HomeMy WebLinkAboutSWG2025-00168 - SWG Application / Design - 5/9/2025 U
eti",4 MASON COUNTY 415 N 6TH STREET,SHELTON,WA 98584
SHETREE 400 360 427 9670,EXT
BELFAIR:360-275-4467,EXT 400
Public Health & Human Services ELMA:360-482-5269,EXT 400
FAX.360-427-7787
On-Site Sewage System Tank Only Permit: SWG2025-00168
OWNER EVANS ET UX LONNIE Phone: 206.940.5672
Address: 7426 NE 155TH ST KENMORE, WA 98028
APPLICANT EVANS ET UX LONNIE Phone: 206.940.5672
Address: 7426 NE 155TH ST KENMORE, WA 98028
SEPTIC INSTALLER AARON SHUMAKER* Phone: 360.509.1222
Address: PO BOX 3378 BELFAIR, WA 98528-3378
Site Address: 490 NE KLAHOWYA RD
Primary Parcel Number: 322237500150
Permit Description: Add septic tank with pump in 2nd comp.for BLD2024-00853
Permit Submitted Date: 05/05/2025
Permit Issued Date: 05/09/2025
Issued By: Rhonda Thompson
Current Permit Fees Paid: $270.00 (additional fees may be required upon installation of system).
Permit Expiration Date: 05/09/2028 (based on date of inspection)
Type of Work OSS New Construction
Components being Replaced: Septic Tank Only
Surfacing Sewage? No Existing Failure? No
Shoreline? No Horizontal Setbacks Met? Yes
Number of Bedrooms: 3 Drinking Water Source: Private Well/Spring
Additional Details: Septic tank with pump in 2nd comp.
Permit Conditions:
1 Horizontal setbacks per WAC246-272A-0210 must be maintained, unless prior approval is
obtained
2 Permit must be installed by a Mason County Certified Installer unless prior written
authorization from Mason County is obtained.
4 Proposed development subject to zoning requirements and approval by the planning
department staff per Mason County Title 17.
3 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/OR DESIGN
APPROVED.
FINAL INSTALLATION APPROVAL IS REQUIRED PRIOR TO TEMPORARY OR FINAL OCCUPANCY OF ANY RELATED STRUCTURES.
For Final Inspection visit: masoncountywa.gov/health/environmental/onsiteloss-inspection-request.php or call:
360-427-9670, extension 400.
1
OFFICIAL USE ONLY
DATE RECEIVED: b I ^ Dom\ g
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't. a,,exv 360-427-9670,ext.400 of366I75aa67.eat 40C SWG c O
415 N.6th Street•S^eltoo.V/A 98589 O
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ON-SITE SEWAGE TANK ONLY APPLICATION x.
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APB:ICANT PHONF m
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Evans Lonnie z
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MAILING ADDRESS-STREET.CITY.STATE.ZIP CODE E
CD
7426 NE 155th St. Kenmore Wa. 98028 m
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SITE ADDRESS-STREET.CI-Y.ZIP CODE
490 Ne Klahowya Rd Belfair Wa 98528 I W
NAME OF DESIGNER PHONE I'O
NAME OF INSTALLER PHONE v I N
Shumaker Construction 360 509 12222 <
y I N
TYPE OF WORK(select one) DRINKING WATER SOURCE O
MI NEW CONSTRUCTION/UPGRADES 0 REPAIR/REPLACEMENT I] PRIVATE INDIVIDUAL WELL ❑ PRIVATE TWO-PARTY WELL Z CO
COMPONENT(S)TO BE REPLACED/INSTALLED 0 PUBLIC WATER SYSTEM .. i
❑ SEPTIC TANK 0 PUMP TANK 0 RV HOLDING TANK BEDROOMS LOT SIZE I -I
III
OTHER Additional grinder to pump to existing tank 3 15.21 acres
TANK(S)SETBACK CHECKLIST (A I 01
OTHER DETAILS(select all that apply) 0
❑ SURFACING SEWAGE 0 EXISTING FAILURE ❑SHORELINE MI 10OFT+PUBLIC/COMMUNITY WELLS r7 CD
) I 1
SUBMITTALS El SOFT+PRIVATE WELLS.SURFACE WATERS.STREAMS,RIVERS
1E1 PLOT PLAN(REQUIRED) I/TANK CROSS SECTION(REQUIRED) U 10FT+DRINKING WATER SUPPLY LINES I O
® PUMP DETAILS(IF APPLICABLE) 0 WAIVER(S)(IF APPLICABLE) ® 5FT+PROPERTY/EASEMENT LINES,FOUNDATIONS,FOOTINGS
r IPLOT PLAN CHECKLIST 0
NI PROPERTY LINES AND EASEMENTS ® EXISTING/PROPOSED STRUCTURES ® EXISTING/PROPOSED OSS COMPONENTS AND LINES
MIWELLS WITHIN 100FT il WATER SUPPLY LINES m DRIVEWAYS/PARKING • SURFACE WATERS,STREAMS,RIVERS,ETC... I C.71
® DIRECTION OF SLOPE/CONTOURS ill PERIMETER/CURTAIN DRAINS II NORTH ARROW e SCALE BAR
DIRECTIONS TO SITE AND SITE CONDITIONS.(cc locked gale)
North Shore to Canyon Rd then to Hurd rd. Left on Klahowya rd follow to the very end .
