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HomeMy WebLinkAboutSWG2025-00337 - SWG Application / Design - 8/26/2025 MASON COUNTY 415 N 6TH STREET,SHELTON,WA 98584 SHELTON:360-427-9670,EXT 400 (4: BELFAIR:360-275-4467,EXT 400 Public Health & Human Services ELMA:360-482-5269,EXT400 FAX:360-427-7787 On-Site Sewage System Permit: SWG2025-00337 APPLICANT HOOTON, MICHELLE Phone: 360-401-5091 Address: 2171 E TIMBERLAKE WEST DR SHELTON, WA 98584 OWNER LEWIS BOBBYE Phone: Address: 1041 E TIMBERLAKE EAST DR SHELTON, WA 98584 SEPTIC DESIGNER Hunter, Adam Phone: 360 753-1226 Address: 2201 93rd Ave SW Olympia, WA 98512 SEPTIC INSTALLER HOUSE BROTHERS Phone: 360-495-4156 Address: PO BOX 1820 MCLEARY, WA 98557 Site Address: 2171 E TIMBERLAKE WEST DR Primary Parcel Number: 220185300037 Permit Description: Repair 2bd ATU to subsurface drip Permit Submitted Date: 08/26/2025 Permit Issued Date: 09/18/2025 Issued By: Rhonda Thompson Current Permit Fees Paid: $825.00 (additional fees may be required upon installation of system). Permit Expiration Date: 09/17/2026 (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/onsite/oss-inspection-request.php or call: 360-427-9670, extension 400. QL&)LI NE OFFICIAL USE ONLY MASON COUNTY DATE RECEIVED: og a �.` r 95 D C Cl) AMOUNT RECEIVED RECEIVED BY: —`f- Public Health & Human Services ,138-�rj v_ R Environmental Health 360-427-9670,ext.400 or 360-275-4467,ext.400 r C 0 415 N.6th Street -Shelton,WA 98584 S W G .0D.5 - oc 337 a 71 z ui CLEAR FORM ON-SITE SEWAGE SYSTEM APPLICATION z 11 m n APPLICANT PHONE ITI I- MICHELLE HOOTON 3604015091 z c MAILING ADDRESS-STREET,CITY.STATE,ZIP CODE C 2171 E TIMBERLAKE WEST DR isr, ELTON WA 98584 m SITE ADDRESS-STREET,CITY.ZIP CODE tr tO xi 2171 E TIMBERLAKE WEST DR �2ji HELTON WA 98584 I N NAME OF DESIGNER l\')1 PHONE 0 ADAM HUNTER3607531226 NAME OF INSTALLER / PHONE HOUSE BROTHERS o I D PERMIT TYPE(select one) `� •a I . WING WATER SOURCE A I O Lf RESIDENTIAL OSS Ll COMM UNITY OSS ILJ COMMERCIAL OSS LJ PRIVATE INDIVIDUAL WELL 6"PRIVATE TWO-PARTY WELL Z a PUBLIC WATER SYSTEM LAKE LIMERICK TYPE OF WORK(select one) I 6 NEW CONSTRUCTION/UPGRADES 6-REPAIR/REPLACEMENT OTHER DETAILS(select all that apply) 0 TABLE X REPAIR I SUBMITTALS ElSURFACING SEWAGE ElEXISTING FAILURE 0 SHORELINE coMI L7 DESIGN FORM(REQUIRED) INJ SEPTIC DESIGN(REQUIRED) BEDROOMS LOT SIZE WAS LOT CREATED AFTER 4/1/2025? r 0 6-WAIVER(S)(IF APPLICABLE) 2 0.29 ❑ YES ❑✓ NO 0 DIRECTIONS TO SITE AND SITE CONDITIONS:(ex.locked gate) E TIMBERLAKE DR TO A LEFT ON ETIMBERLAKE WEST DR TO SITE ON THE RIGHT AT I HOUSE 2171 r O --I ( 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 7AA4 O 'YCi G CZ)L el f' rth1f ....\\A41/ • O1SL, JP1 )-rr 1 tt 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. INSPECTOR SIGNATURE DATE APPLICATION EXPIRATION DATE APPLICATION APPROVED ISSUED BY DATE 4N10c't 4t)l1J77 gJ,ti - THIS FORM MAY BE CANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE Revised:4/14/2025 Aimmonw DESIGN FORM—PAGE ONE Assessor's Parcel Number: 220185300037 -- -- 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 oC.D5" 0o331 Designer's Name: ADAM HUNTER Applicant's Name: MICHELLE HOOTON Designer's Phone Number: 3607531226 Mailing Address: 2171 E TIMBERLAKE WEST DR Designer's Address: PO BOX 162 SHELTON WA 98584 City State Zip OLYMPIA WA 98507 CLEAR FORM City State Zip Designer's Email JHANDASSOCIATES@HOTMAIL.COM DESIGN PARAMETERS Treatment Device ❑Glendon 0 Sand Filter 0 Mound 0 Sand Lined Drainfield 0 Recirculating Filter IT ATU BNR600 ❑Other Treatment Level(check all that apply): J A 1 B J C 4L1 J BL2 J BL3 I E _J N Drainfield Type ❑ Gravity 0 Pressure 0 Trench 0 Bed I'Sub Surface Drip Septic Tank/Drainfield Specifications Laterals Number of Bedrooms 2 Schedule/Class DRIP Daily Flow: Operating Capacity 180 gpd Length 162 ft Lf Daily Flow: Design Flow 240 gpd Diameter 1/2 in Septic Tank Capacity(working) 1060 gal Number 2 V Receiving Soil Type(1-6) 4 Separation 1.5 ft Receiving Soil Appl. Rate 0.6 gpd/ft2 Orifices Required Primary Area 450 ft2 Total Number of Orifices 325 Designed Primary Area 450 ft2 Diameter DRIP in Designed Reserve Area 600 ft2 ✓ Spacing 12 in Trench/Bed Width DRIP ft Manifold Trench/Bed Length 325 ft Schedule/Class 40 Elevation Measurements Length 28 ft Original Drainfield Area Slope 4 % Diameter 1 in New Slope,If Altered N/A % Preferred manifold configuration used? Ea'Yes 0 No Depth of Excavation Up-slope 6 in / Transport Pipe from Original Grade Down-slope 6 in ✓ Schedule/Class 40 Designed Vertical Separation 12 in Length 50 ft Gravel-based Drainfield Required? 