HomeMy WebLinkAboutSWG2025-00079 - SWG Application / Design - 3/10/2025 MASON COUNTY 615 N6THSTREET SHELTON,WA EXT 400
SHELTON:360-275 670,EXT 400
BELFAIR:360-275-0467,EXT 400
Public Health & Human Services ELMA:360482-5269,EXT 400
FAX:360427-7787
On-Site Sewage System Permit: SWG2025-00079
APPLICANT SMITH TAD W&SANDRA L Phone: 360.402.4559
Address: 1540 E SHELTON SPRINGS RD SHELTON,WA 98584
OWNER SMITH TAD W&SANDRA L Phone: 360.402.4559
Address: 1540 E SHELTON SPRINGS RD SHELTON, WA 98584
SEPTIC DESIGNER BOB PAYSSE' Phone: 360-507-1498
Address: 3083 E Mason Benson Road GRAPEVIEW, WA 98546
Site Address: 201 SE Ellis Rd
Primary Parcel Number: 319041490020
Permit Description: New 4-bedroom gravity system wl Class B waiver
Permit Submitted Date: 03/10/2025
Permit Issued Date: 04/08/2025
Issued By: David Anderson
Current Permit Fees Paid: $555.00 (ademoaal fees may be maulrod upon Insbelenon of system).
Permit Expiration Dale: 0312412028 @aced on doe of Inspection)
Permit Conditions:
1 Proposed development subject to zoning requirements and approval by the planning
department sta%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 Designer/Engineer installation approval prior to
backtill 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.govlhealthienvironmentallonsiteloss-inspection-request.php or call:
360.427-9670,extension 400.
OFFICIAL USE ONLY
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NAME OF DESIGNER PXJHE
ROBERT H. PAYSSE M� 360-426-1803
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m I ?DESIGN FORM(REQUIRED) ®SEPTIC DESIGN(0.EpUIRED) BEDROOMS LOT SIZE J4
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OWN COLE, TURN LEFT ON ELLIS ROAD. FOLLOW TO LEFT ON SISTER MEADOWS c I O III
N, SITE ON LEFT, SEE SITE PLAN. PDI SIGN POSTED.
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RECORD DRAWNGANO INSTALLATIOry REPORT
SOILCDDES:
V-VERY G=GRAY£LLY S•SNO L-LOAM E=SILT C=WY E=EXNREMELY R=RODTS REQUIRED FOR FINALAPPRWAL.
INS PEC RBIGW.TURE Z L DATE APPLICATION EXPR TICK DATE APPLI APPROVEO/ISSUEOBY ���ATE
THIS FORM MAY BE3 SCANNED A DAVAILABBLE FOR PUBLLIC ZEW ON THE MASON COUNTY WEBSITE Y REV SEE 12s/0015
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DESIGN FORM—PAGE ONE Assessor's Parcel Number: 3 1 9 0 4 — 1 4 — 9 0 0 2 0
A design will be reviewed when 3 copies of each of the following are submitted:
•Completed design form that has been signed and dated. a Scaled layout sketch,including all applicable items on checklist
•Scaled plot plan,including all applicable items on checklist. Cross-section sketch,including all applicable items on checklist.
This form maybe scanned and available for public view on the Mason County Web sib.Maximum rstne: 11"X17"
PARCEL IDEONWATION .
Permit Number: SWG 10&S - 0• / Designer's Name: ROBERT H.PAYSSE
TAD SMITH 360426-1803
Applicant's Name: Designer's Phone Number:
Mailing Address: 1540 E SHELTON SPRINGS RD Designer's Address: 3083 E MASON BENSON RD
SHELTON WA 98584 GRAPEVIEW WA saw
city State Zip City Stale zip
DESIGN PARAMETERS
Treatment Device
O Glendon Biofhlter ❑Sand Filter ❑Mound ❑Said Lined Drainfreld 11 Recirculating Filter,Type:
❑Aerobic Unit Maks/Model ❑Disinfection Unit Make/Model Other: ATTN.ZONE
Drainfreld Type
R(Gravity, ❑Pressure R(Tmnch ❑Bed ❑Sub Surface Drip
Septic Tank/Drainfield Specifications Laterals
Number of Bedrooms 4 Schedule/Class 2729 PERF
Daily Flow:Operating Capacity 360 gpd Length 50 ft
Daily Flow:Design Flow 480 Slid Diameter 4 in
Septic Tank Capacity(working) 1500 gal Number 4
Receiving.Soil Type(1-6) 3 Separation 10 ft
Receiving Soil Appl.Rate 0.8 gpd/ft' Orifices
Required Primary Area 600 ft, Toml Number of Orifices -
Designed Primary Area 600 ft Diameter - in
Designed Reserve Area 600 ftt Spacing - in
Trench/Bed Width 3 ft Manifold
Trench/Bed Length 200 ft Schedule/Class 3034
Elevation Measurements Length 30 ft
Original Drainfreld Area Slope 3 % Diameter 4 in
New Slope,If Altered 3 a/ Preferred manifold configuration used? GdYes O No
Depth of Excavation Up-slope 8 in Transport Pipe
from Original Grade Dom-slope 7 in Schedule/Class 3034
Designed Vertical Separation 18+ in Length <200 ft
Gravelless Chambers Required? O Yes III No O Optional Diameter 4 in
Pump Required? ❑ Yes lifNo Dosing and Pump Chamber
Pump/Siphon Specifications Number ofdoses/day -
Diff.in Elevation Between Pump&Uppermost Orifice ft Dose quantity - gal
Drainfield Squirt Height/Selected Residual(head) ft Chamber Capacity(Flood) - gal
Uppermost Orifice O Higher ❑Lower than Pump Shutoff Pump controls:Please check those required.
