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HomeMy WebLinkAboutSWG2025-00086 - SWG Application / Design - 3/17/2025 SA ® MASON COUNTY d15N6THELTON:STREET,SHELTON, 0,VIA EXT 100 SHELTON:360-2754470,EXT 400 BELFAIR:3862]54487,EXT 400 Public Health & Human Services ELMA:3604B245269,EXT 400 FAX:360427-7787 On-Site Sewage System Permit: SWG2025-00086 covm-`f APPLICANT WILLIS DEAN A&JANIS E Phone: Address: 260 SE PAULCYN LN SHELTON,WA 98584 OWNER WILLIS DEAN A&JANIS E Phone: Address: 260 SE PAULCYN LN SHELTON.WA 98584 SEPTIC DESIGNER MICAH HALVERSON' Phone: 360-490-6365 Address: PO BOX 1519 SHELTON,WA 98584 SEPTIC INSTALLER JAMIE WORKMAN* Phone: 360463-9573 Address: 120 E TIMBERLAKE DR SHELTON,WA 98584 Site Address: 260 BE PAULCYN LN Primary Parcel Number: 319027790061 Permit Description: Conforming repair 3bd gravity trench Permit Submitted Date: 03/17/2025 Permit Issued Dale: 03/18/2025 Issued By: Rhonda Thompson Current Permit Fees Paid: $825.00 (sddnnnel fees my be Mweced won lmMlleBan d SOMM). Permit Expiration Date: 03/10/2026 (bssedonddodlmPemon) Permit Conditions: 1 Proposed development subject to zoning requirements and approval by the planning department stagper Mason County Title 17. 2 Permit must be installed by a Mason County Certified Installer unless prior mitten 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 back8ll of system components. 5 Installer is responsible for obtaining Septic Designer/Engineer 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 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/onvironmentaL'onsite/"94nspoctiongequesl.php or call: 360-427.9670,extension 400. OFFICIAL USE ONLY DATEManDx MASON COUNTY 03 I y" 2 H ® COMMUNITY SERVICES m NMk MRYU I�Gunmu'NyeaMVEnNronmemalHnM1 ��� ? OT F Ci QZS QC�B(P `o O SW 2 W ON-SITE SEWAGE SYSTEM APPLICATION s m APPLICANT r FNLWE m m Dean Willis c_� 360-259-2983 MAIUNGAGCRESS-STREET,cm,srnrE,zP 260 SE PAULCYN LN, H SHELTON WA 98584 m 81TEAOOREss-sIREET._.P_ �I nl •• SAME ] NMIE OF DESIGNER �"= A0NE MICAH HALVERSON 360-490-6365 (� NAME OF INSTMIER Q PHONE JAMIE WORKMAN 0 I© F£RCM?NFE(aW asl DMNI(INGWATERSIXMiCE O C p:RESIDENTIAL OSS L5.COMMUNITYOSS ECOMMERCLLLOSS EPRNATEINDNIDUALWELL INPRIVATETWOAAR MLL = I1 ttPE OFVroRN(weaaY/ 1IT PUBUCWATER SYSTEM HAR130 -INATERWSTEM 1 GNEWCONSTRUCnON/UPGRADES WNREPAIRIREPLACEMENT OTHERDETAILS(mk O.IPy/ O TABLE IX REPAIR I .,I SUMTMB O3URFACINGSEWAGE H EXISTING FAILURE [)SHORELINE GDESIGN POW(REWIRED) Ih SEPTIC DESIGN(REQUIRED) BEDROOLIS LOT SGT: W I� I7 WANER(S)(IFAPPLICABLE) 3 2.52 I� DIRE[ STOSREANDSITECONDRIg :(az,bdM ) MEET WITH RHONDA 3/10/2025 10 o 10 ti SIIEMUST BE FLAGGED FROMYAIN RGAD ANDTE5TM0lES MUST BEFLAGGEDWRIITEST HOLE NINIY918. I I� OFFICIAL USE ONLY BELOW THIS LINE UPdUDE/FMURESOURCE(fmnSd6NPu ) OVOLUNTARY OMAINTENANCEIPUMPING OBUILDINGPERMIT EIHOMESAI.E OCOMPWNT DOTHER: INSPECTOR SOIL LOGE COIAMENISI CONDRICNS �N 4- `70+1\\ SOILCOOES. ` RECORDDRAWINGANOINSTN TIONREPIXiT v=VERY G=GRAVELLY S=6N0 L=LOMI N=WLT C-CAY E-EMRENELY R=ROOTS REOUIREOFORFINMAPPROV L INSPECTORSIGNATURE DATE MPUtAPON EXPIMTON DAE AP ICATIIXi APPROVEN ISSUED BY DATE �6YYI � lulls 3IIoI2B ������ THIS FORM MAY SCANNED AND AVABABLE FOR PUBLIC VEW ON THE MASON COUNTY VIEBSITE REVISED IMIIM15 DESIGN FORM—PAGE ONE Assessor's Parcel Number: - I c/ 0 e — 7 7 -- 9 O b I A design will be reviewed when 3 conies of each of the following are submitted: Completed design form that has been signed and dated. v 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+m ba scanned and w!!!!h for bac view on tlu Mason C. my Web site.Maximum er size: 11"X 17" A N Permit Number: SWG 70zS - (� Designer's Name: MICAH HALVERSON Applicant's Name: DEAN WILLIS Designer's Phone Number: 