HomeMy WebLinkAboutSWG2024-00471 - SWG Application / Design - 12/20/2024 584
MASON COUNTY 415 NBTHELTON: , 0427-97 ,EXT 400
SHELTON:360-02]-9fi]0,EXT 400
BELFAIR:360-276-0467,EXT 400
Public Health & Human Services ELMA:3604825269,EXT 400
FAX 360427-7787
On-Site Sewage System Permit: SWG2024-00471
APPLICANT SMITH ET UX MITCHEL C Phone:
Address: 18612 SE 41 at Court ISSAQUAH,WA 98027
OWNER SMITH ET UX MITCHEL C Phone:
Address: 18612 SE 41st Court ISSAQUAH,WA 98027
SEPTIC DESIGNER MICAH HALVERSON* Phone: 360-490-6365
Address: PO BOX 1519 SHELTON,WA 98584
SEPTIC INSTALLER THAD BAMFORD` Phone: 360-790-2364
Address: 301 WALLACE KNEELAND BLVD STE 224-332 SHELTON,WA 98584
Site Address: 941 E STADIUM BEACH RD WEST
Primary Parcel Number: 221136000052
Permit Description: Repair 2bd ATU to pressure trench
Permit Submitted Date: 12/20/2024
Permit Issued Date: 12/27/2024
Issued By: Rhonda Thompson
Current Permit Fees Paid: $805.00 (a4dflienelfeesmayb mqui, upw lnslallationofsyaem).
Permit Expiration Date: 11/26/2025 (e..e4an m..fmspxuon)
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 Drainffeld 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 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.govlhealthlenvironmentallonsite/oss-inspection-mquest.php or call:
360-427.9670,extension 400.
i
OFFICIAL USE ONLY
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ON-SITE SEWAGE SYSTEM APPLICATION
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MITCHELL C SMITH 206-6605282 z
WVLINGADDRE88-SIPEETaW VATE.ZFCOOE 3
18612 SE 41 st Court Issaquah WA 98027 a
snEADOREss-STREET cm.aPcoDE
941 E STADIUM BEACH RD W GRAPEVIEW Ilv
NAME OFM ONER PHONE I ^\
Micah Halverson 360-490-6366
NAME OF NSTKLER PHONE
Thad Bamford < I_
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PERMIT TYPE(eebd wre) d1t8(INO WATE0.S01RCE 0
FY RESIDENTIALOSS ❑ COMMUNRY OSS Y]CAMMERCNL O56 lifPRIVATE INOMDUALWELL ❑ PRNATETWOPARTY WELL z I�
TYPE OF WORN(.ebvmel Cr PUBLIC WATER SYSTEM
❑ NEWCONSTRUCTI0NIUPGRADE3 MREPAIRIREPIACEMENT OTHERDETMIS(aMW My WW ❑TABLE W REPAIR I�
gVSMITTe,= [] SURFACWGSEWAGE 10 STINGFAILURE OSHOREUNE
W DESIGN FORM(REQUIRED) FEEFTICDESIGNIREOUIRED) BEDROOMS LOT 60E r
❑WAIVER(S)IIFAPPLI(WILE) 2 6.130.c. °
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dRECTIONB TO SIZE Nm SIRE LONDIIDM3:(ey.b4a>PoNI
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SfIEM1/6rBE MGGFD/WOYYALVRUAOANO lEBFNIXESYUaraE MGGEd MRITE6T xolEMIMEIIa By I II _
OFFICIAL USE ONLY BELOW THIS LINE
UPGRADEIFALURESOURCE(AxmvtlnpR )
OVOLUNTARY ❑MAINTENPR( UMPING []BUILDINGFERAIR E]HOMESALE []COMPLAINT []OTHER:
INSPECTOR SOIL LOGS COMMENTSICONOTIDIB
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SOIL CODES: RECORD OMwIN3A10 Vi5TKIATdI REPORF
V=VERY G=GRAVELLY S=SV10 L=LOAM S.SILT C=CLAY E•EMREMELY N=ROOTS RECUIREDFORF.APPRCIN
MSPECTCR 6IGNA.F DATE PPPLICATION E%PpGTNIN MTE APNUCATICNMYROVEb ISSUEDBY DATE
nl ay 11 J
THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON CWNTY WEBSRE REN6EO1LlIb1S
DESIGN FORM—PAGE ONE Assessor's Parcel Number. Z
A design will be reviewed when 3 tonics of each of the following are submitted:
•Completed design fotm that has been signed and dated. v Scaled layout sketch,including all applicable items on checklist
• Scaled plot plan,including ail applicable items on checklist. °Cross-section sketch,including all applicable items on checklist.