Capacity @ Total Pressure Head - gloat OTimer OElapse Meter ❑Event Counter
Calculated Total Pressure Head - ft If Timer: Pump on - ,Pump off -
Comments
DESIGN FORM—PAGE TWO Assessor's Parcel Number:3 1 9 0 4 — 1 4 -- 9 0 0 2 0
Permit Number: SWG
DESIGN CHECKLISTS
Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch
16 Test hole locations Z Drainfield orientation and layout Reference depth from original grade:
16 Soil logs Ed Trench/bed dimensions and Ed Septic tank
19 Property lines critical distances within layout 66 Drainfield cover
m Existing and proposed wells Ed D-Box/Valve box locations Reference depth from original grade
within 100 ft of property [6 Septic tank/pump chamber and restrictive strata:
19 Measurements to cuts,banks,and locations 0 Laterals,trenchlbed,top and
surface water and critical areas 19 Observation port location bottom
19 Location and orientation of 19 Clean-out location ❑ Curtain drain collector
curtain drain and all absorption Rf Manifold placement ❑ Sand augmentation
components E6 Orifice placement Other cross-section detail:
Location and dimension of ff Lateral placement with distance Rf Observation ports/clean-outs
primary system and reserve area to edge of bed Other Information
Buildings I9 Audible/visual alarm referenced Yes No
10 Direction of slope indicator [� Scale of drawing shown on scale 06 ❑ Design staked out
Id Waterlines bar ❑ Rf Recorded Notices attached
Id Roads,easements,driveways, 56 ❑ Waiver(s)attached
parking ❑ Id Pump curve attached
19 North wow and scale drawing ❑ If Evaluation of failure
shown on scale bar Non-residential justification
❑ (d Waste strength
❑ Tf Flow
DESIGN APPROVAL
The undersigned designer most be notified by installer at time of installation 56 Yes ❑ No
WfAA-Vl � 3( 1 0 ( '9
t Signature of Designer Date AA/�
The undersigned has reviewed this design on behalf of Mason County Public Health and determined itt
compliance with state and local on-sr lations: �s0'yCpUN gp�OB P
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Environmental Health Specialist Date ryFN(.�q 41$
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CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CONDI✓14O4kf4,/
✓ The design is stamped"Approved"by Mason County Public Health.
✓ The Onsite Sewage Permit has not expired,the Permit Expiration Date is: (L
✓ 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.
Updated Dale: 12/7/2015
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tnstbllation & 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 rpiorto 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 topsoil in Primary and Reserve areas. Removal or disturbance to drainfield soils could render design
void.
5.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 forfuture operations and
maintenance. Component manufacturers(ex.ATU,Glendons,)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 Soft to waterlines with all septic components. If less than loft 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 10ft 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 drainfield 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/operator is
responsible for the continuous operation and maintenance of the system per WAC 246-272A. For operation and maintenance
information,refer to Mason County Public Health Homeowner's Manual,which should be received after insdQpt' approval.
14.System owner should be cautious of landscaping around septic components. Root intrusion
can cause premature failure of the drainfield area. In addition,bushes and trees should be kept
away from lids and other septic maintenance points. SON
15. Changes made at time of installation may impact designer calculations,pump sizing,and
compliance w/county and state requirements. Contact designer prior to install w/any FN�jq� 1,S
proposed variations from design. Changes may result in additional fees and permitting. O�q T�Fk'k*
PIONEER DIGGMG, INC ART.°i#3114990020 .�.ru^�wn»
SEPTIC DESIGNS ADDRESS 201 6E ELus RD
3083EMASONBEN'_ONRD. GRAI'EVIEW,WA985 DESIGNER. RDREFLT H.PAYSSE E%wBES
OFFICE 3604261803 FAX 36&427-2353 SHEET, NOTES SCALE NA