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Home My WebLink AboutSWG2025-00353 TANK ONLY - SWG Application / Design - 9/8/2025 MASON COUNTY 415 N 6TH STREET,SHELTON, 98584 SHELTON:360 427-9679670,EXT 400 L 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: SWG2025-00353 COOI•,cY OWNER MOTT JOSEPH PAUL Phone: 360-957-7446 Address: 250 E OSPREY LN SHELTON, WA 98584 APPLICANT MOTT JOSEPH PAUL Phone: 360-957-7446 Address: 250 E OSPREY LN SHELTON, WA 98584 SEWAGE DESIGNER BOB PAYSSE* Phone: 360-507-1498 Address: 3083 E Mason Benson Road GRAPEVIEW, WA 98546 Site Address: 250 E OSPREY LN Primary Parcel Number: 221335000019 Permit Description: Relocate tanks Permit Submitted Date: 09/08/2025 Permit Issued Date: 09/16/2025 Issued By: Rhonda Thompson Current Permit Fees Paid: $270.00 (additional fees may be required upon installation of system). Permit Expiration Date: 09/16/2028 (based on date of inspection) Type of Work Other Components being Replaced: Septic and Pump Tanks Surfacing Sewage? No Existing Failure? No Shoreline? No Horizontal Setbacks Met? Yes Number of Bedrooms: 4 Drinking Water Source: Private Well/Spring Additional Details: Concrete tanks Permit Conditions: 4 Mason County Asbuilt Form, Record Drawing, and Installation fee must be submitted for final installation approval. 5 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. 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 Horizontal setbacks per WAC246-272A-0210 must be maintained, unless prior approval is obtained 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. Mi. OFFICIAL USE ONLY MASON COUNTY DATE RECEIVED � � u) D COMMUNITY SERVICES AMOUNTRECEIVE �, RECEIVED CO L/l^v v_ m co Public Health;Community Health/Environmental Health) C w 360-427.9670.ext.400 or 360-275-4467,<xc.400 A /'' ^r ^ 415 N.6th Street Shelton.WA 98584 S'J J .� /'ti� O O L Y�/� Z di ON-SITE SEWAGE TANK ONLY APPLICATION D -4 m n APPLICANT PHONE m I— JOSEPH MOTT z MAILING ADDRESS-STREET CITY.STATE,ZIP CODE g 250 E OSPREY LANE - SHELTON WA 98584 m SITE ADDRESS-STREET CITY,ZIP CODE Fi 250 E OSPREY LANE -SHELTON WA 98584 I N NAME OF DESIGNER PHONE I N ROBERT H. PAYSSE 360-426-1803 NAME OF INSTALLER PHONE I v TBD Z Ca TYPE OF WORK(select one) DRINKING WATER SOURCE O ❑ NEW CONSTRUCTION/UPGRADES III REPAIR/REPLACEMENT ❑� PRIVATE INDIVIDUAL WELL ❑ PRIVATE TWO-PARTY WELL Z I GJ COMPONENT(S)TO BE REPLACED/INSTALLED 0 PUBLIC WATER SYSTEM I O SEPTIC TANK III PUMP TANK 0 RV HOLDING TANK BEDROOMS LOT SIZE 101 CI OTHER 1 2""- W OTHER DETAILS(select all that apply) TANK(S)SETBACK CHECKLIST 0 I 0 ❑ SURFACING SEWAGE 0 EXISTING FAILURE ❑ SHORELINE 0 100FT+PUBLIC/COMMUNITY WELLS T�C7 I I 0 SUBMITTALS I SOFT+PRIVATE WELLS,SURFACE WATERS.STREAMS,RIVERS O PLOT PLAN(REQUIRED) 0 TANK CROSS SECTION(REQUIRED) 0 10FT+DRINKING WATER SUPPLY LINES I O ❑ PUMP DETAILS(IF APPLICABLE) 0 WAIVER(S)(IF APPLICABLE) 0 5FT+PROPERTY/EASEMENT LINES,FOUNDATIONS,FOOTINGS PLOT PLAN CHECKLIST 15 I Cl 0 PROPERTY LINES AND EASEMENTS IN EXISTING/PROPOSED STRUCTURES III EXISTING/PROPOSED OSS COMPONENTS AND LINES —/ 0 WELLS WITHIN 100FT I3 WATER SUPPLY LINES ® DRIVEWAYS/PARKING III SURFACE WATERS,STREAMS,RIVERS,ETC... I IL DIRECTION OF