HomeMy WebLinkAboutSWG2025-00361 - SWG Application / Design - 9/9/2025I
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,EXT400
FAX:360-427-7787
On-Site Sewage System Permit: SWG2025-00361
APPLICANT TANG COREY L Phone:
Address: 14520 97TH AVE NE BOTHELL, WA 98011
SEPTIC DESIGNER Cooper, Justin Phone: 2533760479
Address: 12201 Osprey Drive Northwest Gig Harbor, WA 98332
Site Address: 60 N Sundown Dr
Primary Parcel Number: 423185000017
Permit Description: 2BR SFR -NuwaterBNR600 + Drip
Permit Submitted Date: 09/09/2025
Permit Issued Date: 09/23/2025
Issued By: Jeff Wilmoth
Current Permit Fees Paid: $825.00 (additional fees may be required upon installation of system).
Permit Expiration Date: 09/14/2028 (based on date of inspection)
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 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.
I
OFFICIAL USE ONLY
Ms,. MASON COUNTY DATE RECENED: Oq , o - a5 C
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AMOUNT RECEIVED: (RECE [DBY. l'� �, W Cl)
� Public Health & Human Services i j �}�Q, v m
Environmental Health 360-427-9670,ext.400 or 360-275-4467,ext.400 C 0
415 N.6th Street-Shelton,WA 98584 SWG n,/l/ 00 2(„' rn o
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CLEAR FORM ON-SITE SEWAGE SYSTEM APP TION z
74
APPLICANT PHONE 1 •
/ �Nz
/l/-/T m I-
COREY REYNOLDS •llf 7�!//l(J
Yi ti
MAILING ADDRESS-STREET,CITY,STATE,ZIP CODE /t.l Jr v,`P 1 O g
14520 97TH AVE NE BOTHEL, WA 98011 2025 N:i/ m
SITE ADDRESS-STREET,CITY,ZIP CODE 8!
60 N SUNDOWN DR HOODSPORT, WA 98548
NAME OF DESIGNER PHONE 1�� I�
JUSTIN W COOPER / ONESCOOP INC 253-376-0479
NAME OF INSTALLER PHONE v I w
AAA SEPTIC / WES GRAVES 360-490-9428
PERMIT TYPE(select one) DRINKING WATER SOURCE - I.--.
R-RESIDENTIAL OSS COMMUNITY OSS COMMERCIAL OSS ff.PRIVATE INDIVIDUAL WELL 6 PRIVATE TWO-PARTY WELL Z P.‘
TYPE OF WORK(select one) 17 PUBLIC WATER SYSTEM
_ff NEW CONSTRUCTION/UPGRADES R-REPAIR/REPLACEMENT OTHER DETAILS(select all that apply) ❑ TABLE X REPAIR
SUBMITTALS 0 SURFACING SEWAGE Et EXISTING FAILURE ❑SHORELINE n
El DESIGN FORM(REQUIRED) El SEPTIC DESIGN(REQUIRED) BEDROOMS LOT SIZE WAS LOT CREATED AFTER 4/1/2025? 0 lei
o WAIVER(S)(IFAPPLICABLE) 2 .34 n YES ENO I
x IQ
DIRECTIONS TO SITE AND SITE CONDITIONS:(ex.locked gale)
HEADING NORTH ON LAKE CUSHMAN RD, FOLLOW N LAKE CUSHMAN RD AT THE IO
TEE( DO NOT TURN RIGHT ONTO NFD-24) TURN LEFT ON N MOUNT CHURCH DR,
TURN LEFT ON N POTLATCH DR, TURN RIGHT ON SUNDOWN DR. HOUSE WILL BE o 0
ON YOUR RIGHT. ONLY 1 SOIL LOG WAS DUG AND FLAGGED DUE TO VERY r
LIMITED SPACE AND THE WATER LINE THAT WAS NOT PRECISELY LOCATED �fJ
SITE MUST BE FLAGGED FROM MAIN ROAD AND TEST HOLES MUST BE FLAGGED WITH TEST HOLE NUMBERS. I
OFFICIAL USE ONLY BELOW THIS LINE -- -
UPGRADE/FAILURE SOURCE(for reporting purposes)
❑VOLUNTARY ❑MAINTENANCE/PUMPING ❑BUILDING PERMIT ['HOME SALE ['COMPLAINT ❑OTHER:
INSPECTOR SOIL LOGS COMMENTS/CONDITIONS
9,1))1/ 1
1-6 17*C1f)(5)±- 44'C(e /.1.41, FY
-70
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.
PECTOR SIGNATURE DATE APPLICATION EXPIRATION DATE A ICATION APPROVED/ISSUED BY DATE
III � - 1(.( - Q11 A)f.A r��
T IS M MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE
9 Revised:6/3/2025
A
•
DESIGN FORM—PAGE ONE Assessor's Parcel Number: 4 2 3 1 8 5 0 0 0 0 1 7
A design will be reviewed when 3 copies 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.
