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HomeMy WebLinkAboutSWG2025-00262 - SWG Application / Design - 7/2/2025 a MASON COUNTY 415 N 6TH STREET,SHELTON,WA 98584 SHELTON:360-427-9670,EXT 400 BELFAIR:360-275-4467,EXT 400 Public Health & Human Services ELMA:360-482-5269,EXT 400 FAX:360-427-7787 On-Site Sewage System Permit: SWG2025-00262 APPLICANT TINAJERO GERARDO ROMERO Phone: Address: 11 W BOLLING RD SHELTON, WA 98584 SEPTIC DESIGNER FRANKLIN CLARK* Phone: 360-830-4765 Address: PO BOX 1954 SILVERDALE, WA 98383 Site Address: 580 SE Yarrow Ln Primary Parcel Number: 320267590171 Permit Description: NEW 3BR gravity Permit Submitted Date: 07/02/2025 Permit Issued Date: 08/11/2025 Issued By: Jeff Wilmoth Current Permit Fees Paid: $555.00 (additional fees may be required upon installation of system). Permit Expiration Date: 07/31/2028 (based 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 Drain field 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 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/environmental/onsiteloss-inspection-request.php or call: 360-427-9670, extension 400. OFFICIAL USE ONLY U OD .; MASON COUNTY DATE RECEIVED: 7 _ Z ZoZ5 c cn f1 AMOUNT RECEIVE,5� RECENED 3Y. a / � CO a) �l� Public Health & Human Services L(/r t hf�//IL(`J ❑ m Environmental Health 360-427-9670,ext.400 or 360-275-4467,ext.400 U) 415 N.6th Street -Shelton,WA 98584 S W G 2°2 G - /�(17 c2 _7) 0 Z ci) ON-SITE SEWAGE SYSTEM APPLICATION APPLICANT PHONE m m Franklin J Clark C7 360.830.4765 Z MAILING ADDRESS-STREET.CITY,STATE,ZIP CODE 11/1-11 C 11 W BOLLING RD,SHELTON,WA 98584 o�� y 00 m zr SITE ADDRESS-STREET.CITY.ZIP CODE V O) 580 SE Yarrow LN,Shelton,WA 98584 Eg C=D ED p� I W NAME OF DESIGNER O' PHONE Franklin J Clark L 1J 0 360.830.4765 IN) NAME GP INSTALLER r(� 1 >, PHONE IQ Franklin J Clark J m 360.830.4765 II V PERMIT TYPE(select one) DRINKING WATER SOURCE III RESIDENTIAL OSS 0 COMMUNITY OSS 0 COMMERCIAL OSS ❑ PRIVATE INDIVIDUAL WELL PRIVATE TWO-PARTY WELL Z 110 TYPE OF WORK(select one) 0 PUBLIC WATER SYSTEM I • NEW CONSTRUCTION 1 UPGRADES 0 REPAIR/REPLACEMENT OTHER DETAILS(select all that apply) 0 TABLE X REPAIR It***4.41 SUBMITTALS 0 SURFACING SEWAGE 0 EXISTING FAILURE 0 SHORELINE co ▪ DESIGN FORM(REQUIRED) E SEPTIC DESIGN(REQUIRED) BEDROOMS LOT SIZE WAS LOT CREA.TED AFTER 4/1/2025?3 1 b IL 1 25 A ❑ WAIVER(S)(IF APPLICABLE) . cres ❑YES ■NO o 1 DIRECTIONS TO SITE AND SITE CONDITIONS.(ex locked gate) X 10 Mason County Community Services-415 N 6th St,Shelton,WA 98584>Take Olympic Hwy S and E Arcadia Ave to SE Binns Swiger Loop Rd lO Follow SE Binns Swiger Loop Rd and SE Fireweed Rd to SE Yarrow Ln>580 SE Yarrow Ln.,Shelton,WA 98584 p I- --+ V 1.1 SITE MUST BE FLAGGED FROM MAIN ROAD AND TEST HOLES MUST BE FLAGGED WITH TEST HOLE NUMBERS. OFFICIAL USE ONLY BELOW THIS LINE UPGRADE I FAILURE SOURCE(tor reporting purposes) ❑VOLUNTARY 0 MAINTENANCE/PUMPING ❑BUILDING PERMIT ❑HOME SALE ['COMPLAINT ❑OTHER: INSPECTOR SOIL LOGSLI / C I COMMENTS/CONDITIONS L CjL / l 3 Sdt, 2 / 6 +a4.' 