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HomeMy WebLinkAboutSWG2025-00102 - SWG Application / Design - 3/28/2025 415 N 8TH STREET,SHELTON,WA 98684 MASON COUNTY SHELTON:380.427.9467,EXT 400 BELF MA:360-482-5269,EXT 400 Public Health & Human Services ELMA:380 FAX: 360-EXT400 FAX:36o-4zT-ne7 On-Site Sewage System Permit: SWG2025.00102 APPLICANT Hunter,Adam Phone: 360 753-1226 Address: 2201 93rd Ave SW Olympia,WA 98512 OWNER WASSON ETAL WESLEY S Phone: 360-581-2046 Address: 1572 SE LYNCH RD SHELTON,WA 98584 Site Address: 1572 BE Lynch Rd Primary Parcel Number: 319094200050 Permit Description: New ADU 2-bedroom Nuwater BNR500 wi subsurface drip drainileld Permit Submitted Date: 03/2812025 Permit Issued Date: 0410812025 Issued By: David Anderson Current Permit Fees Paid: $555.00 Odditionalreas m.y oe.,ked.eoo in to.uoo of-"Wm). Permit Expiration Date: 0410312028 leae.a on eme or M.eeuwn) 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 downslope depth specified on design form. 4 Installer is responsible for obtaining Mason County installation approval prior to bacMlll or 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/onvironmental/onsite/oss-Inspection-request.php or call: 360.427-9670,extension 400. OFFICIAL USE ONLY MASON COUNTY PUBLIC HEALTH ONSITE SEWAGE SYSTEM APPLICATION MAA RMCEMO. M EM1^m�( 415146i115treK(81698) ShehOnW8,98584 N ShAlan:3604979678eM400 eel(air,380.975i181eM408 G 2/T)S' _ 0 SW O VV A 2 N M0.X:ANi MgNE 9 KAREN TEMEN 3605812046 m MRAING ADORE.-S....CRY.6TATE iIP CGOE 1572 SE LYNCH RD SHELTON WA 98584 ; SITEAOCRESS-STREETCM..ZIP0 W 1572 SE LYNCH RD SHELTON WA 98584 }o° 7��.F�Nfft PHONE M HUNTER 3607531226 NSiKLU (NONE c p1EdtALLAPRICISLERFM9 DRMNOWATERBENIRGE �NEWCONSTRUCTION p RVNOLOINOtANKONLY p PRIVATEINAMDUALWELL LA ❑ ftEFUCEMENi SYSTEM ❑ INSTALLATION PERMITONLY Ig PRIVATE TWOYARIV WELL Z I J p TABLE REPAIR p SWGLEFAMILY p COMMUNITYNUBLIC WATER SYSTEM ( I tYAgp' p TANK(S)ONLY ❑ COMLMERCML SYSTEM NAME: O ❑ UPGRNNETOEXISTING D OTHER: RF.ONQTMS LOTSUE ❑ E%ISTING fAAURE •R�Ea^'MP�°� 2 4.1 MWbnNIMtlw' LYNCH RD NORTH TO AERIGHT AT DRIVE FOR1572 TO SITE ON THE LEFT. 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DESIGN FORM—PACE ONE Assessor's Parcel Number:_____ -- -- _—_-- A design will be reviewed when 3 copies of each of the following At submitted: •Completed design form that has been signed and dated. v Scaled layout sketch,including all applicable items on checklist o 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. Warimum paper size: 11"X 17" PARCEL IDENTIFICATION Permit Number: SWGok-102— Designer's Name: ADAM HUNTER KAREN TEMEN 360-753-1226 Applicant's Name: Designer's Phone Number: Mailing Address: 1572 SE LYNCH RD Designer's Address: PO BOX 182 SHELT(N! WA 98584 OLYMPIA WA 99507 city Side Zi City State Zip DESIGN PARAMETERS Treatment Device ❑Glendon Biofilter ❑Sand Filter ❑Mound ❑Sand Lined Drainfield ❑Recirculating Filter,Type: lNAembic Unit Make/MWcIN~WRSNa ❑Disinfection Unit Make/Model Other: Drainfield Type ❑Gravity ❑Pressure O Trench ❑Bed R(Snb Surface Drip Septic Tank/Drainfield Specifications Laterals Numberoffledrecuas 2 Schedule/Class DRIP Daily Flow;Operating Capacity 180 gpd Length 168 ft Daily Flow:Design Flow 240 gild Diameter 