SLOPE/CONTOURS IIIIL PERIMETER/CURTAIN DRAINS ID NORTH ARROW II SCALE BAR DIRECTIONS TO SITE AND SITE CONDITIONS'(ex locked gate) N. HWY 3. RIGHT ON PICKERING RD. LEFT ON STRONG RD. RIGHT ON OSPREY o� LANE. -4.5. Lc) g rn t` Oiiii ' /:=3 OFFICIAL USE ONLY BELOW THIS LINE— t N 4 UPGRADE/FAILURE SOURCE(for reporting purposes) ( LIP* ❑VOLUNTARY ❑MAINTENANCE/PUMPING ❑BUILDING PERMIT ['HOME SALE ['COMPLAINT ❑OTHER: 1 CC--"1 COMMENTS/CONDITIONS ociA4e- - etiA\(---5 SEWAGE TANKS MUST BE LISTED UNDER DOH'LIST OF REGISTERED SEWAGE TANKS'. TANKS MUST MEET CURRENT MINIMUM SIZE REQUIREMENTS,EQUIPPED WTH 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 , SU0 ( z6g1U7-1 - THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE REVISED 12l7/2015 • DESIGN FORM—PAGE ONE Assessor's Parcel Number: 2 2 1 3 3 — 5 0 — 0 0 0 1 9 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. ''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: SWG8 • (303 Designer's Name: ROBERT H.PAYSSE Applicant's Name: JOSEPH MOTT Designer's Phone Number: 360-426-1803 Mailing Address: 250 E OSPREY LANE Designer's Address: 3083 E MASON BENSON RD SHELTON WA 98584 City State Zip GRAPEVIEW WA 98546 City State Zip Designer's Email pioneerdigging@yahoo.com DESIGN PARAMETERS Treatment Device ❑Glendon 0 Sand Filter 0 Mound ❑Sand Lined Drainfield ❑Recirculating Filter 0 ATU LI Other Treatment Level(check all that apply): ❑A ❑ B ❑C 0 BL1 0 BL2 ❑BL3 Cl E ❑N Drainfield Type ❑Gravity NIPressure l 'Trench 0 Bed 0 Sub Surface Drip Septic Tank/Drainfield Specifications A�j ,J'\( �D Number of Bedrooms 4 Schedule/Class K Daily Flow:Operating Capacity - gpd Length SFP 16 2025 ft Daily Flow: Design Flow - gpd Diameter MASON COUNTY EWV1RONMENTAI HEALTH! Septic Tank Capacity(working) 1500 gal Number RET Receiving Soil Type(1-6) - Separation - ft Receiving Soil Appl. Rate - gpd/ft2 Orifices Required Primary Area - ft2 Total Number of Orifices - Designed Primary Area - ft2 Diameter - in Designed Reserve Area - ft2 Spacing - in Trench/Bed Width - ft Manifold Trench/Bed Length - ft Schedule/Class - Elevation Measurements Length - ft Original Drainfield Area Slope - % Diameter - in New Slope,If Altered - % Preferred manifold configuration used? 0 Yes 0 No Depth of Excavation Up-slope - in Transport Pipe from Original Grade Down-slope - in Schedule/Class SCH.40 Designed Vertical Separation - in Length - ft Gravel-based Drainfield Required? 0 Yes 0 No Diameter 2 in Pump Required? 0 Yes 0 No Dosing and Pump Chamber Pump/Siphon Specifications 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) 1500 gal Uppermost Orifice 0 Higher 0 Lower than Pump Shutoff Pump controls:Please check those required. Capacity @ Total Pressure Head - gpm 0 Timer 0 Elapse Meter 0 Event Counter Calculated Total Pressure Head - ft If Timer: Pump on - ,Pump off - Comments RELOCATING EXISTING TANKS AWAY FROM HOME. UTILIZE SAME COMPONENTS & TIMER SETTINGS AS ORIGINAL DESIGN. Revised:4/14/2025 DESIGN FORM—PAGE TWO Assessor's Parcel Number:2 2 1 3 3 — 5 0 -- 0 0 0 1 9 Permit Number: SWG DESIGN CHECKLISTS Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch lid Test hole locations 0 Drainfield orientation and layout Reference depth from