HomeMy WebLinkAboutSWG2025-00287 - SWG Application / Design - 7/21/2025 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: SWG2025-00287
APPLICANT Zimny,Jim Phone: 360-516-7287
Address: 7178 windflower pl nw Seabeck, WA 98380
OWNER SATRAN ROBERT W& KIMBERLY S Phone: 360-731-6061
Address: 191 NE KIMBERLY DR BELFAIR, WA 98528
Site Address: NE Kimberly Dr
Primary Parcel Number: 123303290263
Permit Description: design new 3 bedroom septic system for a new 3 bedroom Moble
Home
Permit Submitted Date: 07/21/2025
Permit Issued Date: 08/19/2025
Issued By: Jeff Wilmoth
Current Permit Fees Paid: $555.00 (additional fees may be required upon installation of system).
Permit Expiration Date: 08/12/2028 (based on dale of nspecimn)
Permit Conditions:
1 Approval of this septic permit does not approve the building location. Building location is
subject to approval from all applicable departments and regulations.
2 Proposed development subject to zoning requirements and approval by the planning
department staff per Mason County Title 17.
3 Permit must be installed by a Mason County Certified Installer unless prior written
authorization from Mason County is obtained.
4 Drain field installation not to exceed designed upslope and downslope depth specified on
design form.
5 Installer is responsible for obtaining Mason County installation approval prior to backfill of
system components.
6 Installer is responsible for obtaining Septic Designer/Engineer installation approval prior to
backfill of system components.
7 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 MAYBE 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.govlhealth/environmentallonsiteloss-inspection-request.php or call:
360427-9670, extension 400.
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--- -- OFFICIAI.USE ONLY -- --
A . MASON COUNTY aE 07 as 9-5 w y
Public Health et Human Services M6j5 ��/'1�nV {\n o m
Environmental Health 360121-9670,eel.400 or 360275i367,ext.400 ✓/ �V y •
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415 N.6th Seem-Shelton WA985H SWG 20 /'N('�ry .f 7 O 2
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CLEAR FORM ON-SITE SEWAGE SYSTEM APPLICATION 3 A
APPLICANT PHONE IrTh 11^ rm
ROBERT SATRAN 360-731-6077 z
MAIL INC. CITY STATE LP CODE En
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191 NE KIMBERLY DR BELFAIR WA 985288218 0 CO
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-STE ADDRESS-STREET CITY ZIP CODE I--J N A
NE KIMBERLY DR BELFAIR WA 985288218 —' --
NAME or DEscNER PwrvE M7
Jim Zimny 360-516-7287 (o `___, m Q �
NAME car INSTALLER PHONE o W
PERMIT TYP IS E eKI Ore) DRINKING WATER SOURCE
Pr RESIDENTIAL OSS r1 COMMUNITY OSS n COMMERCIAL OSS r1 PRIVATE INDIVIDUAL WELL ❑ PRIVATE TWO-PARTY WELL Z h
TYPE OF VTORK1 e stone; 2 PUBLIC WATER SYSTEM '
WI NEWOONSTRUCTION I UPGRADES rI REPAIR/REPLACEMENT OTHER DETAILS(ma)Al Mal aomrl 0 TABLE X REPAIR `IQ
SUBMTTALS 0 SURFACING SEWAGE 0 EXISTING FAILURE 0 SHORELINE co
El DESIGN FORM(REQUIRED) El SEPTIC DESIGN(REQUIRED) REDROOMS I OT 92E WASR LOT CREATED AFTER UITd12S+ S w
El NAIVER(S)(IF APPLICABLE) 3 27,4425q ft OYES ONO C)
DIRECT-DNS TO SITE AND SITE CONDITIONS (e tried gate)
from Belfair take north shore rd 3.1 miles to Mission Creek rd. Follow Mission creek rd1.5 0
miles to NE Seitz Dr and take rt. follow for .3 miles to 91 NE Kimberley Dr. see Pink
Ribbons and follow to test holes. o >S
' test holes are deep unstable med loamy sand to 72H. Please use caution around test
SITE MUST BE FLAGGED PROM MIN ROAD AND TEST IIOES MAT BE RAGGED MITI 713ST HALE NVMWERS
- ----- - - ------- OFF ICI AI USE ONLY BEI OW THIS LINE -- •
UPGRADE I FAIT UHF SOURCE(Icy reporting WICcus)
❑VOLUNTARY O MAINTENANCE/PUMPING LI AMONG PERMIT DIgME SALE ['COMPLAINT 0 OTHER'.