3 L SOIL CODES: RECORD DRAWING AND INSTALLATION REPORT V=VERY G=GRAVELLY S=SAND L=LOAM Si=SILT C=CLAY E=EXTREMELY R=ROOTS REQUIRED FOR FINAL APPROVAL. INS CT R SIGNATURE DATE APPLICATION EXPIRATION DATE AP' ION APPROVED/ISS ED BY DATE lor fit N14-3 i -.7.57 -31 - :Ss �-�J !dipT FO BE SCANNED AND AVAILABLE FOR PUBLIC WON THE MASON COUNTY WEBSITE /� Revis4/1 DESIGN FORM-PAGE ONE Assessor's Parcel Number: 120261. 7S- 90171 A design will be reviewed when 3 conies of each of the following are submitted: '"Completed design form that has been signed and dated. Scaled layout sketch,including all applicable items on checklist. 'd Scaled plot plan,including all applicable items on checklist. 'V Cross-section sketch,including all applicable items on checklist. This form may be scanned and available for public view on the Mason County Web site. Maximum paper size: 11"X 17" PARCEL IDENTIFICATION • Permit Number: SWG 2026- cxyz(eZ Designer's Name: Franklin J Clark Applicant's Name: TINAJERO,GERARDO ROMERO Designer's Phone Number: 360.830.4765 Mailing Address: 11 W BOLLING RD, Designer's Address: P.O.Box 1954 SHELTON,WA 98584 City State Zip Silverdale,WA 98383 City State Zip Designer'sEmail aplusonsite@live.com DESIGN PARAMETERS Treatment Device ❑Glendon 0 Sand Filter 0 Mound 0 Sand Lined Drainfield 0 Recirculating Filter 0 ATU 0 Other Treatment Level (check all thatapply): ❑A ❑B ❑C ❑BL i ❑BL2 ❑BL3 ■E ❑N Drainfield Type Gravity 0 Pressure 0 Trench 0 Bed 0 Sub Surface Drip Septic Tank/Drainfield Specifications Laterals Number of Bedrooms 3 Schedule/Class 3034 Daily Flow: Operating Capacity 360 gpd Length 50 ft Daily Flow: Design Flow 360 gpd Diameter 4 in Septic Tank Capacity(working) 1,200 gal Number 4 Receiving Soil Type(1-6) 4 Separation 5'On Center ft Receiving Soil Appl.Rate Pri:.6/Res:.6 gpd/ft2 Orifices -N/ Required Primary Area 600 ft2 Total Number of Orifices QVt Designed Primary Area 600 ft2 Diameter in Designed ReserveArea 600 ft2 Spacing in Trench/Bed Width 3 ft Manifold-N/A Trench/Bed Length 50 ft Schedule/Class Elevation Measurements Length ft Original Drainfield Area Slope 1 -2 % Diameter in New Slope,If Altered N/A % referred manifold configuration used? 0 Yes ■ No Depth of Excavation Up-slope 14. ‘.),Iv` i pRov Transport Pipe from Original Grade mw„-slope M atedule/Crassir E ' '; 3034 Designed Vertical Separation 36 10 4 2025 ''I'''e 50 ft SON cou ;-.�x: Gravel-based Drainfield Required? 0 Yes ■No �i t 'ONMFNTA yF 4 in Pump Required? ❑Yes ■No MeW DoW 'and Pump Chamber N/A Pump/Siphon Specifications N/A Number of doses/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 ElHigher 0 Lower than Pump Shutoff Pump controls:Please check those required. Capacity @ Total Pressure Head gum 0 Timer 0 Elapse Meter 0 Event Counter Calculated Total Pressure Head ft If Timer: Pump on ,Pump off Comments t5 12(kit_ A ize tu l)u(� f!,y1 - ,i v, J Pc L Ar-e 491,A702-,,,k/ Revised:4/14/2025 DESIGN FORM -PAGE TWO Assessor's Parcel Number. 