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OFFICIAL USE ONLY BELOW THIS LINE I ,,a
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UPGRADE I FAILURE SOURCE(tor reporting purposes) WI
❑VOLUNTARY ❑MAINTENANCE/PUMPING ❑BUILDING PERMIT ❑HOME SALE ❑COMPLAINT ❑OTHER:
COMMENTS r CONDITIONS
7,(JO LtiVr-L +(AA/\L .‘111 rAmp .....,y„ , ,:i(
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SEWAGE TANKS MUST BE LISTER DOH'LIST OF REGISTERED S�GE T�". TANKS MUST Do
MINIMUM SIZE REQUIREMENTS,EQUIPPED WITH RISERS
AND LIDS TO SURFACE.AND INCLUDE AN EFFLUENT FILTER(IF APPLICABLE). RECORD DRAWING AND INSTALLATION REPORT REQUIRED FOR FINAL APPROVAL
INSPECTOR SIGNATURE DATE APPLICATION EXPIRATION DATE APPLICATION APPROVED)ISSUED BY DATE
74J-2P0 ItTra uT SIq/? c
THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE REVISED 12.7:2015
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APPROVED
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MASON COUNTY ENV1RONYENTAL HEALTit
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`��:� ` MASON COUNTY ENVIRONMENTAL HEALTI;
4 ' , I RET
Zonl1ce Po pS
EXISTING GRAVEL DRIVE ORIENT CABIN
- EXISTING DRAINFIELD AS CONFIRMED
\t RESERVE PERUY BY OU.NERS
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S 2002-00445 VIEW
\ 250'GAL.PROPANE TAt`
\ — ROOF O.N. - LOCATE PER OWNER
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\ NEW INSTALLATION OF
RESIDENCE PROPANE TANKS
S4119 SF. - VERIFY LOCATION
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GOVERE�r AND SIZE OF TANKS
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A R 0 MAY 03 2025
MASON COUNTY ENVIRONMENTAL HEALTH
RET
LESOSERIES
IiberPumps
Sewage Pups `.....0'
»-, A Family and Employee Owned Company
1/2 hp
2" Solids Handling •
118 GPM at 10' TDH .
25' Maximum Head
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Features - POWDER
COATED
•Heavy cast iron construction
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•Oil-filled,thermally protected motor
•Permanently lubricated ball bearings
•2 Vane corrosion resistant engineered
thermoplastic etastomer impe.ler ( • Year Warranty
•All stainless-steer fasteners ano rotor shaft I ( 'IOW
•Quick-connect 10'standard power cord
al.ows replacement of cord in seconds
without breaking seals to motor f'
(25'length optional.35'and 5C'bare lead
cords available.) P.'11-
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I Vertical float APPROVED
switch models
i I available in 115V MAY 0 9 2025
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MASON COUNTY ENVIRONMENTAL HEAL.
FEET
SSPM S�.
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LE50-Series
Impeller Shaft
2 Vane semi-open capable of passing a 2 Stainless
spherical solid
Hardware
Paint Stainless
Powder coat
Mechanical Shaft Seal
Max Fluid Temperature Carbon ceramic
104°F (40°C) Continuous duty
140°F(60°C) Intermittent Bearings
Motor Upper wer ball bearings
Submersible type,oil-filled.hermetically sealed, Float Switch (automatic models]
thermally protected
Wide-angle and vertical f oat switch available
Power Cord Type
SJTW.!Quick-connect 10' standard length
(25'cdrd option) Performance Curve
SJOO1V. bare .ead 35'and 50'cords available
60 Hz, 1725 RPM
Motor Housing liters Per Minute
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0 75.7 151.4 227.1 302.8 378.5 454.2 S30.0 605.7
Class 25 cast iron 28 8.5
Volute 24 7.3
Class 25 cast iron 20 6.1
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Dimensional Data 16 a.9
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Weight;l E51M:42 lbs s12
Heightrl4" 8 2.4 I-
Major*idth:11.5"(manual models) A P P R Q V E D 1.2
MAY 0 9 2025 20 40 60 80 100 120 140 160 0
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MASON COUNTY ENVIRONMENTAL HEALTH US Gallons Per Minute`
All Models RET
MODELS HP VOLTS PHASE AMPS DISCHARGE SIZE AUTOMATIC IMPELLER
LE51144 1/2 115 1 12 2"FNPT No 2 Vane Semi-Open
LE51A 1/2 115 1 12 2'FNPT Wide-Angle Float Switch 2 Vane Semi-Open
LE51A1/ 1/2 115 1 12 2"FNPT Vertical Float Switch 2..Vane Semi-Open
LE52M 1/2 208-230 1 6.8 2"FNPT No 2 Vane Semi-Open
LE52AI 1/2 208-230 1 6.8 2"FNPT Wide-Angle Float Switch 2 Vane Semi-Open
1 10 corastandard on above mr,oe.ts.
For 25'Cord opt'oriti.add a'-2'suf`x to model r.ember.Example.LE51A-2
For S5'bare.esd cords on manual models.add a'-3'suffix to model nwnber.Example'L151M-i
i-or 50'bare:eao cords on manual models,ado a--5"suf`ix to model ri,mber Example!LE51M-5
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sve:.:a:.,r.sa. ;.:•_i..,•n.••:.en,$.:r.,.,e. Liberty Pumps 7000AppleTreeAvenue-Bergen,New York14416
Copy g :1€i icer:7 P,-ps.t .E21 A. rights rose>rd.i rrr00'.S c.ki /z: Phone 800-543-2550-Fax 585-494-1839-www.LibertyPumps.com
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MASON COUNTY ENVIRONMENTAL HEALTh
RET
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