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Home My WebLink Aboutswg2025-00039 - SWG Application / Design - 3/4/2025 415 N 6TH STREET,SHELTON,WA 98504 MASON COUNTY SHELTON:360-2754467,EXT 400 BELF MA:360482-5269,EXT 400 Public Health & Human Services ELMA:360 FAX:360-EXT400 FAX:360-027-7787 On-Site Sewage System Permit: SWG2025-00039 APPLICANT CLINE PETER W&LINDA S Phone: Address: 18012 NE 132ND ST REDMOND,WA 98052 OWNER CLINE PETER W&LINDA S Phone: Address: 18012 NE 132NO ST REDMOND,WA 98052 SEPTIC DESIGNER Alex Paysee Phone: 360-426-1803 Address: 3083 E Mason Benson Rd GRAPEVIEW,WA 98546 Site Address: 3901 NE North Shore Rd Primary Parcel Number: 222021400100 New 1-bedroom upgrade to existing 3-bedroom Glendon system (4- Permit Description: bedrooms total) Permit Submitted Date: 02/1112025 Permit Issued Date: David Da Anderson Issued By: vid (additional ren may 5e diduand"Pon matelleuen ofsyntai Current Permit Fees Paid: b 555.00 Permit Expiration Date: 0212112028 (rased on date of Inspection) 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 down slope depth specified on design form. 4 Installer is responsible for obtaining Mason County installation approval prior to back it/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.gov/health/environmentallonsiteloss-inspection-requestphp or call: 360-427-9670, extension 400. OFFICIAL USE ONLY DATEPFLFMB ® MASON COUNTY - C 0rn COMMUNITY SERVICES """' Flhq 5 """`Ez 0p1 v_ < " N,MMIMWh I�Canmu'kyHnkWFRWmnmWNl HeahM1l 0 M , SWG z o p ON-SITE SEWAGE SYSTEM APPLICATION 3 IT 0 P-NE ApPIIGN PETER & LINDA CLINE 3 MAILINCALORESS STREET,CITY.STATE.ZIP CODE 18012 NE 132ND ST REDMOND WA 98052 m SREAODRESS-STREET.COY.APCWE 3901 NE NORTH SHORE RD BELFAIR WA 98528 ^' NAME OF DESIGNER PMNE I N ALEX L. PAYSSE 360-426-1803 NAME OF INSTALLER PHONE N TBD w o PERMITTYPE(sKKYwro) DRNSWINATERSOIMNE ®RESIDENTIALOSS �COMMUNITYOSS OCOMMERCWLMS ®PRIVATE INDIVIDUALMLL �PRNATETWO-PARTY W£LL I2 IN PUBLIC WATER SYSTEM , TYPEay.QRN R.mPIa ®NEWCONSTRUCTICNIUPGRAUES EDREPNRIREPLACEMENT OTNF.RDETNLS(WaIMMM WAY) DYABLE IS REPAIR []SURFACING SEWAGE OEXISTINGFAILURE 0SHOREUNE IA SUBMITTALS ZOESIGLOTS MVENFORM(REQUIRED) ®SEPTIC DESIGN(REQUIRED) eEw+oDMs3 EXIST+ I NEW. 0.65 5] �NUJVER(S)(IFAPPLICABLE) 7. I O I gRELLIONSTO SITEANOSNE CCNDITIOFLS.(e+.NCMOPMI FROM BELFAIR, HEAD OUT NORTH SHORE TO SITE ADDRESS 3901 ON LEFT. o SIIEYVST9E PUGGED FNGM MAINRDAD AHO TEST XWESYV3TKFlAfAED MTIIITE9TIM11EMN19ER0. I I O OFFICIAL USE ONLY BELOW THIS LINE UPGRACEIFNLIME SOURCE(TERAN p)PUMPIl Q VOLUNTARY DMAINTENANCEIPUMPING ❑BUILDING PERMIT OHOME SALE OCOMPUINT BOTHER WMMENTSIGONOTIONS INSPECTORSOILLOGS Ttfs:a ISM h Is i�ra-af r9" w( v2fw. RECORD gUNING AND INSTALLATNN REPORT WILCODEB: REOUIREDFORPNALAPPROLML. V•VERY G=GPAVFRY S=SANO L=LOAM SI=SILT C=CLAY E=EXTREMELY R=ROOTS NS^E RSIGNPTURE GTE APPLIGTKKi E%NMTION GATE AppLICA pPROVENISSDEDBY DATE —Z ti tans' 251 / toz - 3 z THIS FORM MAYBE SCANNED ANO AVAILABLE FOR PUBLIC VIEW ON 1NE MASON COUNTY WEBSITE REPSEJ,'NI2T5 DESIGN FORM—PAGE ONE Assessor's Parcel Number: 2 2 2 0 2 — 1 4 — 0 0 1 0 0 A design will be reviewed when 3 copies of each of the following are submitted: r Completed design form that has been signed and dated. I Scaled layout sketch,including all applicable items on checklist a Scaled plot plan,including all applicable items on checklist. v 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 P-Pel size: //"X/7" PARCEL IDENTIFICATION �7 ALEX L.PAYSSE Permit Number SWG 1 _�1n�-1 Designer's Name: 360d262g03 Applicant's Name: PETER 8 LINDA CLINE Designer's Phone Number: Mailing Address: 18012 NE 132ND ST Designer's Address: 3083 E MASON BENSON RD REDMOND WA 98052 GRAPEVIEW WA 9a54S C' State Zi Ct State Zl. Treatment Device gGlendon Biofilter ❑Sand Filter ❑Mound ❑Sand Lined Drainfield ❑Recirculating Filter,Type: ❑Aerobic Unit Make/Model ❑Disinfection Unit Make/Model der: Drainfield Type ❑Gravity ❑Pressure ❑Trench ❑Bed ❑Sub Surface Drip Septic Tank/Druinfield Specifications Laterals Number of Bedrooms 4(3 EXIST.