original grade: 1 Soil logs 0 Trench/bed dimensions and g Septic tank Property lines critical distances within layout 0 Drainfield cover 10 Existing and proposed wells 0 D-Box/Valve box locations Reference depth from original grade within 100 ft of property 0 Septic tank/pump chamber and restrictive strata: Rf Measurements to cuts,banks, and locations 0 Laterals,trench/bed,top and surface water and critical areas 0 Observation port location bottom • Location and orientation of 0 Clean-out location 0 Curtain drain collector curtain drain and all absorption ❑ Manifold placement 0 Sand augmentation components 0 Orifice placement Other cross-section detail: 10 Location and dimension of 0 Lateral placement with distance l ' Observation ports/clean-outs primary system and reserve area to edge of bed g Other Information Buildings 0 Audible/visual alarm referenced Yes No Direction of slope indicator 0 Scale of drawing shown on scale 0 g Design staked out 10 Waterlines bar 0 g Recorded Notices attached 10 Roads,easements,driveways, p Elevation benchmark and relative 0 LI Waiver(s)attached parking elevations of system components 0 11 Pump curve attached Iil North arrow and scale drawing 0 g Evaluation of failure shown on scale bar Non-residential justification ❑ Ii6 Waste strength ❑ t'Flow DESIGN APPROVAL The undersigned designer must be notified by i taller at ' e of installation g Yes 0 No Q ,,,,t_ 9 i 7,$-- Signature of Designer Uate 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-site regul ions: v � I2 I`� C D� Environmental Health Speci list Date CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CONDITION: V 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. 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 DISCONNECT EXISTING TANKS AND RELOCATE SOUTH OF HOME. EXTEND 4"3034 SEWER LINE &2"SCH. 40 TRANSPORT LINE DOWN BACK OF HOME & RECONNECT. INSTALL CLEANOUT BETWEEN TANK& HOME. N `\ KEEP TANKS & LINES 50'+ FROM PRIVATE WELL& `\ 100'+ FROM COMMUNITY WELL. \ - - - - - /I/ // / , / 1 I/ I/ �_ EXISTING /' < I I r ,!I \ DRAINFIELD �,'�7�\ \\ --__�� ,� i� .--- \ // cz3 , 7 7 1 / \ /// , / �� COMMUNITY WELL �' EXISTING / ' �� R100, ' TANKS r I-- ..- a �' C; _ ,..- , ,..........._ .. ,.. - , , , . \ \\ \ /\ , WELL -\ \ Rss,I \ \ I \ I 1 I \ `. 1 I / ----...7\7. _,,X_ ---. NEW HOME WI I PROPOSED j I I TANKS I 014rPt. j Alsr k,c, r A 91.vl- SEP 1 6 2025 STS0717 ',;i J�,0.}'I^ACBERTM>��SEF r/ ` *a we MASON COUNTY ENVIRONMENTAL HEALTH we- RET EXPIRES AN ASBUILT/INSTALL SIGNOFF FEE WILL BE CHARGED AT TIME OF INSTALLATION CUSTOMER: JOSEPH MOTT TEST HOLE I: PIONEER DIGGING, INC. PARCEL#:22133 So-00019 `\ SEPTIC DESIGNS ADDRESS: 250 E OSPREY LANE I \NI:ONL 3083 E MASON BENSON RD. CRAPEVIEW,WA 98546 DESIGNER: ROBERT H.PAYSSE PAT DISCLAIMER SURVEYS HELD MEASUUT A REMENTSANDCOUNTY GIBS.DESIGNINTE/NNDDED FONTY R SEPTIC OFFICE-360-426-1803 FAX-36l1.427-2353 /'N P AGE P}LAINL SCALE I.SO PURPOSES ONLY PROPOSED DEVELOPMENT MAY BE SUBJECT TO OTHER DESIGDEPARTMENT/AGENCY REVIEW DESIGNER NOT RESPONSIBLE FOR SETBACKS UNRELATED TO SEPTIC COMPONENTS 24"RIBBED RISERS W/BOLT ON WATER-TIGHT LIDS CLEANOUT USE RISER LID ADAPTERS WITH NO GASKET UPS . o e FINISHED GRADE _ Ca = WATER-TIGHT ---=-_ � 4 -1 - )OlNTS Ea 'TJ•Y .. .:31 OM INLET TU- c ' j- _ I OUTLET TWO WAY TEE i ?