HomeMy WebLinkAboutSWG2025-00295 - SWG Application / Design - 7/28/2025 MASON COUNTY 415 N 6TH STREET,SHELTON,WA 98584
A .: 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: SWG2025-00295
APPLICANT CAIN ET AL JEFFREY G & BRITTANY D Phone:
Address: TRENT J & SHARON D SPURGEON RETON, WA 98058
OWNER CAIN ET AL JEFFREY G & BRITTANY D Phone:
Address: TRENT J & SHARON D SPURGEON RETON, WA 98058
SEPTIC DESIGNER Nathan Cleaver Phone: 360-598-6546
Address: 23994 NE Orseth Rd POULSBO, WA 98370
Site Address: E Trails End PI
Primary Parcel Number: 222235105029
Permit Description: new 3BR SFR - Pressure
Permit Submitted Date: 07/28/2025
Permit Issued Date: 10/14/2025
Issued By: Jeff Wilmoth
Current Permit Fees Paid: $825.00 (additional fees may be required upon installation of system).
Permit Expiration Date: 10/14/2028 (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.
1
OFFICIAL USE ONLY
a , MASON COUNTY GATE RECEIVED: 67 2 ¢ ^O�5
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`1 AMOUNT RECEIVE RECEIVED BY:
l- Public Health & Human Services g��j o m
Environmental Health 360-427-9670,ext.400 or 360-275-4467,ext.400 <
415 N.6th Street -Shelton,WA 98584 S W G aO�`j — /�1ic. �r� 0 73
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ON-SITE SEWAGE SYSTEM APPLICATION
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APPLICANTPHONE m m
Trent Spurgeon FLE__—:
�] (253) 261-7698 I-
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Trent ADDRESS-STREET,CITY STATE,ZIP CODE LA"-) -f E
10023 SE 246th PI Kent WA 98030 v m
�11 SITE ADDRESS-STREET,CITY,ZIP CODE t.�J
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P Trails End PI Belfair WA 98528 I '`'
NAME OF DESIGNER00
fli 'PHONE Q" I N
ii Nathan N. Cleaver c (360) 598-6546
NAME OF INSTALLER 4 m PHONE N
�;� C.�,-�- - '�6o Li ZG Li ZZI o
N IN
PERMITRM TYPE(select one) DRINKING WATER SOURCE O
1i.RESIDENTIAL OSS COMMUNITY OSS COMMERCIAL OSS b PRIVATE INDIVIDUAL WELL E PRIVATE TWO-PARTY WELL Z I W
TYPE OF WORK(select one) 7 PUBLIC WATER SYSTEM Trails End Water District 2
t
IN NEW CONSTRUCTION I UPGRADES Eil REPAIR 1 REPLACEMENT OTHER DETAILS(select all that apply) 0 TABLE X REPAIR N I CJ1
SUBMITTALS 0 SURFACING SEWAGE 0 EXISTING FAILURE 0 SHORELINECO
grDESIGN FORM(REQUIRED) ,%1SEPTIC DESIGN(REQUIRED) BEDROOMS LOT SIZE WAS LOT CREATED AFTER 4/1/20257 O r 1 —t
5WAIVER(S)(IF APPLICABLE) 3 0.33acri ❑ YES ❑� NO 0
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DIRECTIONS TO SITE AND SITE CONDITIONS;(ex locked gale)
Head north on Highway 3, turn left on Mason Benson Rd E, turn right on E Trails Rd, turn al I c'
right on E Trails End Dr, turn left on to the second rd, continue to the E trails End Dr & E
Trails End PI intersection. Property is SE corner lot. -4
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N IN
SITE MUST BE FLAGGED FROM MAIN ROAD AND TEST HOLES MUST BE FLAGGED WITH TEST HOLE NUMBERS. I
OFFICIAL USE ONLY 3ELOW THIS LINE
UPGRADE/FAILURE SOURCE(for reporting purposes)
❑VOLUNTARY ❑MAINTENANCE/PUMPING ❑BUILDING PERMIT ['HOME SALE ❑COMPLAINT ❑OTHER:
INSPECTOR SOIL LOGS COMMENTS!CONDITIONS
3 3 Z_...—
3 (e- )(_, 4 ivt-a)TqJ
..7_, `1.
9._ 1 67
RECORD DRAWING AND INSTALLATION REPORT
SOIL CODES:
V=VERY G=GRAVELLY S=SAND L=LOAM Si=SILT C=CLAY E=EXTREMELY R=ROOTS REQUIRED FOR FINAL APPROVAL.