+1 New) Schedule/Class GLENDON Daily Flow:Operating Capacity 360 gpd Length It Daily Flow:Design Flow 480 gpd Diameter - in Septic Tank Capacity(working) 1200(EXIST) gal Number - Receiving Soil Type(1-6) 3 Separation ft Receiving Soil Appl.Rate 0.8 gpd/ft' Orifices Required Primary Area 210 ft' Total Number of Orifices GLENDON Designed Primary Area 210 ft' Diameter - In Designed Reserve Area 210 ft2 Spacing - in Trench/Bed Width 14 ft Manifold Trench/Bed Length 15 ft Schedule/Class SC 40 Elevation Measurements Length <6p ft Original Drainfield Area Slope 0 % Diameter 1 in New Slope,If Altered 0 % Preferred manifold configuration used? S(Yes ❑No Depth of Excavation Upslope GLENDON in Transport Pipe from Original Grade Down-snipe GLENDON in Schedule/Class EXISTING Designed Vertical Separation 12+ in Length - ft Gravelless Chambers Required? ❑Yes O No ❑Optional Diameter - in Pump Required? O Yes O No Dosing and Pump Chamber Pump/Siphon Specifications Number of doses/day GLENDON Diff.in Elevation Between Pump&Uppermost Orifice=ft pose quantity GLENDON gal Drainfield Squirt Height/Selected Residual(head) ft Chamber Capacity(flood) 1200(EXISTING) gal Uppermost Orifice If Higher ❑Lower than Pump Shutoff Pump controls:Please check those required. Capacity @Total Pressure Head - gpm dTimer fi(Elapse Meter EX Event Counter Calculated Total Pressure Head - ft If Timer: Pump on GLENDON ,pump off GLENDON Comments RUN PUMP TEST AFTER INSTALLATION. EXISTING PUMP SHOULD BE SIZED TO ACCOMODATE. DESIGN FORM—PAGE TWO Assessor's Parcel Number:2 2 2 0 2 — 1 4 — 0 O 1 0 0 Permit Number: SWG DESIGN CHECKLISTS Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch 66 Test hole locations Z Drainfteld orientation and layout Reference depth from original grade: A Soil logs 9 Trenchi ed dimensions and Rf Septic tank I1 Property lines critical distances within layout 19 Drainfield cover lA D-Box/Valve box locations � Existing and proposed wells Reference depth from original grade within 100It of property A Septic tank/pump chamber and restrictive strata: m Measurements to cuts,banks,and locations E9 Laterals,trench/bed,top and surface water and critical areas Z Observation port location bottom ig Location and orientation of Rl Clean-out location ❑ Curtain drain collector curtain drain and all absorption Ri Manifold placement ❑ Sand augmentation components l9 Orifice placement Other cross-section detail: Location and dimension of Lateral placement with distance Rf Observation ports/clean-outs primary system and reserve area to edge of bed Other Information Buildings 19 Audible/visual alarm referenced Yes No R1 Direction of slope indicator 59 Scale of drawing shown on scale 06 ❑ Design staked out GJ Waterlines bar ❑ Rf Recorded Notices attached Ed Roads,easements,driveways, ❑ 56 Waiver(s)attached parking ❑ [9 Pump curve attached 0 North avow and scale drawing ❑ If Evaluation of failure shown on scale bar Non-residential justification ❑ Rf Waste strength ❑ 56 Flow DESICN APPROVAL The undersigned designer must be notified by installer at time of installation fid Yes ❑ No pA ,� Ro Signature of signer Date 'y✓Spd, ,9y C Q( The undersigned has reviewed this design on behalf of Mason County Public Health and determt to b8 compliance with state and local on-site ations: p✓g0*41 3a�016 �y Environmental Health Specialist Date y<Tq 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 re uired. This form may be scanned and available for public view on the Mason County Web s pdated Date. 12/7Y2015 ' PECOMMI5SIONED WELL OAF' 11 210 SF RESERVE 14'x 15' 5TORAGE/SHED (OLD CABIN) ' 1 ABANDON E4 pp PROPOSEDADDITION A t. TO EXISTING 055. 