320z4 '' lc- 9 0171 Permit Number: SWG DESIGN CHECKLISTS Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch I Test hole locations ■ Drainfield orientation and layout y Reference depth from original grade: ■ Soil logs ■ Trench/bed dimensions and ■ Property lines critical distances within layout ■ Septic tank ■ Drainfield cover ■ Existing and proposed wells ■ D-Box/Valve box locations within 100 ft of property ■ Septic tank/pump chamber Reference depth from original grade an,f1 restrictive strata: ® Measurements to cuts,banks,and locations -N/A surface water and critical areas I Observation port location 1 Laterals,trench bed,top and bottom 0 Location and orientation of ■ Clean-out location -N/A® Curtain drain collector N/Acurtain cum drain and all absorption ®A Manifold placement -N/A® Sand augmentation p ®A Orifice placement Other cross-section detail: I Location and dimension of El Lateral placement with distance ■ Observation ports/clean-outs primary system and reserve area ■ Buildings to edge of bed Other Information II Direction of slope indicator -N/A Audible/visual alarm referenced Yes No ,Waterlines ■ Scale of drawing shown on scale El ■ Design staked out bar 0 I Recorded Notices attached h Roads,easements,driveways, ■ Elevation benchmark and relat - El I Waiver(s)attached parking el ati s s c r ® ■ Pump curve attached ■ North arrow and scale drawing '': El ■ Evaluation of failure shown on scale bar ' AUG 0 4 2025 ..s Non-residential justification ® ■ Waste strength MRgpa r�UNTY ENVIRONMENTAL HEALT 021 ■ Flow DESIGN Alr W/A, The undersigned designer must be notified by installer at time of installation I Yes El No am,&i . �y , 06/28/2025 Signature of Desi i 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-s' gulations: A' vv AR �J Envir m:' 1!� 1 alth Specialist Da CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CONDITION: 0 The design is stamped"Approved"by Mason County Public Health. 0 The Onsite Sewage Permit has not expired,the Permit Expiration Date is: ` 3 I- 2---5 0 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. Revised:4/14/2025 SYMBOLS LEGEND 165'+/- i - i �` O. CLEMoUT W 1 I I O 1 (52) 1200-GAL 9yTICTANK • aNitl: p f 0 FOUND PROP9iT1'C0RNER i11/1 ; I • 1 ' ' O i I TREE MONS O Ilir • 1 • • . 1 ®) I o i j SGl TEST PR LGCABON • 1 © WATER9UPLYNEl1 I O)1 O O 0 WATER IEIER I • 11,10 Allo i E ELECTRICAL TRANSFORMER I i / 0 , I 0 ELECTWCAL All cnoN BOXil 0 it • • 1 J -©- U UTYPOLE ' 111 O 0k iOki illik: (i) WM PORT LOCADON � • •.- 0 EpSTNG TIC(GENETiIq c I W WATER Ur i o / //`o • ` DRN DWS gNGWATETISUPPLYUlf • i • -R- POWERLNE I � c! ,i „:c., /41.rk (—X- FLELNE(EJOSRATi) I i 'C 1 I TREE OR RUSH LNE /• Q0� R. = / i •0 0 ' ,. / i l�, /er 0,. ... 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