''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.Maximum paper size: 11"X 17"
PARCEL IDENTIFICATION
Permit Number: SWG 27 ac .6-,,0t Designer's Name: JUSTIN W COOPER
Applicant's Name: COREY REYNOLDS Designer's Phone Number: 253-376-0479
Mailing Address:
60 N SUNDOWN DR Designer's Address: 12201 OSPREY DR NW
HOODSPORT WA 98548 City State Zip GIG HARBOR WA 98332
CLEAR FORM
City State Zip Designer's Email COOPJUSTINCGMAIL.COM
DESIGN PARAMETERS
Treatment Device
❑Glendon 0 Sand Filter 0 Mound 0 Sand Lined Drainfield ❑ Recirculating Filter Q ATU NuWATE ❑Other
Treatment Level(check all that apply): ❑ A eB ❑C ❑BL l ❑BL2 ❑BL3 ❑ E ❑N
Drainfield Type
❑Gravity 0 Pressure 0 Trench 0 Bed 'Sub Surface Drip
Septic Tank/Drainfield Specifications Laterals
Number of Bedrooms 2 Schedule/Class 1/2"flex pvc tubing
Daily Flow:Operating Capacity 240 gpd Length 300 ft
Daily Flow: Design Flow 240 gpd Diameter 1/2 in
Septic Tank Capacity(working) 1060 gal Number
Receiving Soil Type(1-6) 4 Separation 2 ft .
Receiving Soil Appl. Rate .6 gpd/ft2 Orifices
Required Primary Area 600 ft2 Total NiOe 300
Designed Primary Area 600 ft2 i e 1/2 in
2025 ��..
Designed Reserve Area N/A ft2paci ) `j MEN�P�\OV 12 in
Trench/Bed Width N/A ft �N��RON Manifold
Trench/Bed Length - ( ` N/A ft Ac ute/C136VI
Elevation Measurements Length ft
Original Drainfield Area Slope 11 % Diameter in
New Slope,If Altered % Preferred manifold configuration used? 0 Yes 0 No
Depth of Excavation Up-slope 6 in Transport Pipe
from Original Grade Down slope 6 in Schedule/Class 1" SCH40 PVC
Designed Vertical Separation 12 in Length 97 ft
Gravel-based Drainfield Required? 0 Yes PJ No Diameter 1 in
Pump Required? P'Yes 0 No Dosing and Pump Chamber
Pump/Siphon Specifications Number of doses/day 12
Diff. in Elevation Between Pump&Uppermost Orifice 20.3 ft Dose quantity 21 gal
Drainfield Squirt Height/Selected Residual(head) ft Chamber Capacity(flood) 180 gal
Uppermost Orifice 0 Higher 0 Lower tha P mp Shutoff Pump controls:Please check those required.
Capacity @ Total Pressure Head gpm 0 Timer 0 Elapse Meter 0 Event Counter
Calculated Total Pressure Head 128.1 ft If Timer: Pump on ,Pump off
Comments $ Se f k. 'r M " /1/‘vtv4- 1W f.t� Se�b�ik -d
6o1v" .4 -F 6 ovivdlOtf j d, A
Revised: 6/11/2025
. DESIGN FORM—PAGE TWO Assessor's Parcel Number 4 12 13 11 18 15 10 10 10 10 1 1 17
Permit Number: SWG 25-1527
DESIGN CHECKLISTS
Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch
1r Test hole locations Er Drainfield orientation and layout Reference depth from original grade:
1e Soil logs Er Trench/bed dimensions and Fr Septic tank
V Property lines critical distances within layout l Drainfield cover
❑ Existing and proposed wells 0 D-BoxNalve box locations Reference depth from original grade
within 100 ft of property V Septic tank/pump chamber and restrictive strata:
❑ Measurements to cuts, banks, and locations Ilir Laterals, trench bed, top and
surface water and critical areas Er Observation port location bottom
❑ Location and orientation of 0' Clean-out location 0 Curtain drain collector
curtain drain and all absorption 0 Manifold placement 0 Sand augmentation
components
E' Orifice placement Other cross-section detail:
er Location and dimension of 0 Lateral placement with distance V Observation ports/clean-outs
primary system and reserve area to edge of bed
iie Buildings g Other Information
le Audible/visual alarm referenced Yes No
e r Direction of slope indicator Pr Scale of drawing shown on scale 0 PVDesign staked out
le Waterlines bar 0 VRecorded Notices attached
Er Roads, easements,driveways, Elevatio b c a riot' 0 VWaiver(s)attached
parking eA
oyr o p ,a p
0 VPum curve attached
1r North arrow and scale drawing lir0 Evaluation of failure
shown on scale bar SEP 2 5 2025 Non-residential justification
MASON COUNTY ENVIRONMENTAL HEAL ❑ ❑ Waste strength
❑ ❑ Flow
JBW
DESIGN APPROVAL
The undersigned designer must be notified by installer at time of installation VYes 0 No
9-9-25
Sig,ature o Iles., er 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 o
itite regulations:lt
t 'l".23--25'
E ental Health Specialist Date
CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CONDITION:
✓ The design is stamped"Approved"by Mason County Public Health.✓ The Onsite Sewage Permit has not expired,the Permit Expiration Date is: -/p,"1 Y-.2-8
✓ 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: 6/11/2025
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