INSPECTOR SOIL LOSS COMMENTS/CONDITIONS
(di Ot25
ND
SOIL FADES. REGPRD DRAW NG AND INSTALLATION REPORT
V=VERY G=GRAVELLY S=SAND L-LOAM Si=SILT C=CLAY F-ENTREMELY R=ROOTS REWIRED FOR FINAL APPROVAL
NSP OR SIGNATURE DALE APPLICATIONEX%IUI ION DATE A ON APPROVED:ISSUEDIBY�, DATE
T Fr �PAYBE BESCANNED AND AVAILABLE FOR PUBLIC VIEV/ON THE MASON COUNTY WERSITE Revised.6/3/2025
DESIGN FORM—PAGE ONE Assessor's Parcel Number: 1 2 3 3 0 3 2 9 0 2 6 3
A design w ill he rrviewed when 3 conies of each of the following arc submitted:
Completed design form that has been signed aid dated. " Scaled layout sketch including all applicable items on checklist.
v Scaled plot plan including all applicable items on checklist "'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..%laxanu,n paper sire 11' 117-
PARCEL�p IDENTIFICATION
Permit Number SWG a ,5' ' 00(917 Designers Fame Jim Zimny
Applicant's Name. ROBERT SATRAN Designer's Phone Number: 360-516-7287
Mailing Address. I91 NE KIMBERLY DR Designer's Address: 7178 Windtlower pl NW
BELFAIR WA 98528 City Slate Zip Seebeck WA 98380
CLEAR FORM
Citt State Zip Designer's Email apddesigns@lcloud corn
DIISIGN PARAMETERS '
Treatment Device
❑Glendon 0 Sand Filter 0 Mound 0 Sand Lined Iainfield 0 Recirculating Filter ❑AlG 0 Other
Treatment Level(check all thin applyl'. 0 A 0 13 ❑C. 0 131.1 0 B1.2 0131.3 Qf E 0 N
Drainfield Type
M'Gravity 0 Pressure WTrench 0 Bed 0 Sub Surface Drip
Septic Tank/Drainfield Specifications Laterals
Number of Bedrooms 3 Schedule/Class 3034
Dail Flotc•Operating Capacity 270 gpd Length 75 ft
Dail Flott Design Hon 360 gpd Diameter 4 in
Septic Tank Capacity (working) 1250 gal Number 2
Receiving Soil Type(1-61 3 Separation 5 etc ft
Receiving Soil Appl. Rate 0.8 gpd/ft- Orifices
Required Primary Area 450 ft' Total Number o r cgs NA
(,. z
Designed Primary Area 450 ft- Diameter �c° i in
Designed Reserve Area 450 ft'- Spacing *I. • `�x in
Trench/Bed Width 3 ft 1,ern.� n;rr:'I >:sR ' NA_ - Manifold
.