` h SEP 16 2025 r •t WATER-TIGHT JOINTS ,.. — MASON COUNTY ENVIRONMENTAL H A~ f RET :1 — sel 1500 GALLONWATER77GHT `.'• CONCR//1 SEPTIC TANK r r` �"O51 TANKS MUST BE e: ;: P R E �EFjFLUENT ON STATE DOH LTER Of\ APPROVED LIST �'� JAN 10 22 •e• OF SEWAGE 44- • .:\ TANKS � .' \ `• — re• u.\ .f •. PUMP TANKS 09pF1 Y AQUAWORKS CONTROL PANEL °',-•c�:.C.:"',.,.I. ssE �\ OVER 1000 GAL. WiTI.MER•EVENT COUNTER E7PRES ••i ..•• REQUIRES TWO ez HOUR METER ..ice EIE�:..,..»_tivORK xw: 24"RIBBED RISERS ACCESS RISERS c i- E`:<EC E:E`-7,.:c,,,,: W/WATER TIGHT LIDS TO GRADE --_ FINISHED GRADE = —_ --- -- - TRANSPORT LINE INLET I UNION & BALL VALVE 100 GALLON WA7ER77GHT OM 5 1 • CONCR.I PUMP TANK E 4 (28.5 GAL /IN.) I ANTI-SIPHON WATER-TIGHT IF D F DOWN JOINTS SLOPE :• PRESSURE TRANSDUCER I CHECK VALVE USE TANKS FITTED — W/CAST IN WATER • •• TIGHT FITTINGS FOR USE RUBBER I NLET/OUTLES AND • PUMP BUCKET: • • GROMETS FOR CAST IN RISER BUCKET HEIGHT MUST BE TRANSPORT LINE ADAPTERS TO AT LEAST HEIGHT OF PUMP AND ELECTRICAL ENSURE WATER ON RISERS. MAKE TIGHTNESS • • • .d • • ' - • •` •• '•.' . . • • • <I SURE ALL HOLES ARE WATER-TIGHT IN CUSTOMER: JERAD MAKAY SCALE.NA PIONEER DIGGING? 11V� f'ARCF1.-2213350-00019 INSTALL TANKS ON ORIGINAL OR SEPTIC DESIGNS ADDRESS: 250 E OSPRAY LANE COLS. RUN CROSS N CONNECTIONS INTO OMPACTED LEVEL RIGINAL SOILS TO 3083 6,WAS.��;BEN6DN RD: 'CIWEVIEW,WA 9d� DESIGNER: ROBERT H.PAYSSE AVOID St I I LING. OFFICE 3404201803: -rAx.360.4r 35 DESIGN PAGE TANKS DETAIL I 1t 44 TkVili K.M._ JiT i�uui,Ey L)iV1 jnstallation & System Notes 1. Installer must contact designer for final inspection of the installation prior to cover. All components, including tanks, lids, transport line, drainfield,and water lines must be open for inspection. A$350.00 fee will be charged for time involved with the inspection of the installation and creation of the record drawing. The designer reserves the right to charge additional fees if multiple visits are needed due to installation errors or inaccessible components. 2. This septic design must be installed by a certified installer with the local health department. All components shall be installed according to state, county, and manufacturer requirements. For Homeowner Installs,the owner must get approval from the designer and local health department prior to attempting installation. 'I 3. Designer is not a surveyor. Installer must familiarize themselves with property line locations prior to installation. Any confusion or conflicts with line locations should be reported to the property owner. A licensed surveyor may be necessary prior to installation to confirm all line locations. Any discrepancies found must be reported to the designer immediately. 4. Drainfield area may only be cleared by a licensed installer familiar with sensitive drainfield area preservation. The builder, lot developer, or property owner shall not clear the drainfield area. Any clearing required for drainfield installation shall not remove or disturb any top soil in Primary and Reserve areas. Removal or disturbance to drainfield soils could render design void. 5. The property owner and installer are responsible for locating all underground utilities (ex. water,gas, electric) prior to installation. Any utility locations shown within design drawings are likely approximate and may not be exact. 