360-490-6365 Mailing Address: 260 SE PAULCYN LN, Designer's Address: PO BOX 1519 SHELTON WA 98584 SHELTON WA 98584 City State zip city State Zip DESIGN PARANICRO Treatment Device ❑Gleadon Mother ❑ Send Filter ❑Mound ❑ Send Lined Drainfield ❑Recirculating Filter,Type: ❑Aerobic Unit Make/Model ❑Disinfection Unit Make/Model Other: SEPTIC TANK Drainfield Type IIrGravity ❑Pressure Er Trench 0 Bed ❑ Sub Surface Drip Septic Tank/Drainfield Specifications Laterals Number ofBedmoms 3 Schedule/Class ASTM.2729 PERF Daily Flow:Operating Capacity 360 gpd Length 50 ft Daily Flow:Design Flow 360 gpd Diameter 4' in Septic Tank Capacity(working) EXISTING 1200 gal Number 3 Receiving Soil Type(1-6) 3 Separation 6'OC ft Receiving Soil Appl.Rate .6 gpd/ft' Orifices Required Primary Area 450 111 Total Number of Orifices PERF Designed Primary Area 450 ftr Diameter in Designed Reserve Area N/A fft Spacing ' in Trench/Bed Width 3 ft Manifold Trench/Bed Length 150 ft Schedule/Class D-BOX Elevation Measurements Length ft Original Drainfield Area Slope 12 % Diameter in New Slope,If Altered SAME % Preferred manifold configuration used? 0 Yes OfNo Depth of Excavation Up slwp 34 MAX in Transport Pipe from Original Grade Dowu_,l, IT-29" in Schedule/Class ASTM 3034 Designed Vertical Separation 361w in Length 50 ft Gravelless Chambers Required? ❑Yes Id No 0 Optional Diameter 4 in Pump Required? ❑Yes E(No Dosing and Pump Chamber Pump/Siphon Specifications Number ofdoses/day GRAVITY Diff.in Elevation Between Pump&Uppermost Orifice ft Dose quantity gal Drainfield Squirt Height/Selected Residual(head) ft Chamber Capacity(flood) gal Uppermost Orifice 0 Higher 0 Lower than Pump Shutoff Pump controls:Please check those required. Capacity @ Total Pressure Head gpm OTirner apge j�etyL vart counter Calculated Total Pressure Head ft If Timer: Pump on F•7 sL1�'f�IP commens MAR 18 2025 MASON COUNTS11,S1R YBTALHEALTH T DESIGN FORM—PAGE TWO Assessor's Parcel Number: .3 7 7 — 17 O © 6 Permit Number: SWG DESIGN.:CHECKUSTS Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch 19 Test hole locations IN Drainfield orientation and layout Reference depth from original grade: ® Soil logs PI Trench/bed dimensions and 16 Septic tank 0 Property lines critical distances within layout B Drainfield cover 0 Existing and proposed wells 19 D-Box(Valve box locations Reference depth from original grade within 100 it of property H Septic tankipump chamber and restrictive strata: H Measurements to cuts,banks,and locations IR Laterals,trench/bed,top and surface water and critical areas IN Observation port location bottom B Location and orientation of B Cleanout location ❑ Curtain drain collector curtain drain and all absorption Ipf Manifold placement ❑ Sand augmentation components Iff Orifice placement Other cross-section detail: 19 Location and dimension of if Lateral placement with distance If Observation ports/clean-outs primary system and reserve area to edge of bed Other Information Iff Buildings 19 Audible/visual alarm referenced Yes No 10 Direction of slope indicator Ef Scale of drawing shown on scale Ef ❑ Design staked out M Waterlines bar ❑ 16 Recorded Notices attached 9 Roads, easements,driveways, ❑ E1 W aiver(s) attached ping ❑ K Pump curve attached • 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 b otified by installer at time of installation 16 Yes ❑ No 31i71re z 5 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: Vina4Yurisu� Environmental Heal Specialist Date CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CONDITION: ✓ The design is stamped"Approved"by Mason County Public Health. -J I b I '�� 4 ✓ 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. 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