1 O V (4TH BED) 1 MgSONCOUNryAR t7 4 ADIJr �.J EXISTING 3BEDROOM L — I EXISTINGTAN�/R0NAfev GLENDON SYSTEM , �I �. 1200 GAL. SEPTIC4TAI TPE'4k PRIMARY& RESERVE I �`� 1200 GAL. PUMP TANK EXISTING LINE LOCATIONS _1_ EXISTING GARAGE AREAPPROXIMATE. 1 �� \ �\ ot LOCATES FOR ELECTRICAL I 1 O' I 1 EXISTING 3 BEDROOM NEEDED. I� HOME TO BE REMODELED j EXISTING WELL / EXISTING \ WELL I R7p0 �`� ° � �� Ii 1° R700- I EXISTING \ / \ WELL �� \\ r OHWM INSTALLATION NOTES: HOOD CANAL INSTALL4TH GLENDON MODULE TO ACCOMMODATE FUTURE HOME REMODEL ---�— "' RE-PLUMB VALVE BOX AND RUN ADDITIONAL f 3 FEEDER LINE. ADD SAND TO EXISTING SYSTEM ' AUIIaIe FAT$ AND RESHAPE PER GLENDON SPECIFICATIONS. s ` CEPAR TREES WIN DRAINFIELDAREAARE ALSO TO BE REMOVED. AN ASBOILTI INSTALL SIGNOFF FEE WILL BE CHARGED AT TIME OF INSTALLATION CUSTOMER: PETER CLPIE INFrORIVATIONKEVIOUSDHANO-UG HE9GN FOR OOLE ROV DMONJAL IL ID IN PIONEER DIGGING, INC- PARCH.r.22202-"100 NEW RESERVE 01I8 GIS ROOTS®18.H2O IS 20 SEPTIC DESIGNS ADDRESS: 39MNOR7HSNORERD 3083 E MASON BFHSON RD. fdtAPEVIEW,WA 98546 DESIGNER: AEEx L PAl55E OFFlCF-36D4261803 FAX-3604V 2353 SHEET: SREPLAN SCALE 1'=30 120 / 0.8 = 1505F I EXISTING GATE 1505F+ 605F (VESSEL) I �� = 210 5 F REQ. 14 X 15 = 2105F SUGGEST CVRBING/BARRIER 51 J TO AVOID VEHICULAR TRAFFIC 15' "11\15TALLAND Ap b' GLENDON I SHAPE PEP, DRIVEWAY A 11c SPECIFICATIONS I 10, 0 Mqs 11A1j V` 'j °NC04N74' 41pp5 t,. PROPOSED e R0N1F ADDITION TO I ✓q NTq HE9[T, EXISTING SYSTEM I INSTALLATION NOTES: I INSTALL 4TH GLENDON MODULE 0 TO ACCOMMODATE FUTURE HOME REMODEL, RE-PLUMB VALVE BOX AND RUN ADDITIONAL FEEDER LINE, ADD SAND TO EXISTING EXISTING 3 BEDROOM SYSTEM AND RESHAPE PER GLENDON, PRIMARY GLENDON 5PECIFICATIONS. CEDAR & RESERVE AREA. I TREES WIN DRAINFIELDAREAARE REFERENCE: 1 N G AL50 TO BE REMOVED, SWG2000-00441 I I I I 0 PREVIOUS PERMIT OBTAINED WAIVER I APPROVAL FOR I SETBACK REDUCTION ' .uSLae oA.>g TRANS. LINE J AN ASBUILTI INSTALL SIGNOFF FEE WILL Q� (NO CHANGES) \�� BE CHARGED AT TIME OF INSTALLATION / CU MER: PETER CLPE NFORMATION.MOUS HAND-DGN OUG HOLE PROVIDEDILIN PIONEER DIGGING, INC PARCEL#72Z_1'F00100 NEW RESERVE BLS GLS,ROOTS®IR H2O 020 SEPTIC DESIGNS ADDRES4 3901 NORTH SHORE RI) 3083 E MASON BE—WN RD. CWM IEW.WA9Ss4G DESIGNER: ALIXLPAYffiE �.E,.rw .o. OFFICE 3604261803 FAX 3604272353 SHEET: OF MAL SCALE P-10' Ew owow.w..r...ow Installation & System Notes 1. Installer must contact designer for final inspection of the installation prior to cover. All components,including tanks,lids, transport line,drainfield,and water lines must be open for inspection. A$350.00 fee will be charged for time involved with the inspection of the installation and creation of the record drawing. The designer reserves the right to charge additional fees if multiple visits are needed due to installation errors or inaccessible components. 2.This septic design must be installed by a certified Installer with the local health department. All components shall be installed according to state,county,and manufacturer requirements. For Homeowner Installs,the owner must get approval from the designer and local health department Rqato attempting installation. 