This form mar be stated and avallrawe for puMk view an the Mason Web 4h.Maximum o er size: 11"X 17"
Permit Numberf SWO 2oz7 ' x Designer's Name: MicahHaNerson
-
Applicant'sName: MITCHELLC SMITH Designer's Phone Number: 360-490-6365
Bn Mailing Address:
18612 SE 41at Court Designer's Address: PO Box 1519
Issaquah WA 98027 Shehon Wa 985"
Ci State Zf Ci State Zi
Treatment Device
❑Glendon Biofilter ❑Send Filter ❑Mound ❑ Sand Lined Drainfield ❑Recirculating Filter,Type:
G!(Aerobic Unit MekeMiotlel NuWalarBNR-500 p Disinfection Unit Make/Model Other.
Drainfield Type
❑Gravity lif Pressure lid Trench ❑Bed ❑Sub Surface Drip
Septic Tank/Drainfield Specifications Laterals
Number of Bedrooms 2 Schedule/Class 40
Daily Flow:Operating Capacity 240 gpd Length 54 ft
Daily Flow:Design Flow 240 gpd Diameter 1 1/4 in
Septic Turk Capacity(working) 500+NuWater gal Number 3
Receiving Soil Type(1-6) 3 Separation 9'+On-Center ft
Receiving Sod Appl.Rate .8 gpd/ft Orifices
Required Primary Area 300 fta Total Number of Orifices 42
Designed Primary Area 486 tjr Diameter 3/16 in
Designed Reserve Area 486 ft' Spacing 48 in
Trench/Bed Width 3 ft Manifold
TrenchBed Length 162 ft Schedule/Class 40
Elevation Measurements Length Preferred It
Original Drainfield Area Slope 12 % Diameter 2 in
New Slope,If Altered same /o Preferred manifold configuration used? lif Yes O No
Depth of Excavation Up-slope 14 in Transport Pipe
from Original Grade Down-slope 9.68 in Schedule/Class 40
Designed Vertical Separation 12+ in Length 20 ft
Gravelless Chambers Required? ❑Yes ❑No 51 Optional Diameter 2 in
Pump Required? It Yes []No Dosing and Pump Chamber
Pump/Siphon Specifications Number ofdoses/day 6
Diff.in Elevation Between Pump&Uppermost Orifice '—it Dose quantity 40 gal
Drainfield Squirt Height/Selected Residual(head) 2_+ it Chamber Capacity(flood) 1200 gal
Uppermost Orifice re Higher Illf Lower than Pump Shutoff Pump controls:Please check those required.
Capacity(a)Total Pressure Head 32.1 8Pm RiTianer GdElapse Meter Event Counter
Calculated Total Pressure Head 10.8 it If Timer: Pump on Ohm
Comments
DEC 2 7 2024
MASON COUNTY E1N19R0!NYENTAL HEALTH
DESIGN FORM—PAGE TWO Assessor's Parcel Number: Z I
Permit Number: SWG
DESIGN CHECKLISTS
Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch
it Test hole locations 19 Drainfield orientation and layout Reference depth from original grade:
0 Soil logs Ef Trench/bed dimensions and Rf Septic tank
m Property lines critical distances within layout TZ Drainfield cover
Existing and proposed wells 66 D-BoxNalve box locations Reference depth from original grade
within 100 ft of property 56 Septic tank/pump chamber and restrictive strata:
m Measurements to arts,banks,and locations 0 Laterals,trench/bed,top and
surface water and critical areas 59 Observation port location bottom
0 Location and orientation of G6 Cleanout location ❑ Curtain drain collector
curtain drain and all absorption 66 Manifold placement ❑ Sand augmentation
components 19 Orifice placement Other cross-section detail:
m Location and dimension of 21 Lateral placement with distance Ed Observation porWcleanouts
primary system and reserve area to edge of bed Other Information
16 Buildings 56 Audible/visual alarm referenced Yes No
m Direction of slope indicator Scale of drawing shown on scale ❑ Rf Design staked out
A Waterlines bar ❑ Ed Recorded Notices attached
Id Roads, easements,driveways, ❑ E6 Waiver(s)attached
parking 19 ❑ Pump curve attached
la North arrow and scale drawing ❑ 9 Evaluation of failure
shown on scale bar Non-residential justification
❑ ❑ Waste strength
❑ ❑Flow
DESIGN APPROVAL
The undersigned designer must be nr red by installer at time of installation O Yes ❑ No
_
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Signature of Designer Date
The undersigned has reviewed this design on behalf of Mason County Public Health and determined it to be in
compliance with state and local on-site regulations:
{2- 'F��/rer 5'wl l�ilz7l�7
Environmental Health Specialist Date
CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CONDITION:
✓ The design is stamped"Approved"by Mason County Public Health. 61 ) 2 6(G�
✓ 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.
Ud Date: 12/72015
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