ ❑Waste strength ❑ ❑ Flow P ESIGN APPROVAL The undersigned designestaller at time of installation E�Yes ❑ No S/22/24 esigner Date The undersigned has revihalf of Mason County Public Health and determined it to be in compliance with state anns: 4.09.09 R Thomps rl�°� 1:56-07'00' Environmental Health Speci ­ Date CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CONDITION: ✓ The design is stamped"Approved"by Mason County Public Health. g/30/2027 ✓ 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. 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