3. Designer is not a surveyor. Installer must familiarize themselves with property line locations prior to installation. Any confusion or conflicts with line locations should be reported to the property owner. A licensed surveyor may be necessary prior to Installation to confirm all line locations. Any discrepancies found must be reported to the designer immediately. 4.Drainfeld area may only be cleared by a licensed installer familiar with sensitive drainfield area preservation. The builder,lot developer,or property owner shall not clear the drainfield area. Any clearing required for drainfield installation shall not remove or disturb any top soil in Primary and Reserve areas. Removal or disturbance to drainfield soils could render design void. S.The property owner and installer are responsible for locating all underground utilities(ex.water,gas,electric)prior to installation. Any utility locations shown within design drawings are likely approximate and may not be exact. 6.All proposed tanks must be Installed on original soils or compacted gravels. Extend all tank connection lines out onto original soil to avoid settling issues. Risers and lids must be brought to finished grade and left accessible for future operations and maintenance. Component manufacturers(ex.ATU,Glendon,)may have other requirements not listed within this design. 7.All electrical wiring shall be done by a licensed electrician or homeowner(if allowed)and must be Permitted through labor and Industries. Designer not responsible for electrical permitting or other electrical specific code requirements. 8.The proposed septic system should be installed in dry weather conditions. Any failed attempts at installation during wet weather conditions may render this design void. 9.Maintain loft to waterlines with all septic components. If less than 10ft is required,sleeving in sch.40 pvc is required. If sewage transport lines and waterlines must cross,waterline must be 18"above sewage line with one of the lines sleeved in sch. 40 pvc 30ft In each direction of crossing. 10.This design may include waiver applications with specific mitigation measures pertaining to installation,operation and maintenance of the proposed components. 11.Stormwater runoff,footing drains,roof drains must be diverted away from any septic system components. No curtain, foundation,perimeter drains shall be installed 30ft downslope and loft upslope of drainfeld areas. 12.This design is site specific and intended to meet state and county requirements that are related to the system components being proposed. Any placement of proposed buildings,proposed wells or other non-related items on these drawings may or may not meet other requirements. 13.All onsite septic systems require regular maintenance to verify satisfactory operation. The system owner/o responsible for the continuous operation and maintenance of the system per WAC 246-272A. For operation and mai information,refer to Mason County Public Health Homeowner's Manual,which should be received 6��tp�CstallVn a p .� 14.System owner should be cautious of landscaping around septic components. Root intrusion O', 4 can cause premature failure of the drainfield area. In addition,bushes and trees should be kept NpjR�N�F :1 away from lids and other septic maintenance points. NT � 15. Changes made at time of installation may impact designer calculations,pump sizing,and A'..,�„ compliance w/county and state requirements. Contact designer prior to install w/any proposed variations from design. Changes may result in additional fees and permitting. + •. PIONEER. DIGGING, NC_ ARCS 22202400100 It r'®" SEPTIC DESIGNS ADDRESS: 39a NORTH SHORE RD H R z . 3083 E MASON BeWN KID. C"VIEw,wA98546 DESIGNER ALEXLPAYSSE OFFICE 3604261803 FAX-3604272353 SHEET: NOTES SCALE' NA