0 Ycs lZi No Diameter 1 in Pump Required? E'Yes 0 No Dosing and Pump Chamber Pump/Siphon Specifications Number of doses/day 12 Diff. in Elevation Between Pump&Uppermost Orifice 9 ft Dose quantity 20 gal Drainfield Squirt Height/Selected Residual(head) 23.1 ft Chamber Capacity(flood) 1060 gal Uppermost Orifice I 'Higher 0 Lower than Pump Shutoff Pump controls:Please check those required. Capacity @ Total Pressure Head 6.3 gpm IS( Timer E7'Elapse Meter 44 Event Counter Calculated Total Pressure Head 92.2 ft If Timer: Pump on 20GAL ,Pump off 2HRS Comments APPROVED SEP 18 2025 MASON COUNTY ENVIRONMENTAL HEALTN Revised:4/14/2025 neT DESIGN FORM—PAGE TWO Assessor's Parcel Number: 220185300037 -- Permit Number: SWG DESIGN CHECKLISTS Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch • Test hole locations ' Drainfield orientation and layout Reference depth from original grade: 21 Soil logs Er Trench/bed dimensions and M' Septic tank g Property lines critical distances within layout ®' Drainfield cover g Existing and proposed wells D-Box/Valve box locations Reference depth from original grade within 100 ft of property Er Septic tank/pump chamber and restrictive strata: Measurements to cuts,banks,and locations ®' Laterals,trench bed, top and surface water and critical areas Ef Observation port location bottom a Location and orientation of 2 Clean-out location a Curtain drain collector curtain drain and all absorption ' Manifold placement 1 Sand augmentation components Eg Orifice placement Other cross-section detail: g Location and dimension of Q( Lateral placement with distance Er Observation ports/clean-outs primary system and reserve area to edge of bed g Other Information 121 Buildings g Audible/visual alarm referenced Yes No g Direction of slope indicator 2 Scale of drawing shown on scale L� ❑ Designstaked out g Waterlines bar 0 0 Recorded Notices attached Roads, easements,driveways, Q Elevation benchmark and relative 0 ❑ Waiver(s)attached parking elevations of system components Er ❑ Pump curve attached Er North arrow and scale drawing 0 0 Evaluation of failure shown on scale bar Non-residential justification ❑ ❑ Waste strength ❑ ❑ Flow DESIGN APPROVAL The undersigned designer must be , 011!1111 •‘ installer at time of installation g Yes 0 No 8/26/25 Designer Date The undersigned has reviewed thi sign on behalf of Mason County Public Health and determined it to be in compliance with state and local on-site regulations: C C`" \ "ttL Environmental Health Sp ialist 1 Date CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CONDITION: ✓ The design is stamped"Approved"by Mason County Public Health. r(� ✓ The Onsite Sewage Permit has not expired, the Permit Expiration Date is: l ✓ flf0 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 N . ROVED ,r S EP• "'eN MASON �8 2025 _ , . =Y0- ENV1RO �, 3^ RET NMENTgIHEALTH .-F S.y �Y ,L !WM 2gZ,a2,1, WIMP i2zl' Fc m • it Fil#23s E. 10 yJ12,0 oofi§! $El a°1 g;".€ s C E =;w YA1 .a - 824 ;.5 .iy s-w' os y HuitH "O I P z 1S a " i p9O = a' s1fl1 O .4 - ; 3s1 -Gl; cs !pa u swYB of F_ b 09i E.N p g i E E 3 5 `o ff' tl4 2 A` S .2t E,Elk V o � z2„3e� O epee E ill g �.y$ a sg g $� _ =g `22 > s F li aS w E ^°.� P m $ pp y � 0 5�� °F H Y'l- C r S i ,.§� 0o aa�5 a d Q =g;g d 1 , n o ,A1; c Y 9 glVi ji 2 I 1 _ a. 3w L8 U $�_� z N _ c, a HI E sosgEa! .a 28“os;s c gooE 0 = ^2 o E 8 E _ o t o C w ip, I a.) t) =wig w s o _ r g ti - 7. < » _ 3 0 Js�g �N F _ - r 2 =o o o S 3 31 d s i v u o = �0�►2 a s o" �, 3g g c Q E $ a m g" n 7 �fi y ° € < 8 y c :7 w w e.c c " $ u b o : ; i re l q ;sga; C o z .4 E. 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