Trench/Red Length 150 R Sated
Elevation Measurements Length 7 20-7)- ft
Original Drainfield Area Slope 1 ,o Diameter in
New Slope_If Altered 1 i0 Preferred manifold configuration used'. O Yes 0 No
Depth of Excavation ct*aopc 24 in Transport Pipe
from Original Grade Domi_sIope 24 in Schedule/Class 3034
Designed Vertical Separation 36 in Length 20 ft
Gravel-based Drainfield Required? G1 Yes 0 No Diameter 4 in
Pump Required? ❑ Yes 0 No Dosing and Pump Chamber
Pump/Siphon Specifications Number of doses/day NA
Diff. in Elevation Between Pump& Uppermost Orifice It Dose quantity gal
Drainfield Squirt Height/Selected Residual (head) -__ft Chamber Capacity (flood) gal
Uppermost Orifice O Higher 0 Lower than Pump Shutoff Pump controls: Please check those required.
Capacity to.Total Pressure Head gpin 0 Timer 0 Elapse Meter 0 Event Counter
If
Calculated Total Pressure Head ft If imcpP Pump off
Comments r/
evc6 & {
AUG I 20025 4 f.;
tm4t
JRW Revised:6/11/2025
DESIGN FORM- PAGE TWO Assessors Parcel Number. 1 2 3 3 U 3 2 9 0 2 6 3
Permit Number SWG
DESIGN CHECKLISTS
Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch
er Test hole locations le Drainfield orientation and layout Reference depth from original grade.
et Soil logs Fr Trench/bed dimensions and Fr Septic tank
Property lines critical distances within layout fir Drainfield cover
er Existing and proposed oclls D-Ros/Valve boy locations Reference depth from original grade
within 100 ft of property et Septic tank/pump chamber and restrictive strata:
V Measurements to cuts. banks. and locations
Fr Laterals.[rcnchlbed, top and
surface water and critical areas Fi Obsen ation port location bottom
ef Location and orientation of Fr Clean-out location 0 Curtain drain collector
curtain drain and all absorption er Manifold placement 0 Sand augmentation
components 0 Orifice placement Other cross-section detail.
es Location and dimension of er Observation ports/clean-outs
pnman system and reserve area li Lateral placement with distance P
to edge of bed Other Information
lie Buildings ❑ Audible/visual alarm referenced Yes No
er Direction of slope indicator le Scale of drawing shown on scale 0 0 Design staked nut
✓ Waterlines bar 0 0 Recorded Notices attached
Fr Roads, easements-driveways. ✓ Elevation benchmar and relative 0 0 Waiver(s) attached
parking ;LIP;
pp�p Itions of syst, mponents 0 ❑ Pump curve attacheder PRt ❑ ❑ Evaluation of failure
North arror d I r r m� : k
show non s bar I'
^3r, :Von-residential justification
AUG ��2� ;: w a i ❑ ❑ Waste strength
y, - N: 0 0 Flow.
.I f`rvll:`l1 Ff Ir r J-ni l 1k
➢BW DE s 1 Y
The undersigned designer must be notified by in • Ilcr at dine of Stallation LJ./
Yes 0 No
I
/
Signature of 'sign Date
The undersigned has reviewed this design on behalf of Mason Counts Public Health and determined it to be in
compliance with state and local on-' . regulations.
15�2�
Endo c al Health Specialist ate
CAUTION: DESIGN APP 'AL IS VALID ONLY TINDER THE FOLLOWING CONDITION:
✓ The design is stamped Approved- by Mason Count) Public Health. 1� ��
✓ The Onsite Sewage Permit has not expired. the Permit Expiration Date is: yD
✓ 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 I Iealth.
An Installation Fee is required.
This form may be scanned and available for public view on the Mason County Web site. Revised: Fri 1/2025
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Advantage Perc & Design
Construction Notes for Gravity 3 Bedroom System:
Equal Distribution w/ 1 ''/: minus washed rock and 3034 pert pipe
Install 2—75' Laterals w/4 hole d-box.
Install on 5'foot centers.
Install 24-" deep on low side of trench maintain 36"of vertical separation
Install level and along contours.
Install in dry weather only.
Use 1250-Gallon septic
System designed for typical residential waste strength sewage only.
System designed for 360 Gallons Per Day
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