I CTOR SIGNATURE DATE APPLICATION EXPIRATION DATE ''LIGATION APPROVED!ISSUED BY DATE
4‘41/66 tl—tt—
al — it 2-75
T IS MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE ' Revised:4/14/2025
DESIGN FORM—PAGE ONE Assessor's Parcel Number: 2 2 2 2 3 — 5 1 — 0 5 0 2 9
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 be scanned and available for . blic view on the Mason County Web site.Maximum `, •r sire: 1I•"X 17"
Permit Number: SWG , 025 - 00D. Designer's Name: Nathan N. Cleaver
Applicant's Name: Trent Spurgeon Designer's Phone Number: (360)598-6546
Mailing Address:
10023 SE 246th PI Designer's Address: 23994 NE Orseth Rd
Kent WA 98030 City State Zip Poulsbo WA 98370
C. State Zi Designer's Email nathan nathancleaver.com
Treatment Device
0 Glendon 0 Sand Filter 0 Mound 0 Sand Lined Drainfield 0 Recirculating Filter 0 ATU U Other
Treatment Level (check all that apply): ❑ A ❑B ❑ C ❑ BL 1 E B1.2 ❑ BL3 1❑ E ❑N
Drainfield Type
0 Gravity gliPressure ffiTrench 0 Bed 0 Sub Surface Drip
Septic Tank/Drainfield Specifications Laterals
Number of Bedrooms 3 Schedule/Class Schedule 40
Daily Flow: Operating Capacity 270 gpd Length 35 ft
Daily Flow: Design Flow 360 gpd Diameter 1 in
Septic Tank Capacity(working) 1,250 gal Number 6
Receiving Soil Type(1-6) 4 Separation
5 ft
Receiving Soil Appl. Rate 0.6 gpd/ft2 Orifices
Required Primary Area 800 ft2 Total Number of Orifices 50
Designed Primary Area 800 ft2 Diameter 1/8 in
Designed Reserve Area 1,600 ft2 Spacing 48 in
Trench/Bed Width 3 ft Manifold
Trench/Bed Length 35 ft Schedule/Class
Elevation Measurements Length ft
Original Drainfield Area Slope 6-8 % Diameter in
New Slope, If Altered NA % Preferred manifold configuration used? 0 Yes 0 No
Depth of Excavation Up-slope 9 in Transport Pipe
from Original Grade Down-slope 6 in Schedule/Class Schedule 40
Designed Vertical Separation 24 in Length 25 ft
Gravel-based Drainfield Required? L'Yes 0 No Diameter 2 in
Pump Required? fi 'Yes 0 No Dosing and Pump Chamber
Pump/Siphon Specifications Number of doses/day 12
Diff. in Elevation Between Pump& Uppermost Orifice 10 ft Dose quantity 22.5 gal
Drainfield Squirt Height/Selected Residual (head) 23 ft Chamber Capacity(flood) 1,250 gal
Uppermost Orifice CI Higher [I Lower than Pump Shutoff Pump controls: Please check those required.
Capacity fa;Total Pressure Head 28 gpm op T ily` 4l 6 �`E pse Meter G ' Event Counter
Calculated Total Pressure Head ft f pi
i on ( - Pump off 2 Hours
OCT 1 4 21125 Comments `�
MASON COUNTY ENVIRONMENTAL HEALTH
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DESIGN FORM—PAGE TWO Assessor's Parcel Number: 2 2 2 2 3 -- 5 1 -- 0 5 0 2 9
Permit Number: SWG
DESIGN CHECKLISTS
Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch
Fri Test hole locations 66 Drainfield orientation and layout Reference depth from original grade:
g Soil logs RI Trench/bed dimensions and g Septic tank
g Property lines critical distances within layout Gi1 Drainfield cover
g Existing and proposed wells g D-Box/Valve box locations Reference depth from original grade
within 100 ft of property g Septic tank/pump chamber and restrictive strata:
6Z1 Measurements to cuts,banks, and locations (2l Laterals,trench/bed,top and
surface water and critical areas 6Z( Observation port location bottom
121 Location and orientation of g Clean-out location 0 Curtain drain collector
curtain drain and all absorption 0 Manifold placement 0 Sand augmentation
components 621 Orifice placement Other cross-section detail:
• Location and dimension of 0 Lateral placement with distance 121 Observation ports/clean-outs
primary system and reserve area to edge of bed
g Other Information
❑ Buildings RI Audible/visual alarm referenced Yes No
• Direction of slope indicator 12r Scale of drawing shown on scale 0 0 Design staked out
O Waterlines bar 0 0 Recorded Notices attached
❑ parking easements,driveways, 0 In itritn
❑ 0
Waiver(s)
p attached
0 0 Pump curve attached
g North arrow and scale drawing 1 ; ❑ 0 Evaluation of failure
shown on scale bar OCT 4 1075 4. ,, Non-residential justification
MASON COUNTY ENVIRONMENTAL HEALT, 0 0 Waste strength
JBW ❑ ❑ Flow
DESIGN APPROVAL
The undersigned designer must be noti ' I stallc at time of installation 0 Yes 0 No
22 Z5
ignature of Designer 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- ' regulations:
��� L)b1n�`�1 7o-�Y-2S
Env ro re'' tal 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: ' tf-2
✓ 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
SOIL EVALUATION
Property Owner/s Trent Spurgeon System Designer Nathan N. Cleaver
Date soils logged: Logged by: Nathan N. Cleaver
LEGAL DESCRIPTION: Section 16 Township 23N Range 1W Parcel#/s 12316-23-00040
Include soil textural characteristics and depths at which significant changes occur. "`
Be sure to include depth where mottling or impermeable layers occur. Use additional sheets'as necessary. h
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0-2" Loose Duff
++ Loose
2-33 Brown Gravelly 6 NA >43"
1 Sandy Loam
i
33-43 Present Loose
at 33-43" Grey Till
0-2" Loose Duff
2 2-36" Loose Brown Gravelly 0.6 NA >45"
Sandy Loam
36-45" Present Loose
at 36-45" Grey Till
Loose Duff
0-2"
Loose Brown Gravelly 0 6 NA >42"
3 2-28" Sandy Loam
28-42" Present Loose Grey Till
at 28-42"
0-2" Loose Duff
2-22" Loose Brown Gravelly 0.6 NA >43"
4 Sandy Loam
22-43" Present Loose
at 22-43" Grey Till
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