6. All proposed tanks must be installed on original soils or compacted gravels. Extend all tank connection lines out onto original soil to avoid settling issues. Risers and lids must be brought to finished grade and left accessible for future operations and maintenance. Component manufacturers (ex. ATU,Glendons,) may have other requirements not listed within this design. 7. All electrical wiring shall be done by a licensed electrician or homeowner(if allowed) and must be permitted through Labor and Industries. Designer not responsible for electrical permitting or other electrical specific code requirements. 8. The proposed septic system should be installed in dry weather conditions. Any failed attempts at installation during wet weather conditions may render this design void. 9. Maintain 10ft to waterlines with all septic components. If less than 10ft is required,sleeving in sch. 40 pvc is required. If sewage transport lines and waterlines must cross,waterline must be 18" above sewage line with one of the lines sleeved in sch. 40 pvc 10ft in each direction of crossing. 10. This design may include waiver applications with specific mitigation measures pertaining to installation,operation and maintenance of the proposed components. 11. Stormwater runoff,footing drains, roof drains must be diverted away from any septic system components. No curtain, foundation, perimeter drains shall be installed 30ft downslope and loft upslope of drainfield areas. 12. This design is site specific and intended to meet state and county requirements that are related to the system components being proposed. Any placement of proposed buildings, proposed wells or other non-related items on these drawings may or may not meet other requirements. 13. All onsite septic systems require regular maintenance to verify satisfactory operation. The system owner/operator is responsible for the continuous operation and maintenance of the system per WAC 246-272A. For op ration and maintenance information, refer to Mason County Public Health Homeowner's Manual,which should be received L�I�lgTi1� p 14. System owner should be cautious of landscaping around septic components. Root intrusion '' \\ VV D can cause premature failure of the drainfield area. In addition, bushes and trees should be kep SEP 16 2p25 away from lids and other septic maintenance points. MASON COUNTY ENVIRON.MEh'TAL HEAQH 15. Changes made at time of installation may impact designer calculations, pump sizing, and RET compliance w/county and state requirements. Contact designer prior to install w/any 4' proposed variations from design. Changes may result in additional fees and permitting. PIONEER DIGGING, INC. CUSTOMER: JOSEPH MOTT PARCEL#:22133-50-00019 • SIC03V 1- Y ROBERT .1r5SE "7"O' SEPTIC DESIGNS ADDRFSS: 250E OSPREY LN i,; . sr. rt 3083 E MASON BENSON RD. GRAPEVIEW,WA 98546 DESIGNER: ROBERT FL PAYSSE EXPIRES OFFICE-360-4261803 FAX 360-427-2353 SHEFT: NOTES SCALE NA