1/2 in Septic Tank Capacity 1000 l gal Number 3 Receiving Soil Type(1.6) 5 Separation 1.67 it Receiving Soil Appl.Rate 0.4 gpd/fla Orifices Required Primary Arco "M �fta Total Number of Orifices 504 Designed Primary Area 756 ft1 Diameter DRIP in Designed Reserve Area — ftz� Spacing 12 in Trench/Bed Width 18 fl Manifold Trench/Bed Length DRIP ft Schedule/Class 40 Elevation Measurements Length 18 it Original Drainfield Area Slope S % Diameter 1 to New Slope,If Altered 5 % Preferred ar.mfoid configuration used? EYYcs ❑No Depth of Excavation Uµmope 11 in Transport Pipe from Original Grade Dornslope 11 in Schedule/Class 40 Designed Vertical Separation 12 in Length 80 $ Graveness Chambers Required? ❑Yes QfNo [3 Optional Diameter 1 in Pump Required? I(Yes ❑No Dosing and Pump Chamber Pump/Siphml Specifications Number ofdoscs/day 12 Difference in Elevation Between Punip Shutoffand Uppermost Dose quantity 20 gal Orifice ft Chamber Capacity loan J' gal Uppermost Orifice ItHigher O Lower than Pump Shutoff Pump controls: Please check those required. Capacity @ Total Pressure Head 8.5 gpm Wfimer RElapse Meter ErEvent Counter Calculated Total Pressure Head we ft If Timer: Pump on 20—GAL ,Pump off 2 HRS Comments DESIGN FORM—PAGE TWO Assessor's Parcel Number:_____ -- _ -- PermitNumber: SING DESIGN CHECKLISTS Scaled Plot Plan Scaled Layout Sketch Criiss-Section Sketch 2f Test hole locations 9 Dminfield orientation and layout Reference depth from original grade: 13 Soil logs Trench/bed dimensions and 61 Septic tank EZ Property lines critical distances within layout 9 Drainfteld cover 19 Existing and proposed wells 9 D-Box/Valve box locations Reference depth from original grade within 10011 of property EZ Septic tank/punrp chamber and restrictive strata: 12 Measurements to cuts,banks,and locations ❑ Laterals,trenchlbed,lop and surface water and critical areas El Observation port location bottom ♦a Location and orientation of 0 Clean-out location ❑ Curtain drain collector curtain drain and all absorption &f Manifold placement ❑ Sand augmentation components 0 Orifice placement Other cross-section detail: 19 Location and dimension of lY Lateral placement with distance 9 Observation ports/clean-outs primary system and reserve area to edge of bed Other Information Gl Buildings 9 Audible/visual alarm referenced Yes No E9 Direction of slope indicator R( Scale of drawing shown on scale d ❑ Design staked out E5 Waterlines bar ❑ ❑ Recorded Notices attached IT Roads,easements,driveways, ❑ ❑ Waiver(s)attached parking Er ❑ Pump curve attached E9 North armor and scale drawing ❑ ❑ Evaluation of failure shown on scale bar Non-residenlial justification ❑ ❑ Waste strength ❑ ❑ Flow DESIGN APPROVAL The undersigned designer must be notified by installer at time of installation 4i<Yes ❑ No 3127/25 i a t of D signer Date /yp� The undersigned has reviewed this d ign on behalf of Mason County Public Health and deteer nineG it compliance with state and local on-si lotions: 4''SONc0&N APp p810 Environmental Health Specialist Date 1Yp11,y��y�'�"'�,�`,.��M'dd//�� CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CONDPPIONrl *)41y ✓ 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. 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