HomeMy WebLinkAboutSWG2025-00357 - SWG Application / Design - 9/8/2025 MASON COUNTY 415 N 6TH STREET,SHELTON,WA 98584
SHELTON:360-427-9670,EXT 400
J 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 Permit: SWG2025-00357 C,OVIVr(
APPLICANT Mike Minner Phone:
Address: PO Box 636 SEQUIM, WA 98382
OWNER SWINDLER'S COVE LLC Phone: 253-381-2235
Address: 9815 59TH ST NW GIG HARBOR, WA 98335
SEPTIC DESIGNER CINDY WAITE* Phone: 360-701-0205
Address: 80 E PICKERING LANE SHELTON, WA 98584
Site Address: UNKNOWN
Primary Parcel Number: 320103150120
Permit Description: New 4 bd gravity trench with Class B waiver
Permit Submitted Date: 09/08/2025
Permit Issued Date: 10/20/2025
Issued By: Rhonda Thompson
Current Permit Fees Paid: $825.00 (additional fees may be required upon installation of system).
Permit Expiration Date: 09/17/2028 (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.
OFFICIAL USE ONLY///111 -
a MASON COUNTY DATE RECEIVED: j�U /J�1/ — `v('� C ›
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AMOUNT RECEIVED, RECEIVED BV:
— -- Public Health & Human Services � r co m
Environmental Health 360-427-9670,ext.400 or 360-275-4467,ext.400 �1/ C Cl)
415 N.6th Street-Shelton,WA 98584 S W G _i 5 - co/t� O Si
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ON-SITE SEWAGE SYSTEM APPLICATION 3
APPLICANT �� PHONE m m
MIKE/BARB MINNER ' )�_` �1 3.60-507-0534 Z
MAILING ADDRESS-STREET.CITY,STATE,ZIP CODE \\ / 3
po bOX 636 ( -, SEQUIM WA 98382 co
SITE ADDRESS-STREET,CITY,ZIP CODE C i '-
XXX E LONE FIR DR 1D Z SHELTON WA 98584 I (4NAME OF DESIGNER � LU PHONE N
CINDY WAITE Q /1I, 360-701-0205
NAME OF INSTALLER - , PHONE v 1 CD
TBD CO ....E
PERMIT TYPE(select one) DRINKING WATER SOURCE O
W.RESIDENTIAL OSS COMMUNITY OSS COMMERCIAL OSS V PRIVATE INDIVIDUAL WELL ba PRIVATE TWO-PARTY WELL Z I 0
TYPE OF WORK(select one) PUBLIC WATER SYSTEM
I
NEW CONSTRUCTION I UPGRADES REPAIR/REPLACEMENT OTHER DETAILS(select all that apply) ❑ TABLE X REPAIR I w
03
SUBMITTALS CISURFACING SEWAGE 0 EXISTING FAILURE 0 SHORELINE
MI
L�7 DESIGN FORM(REQUIRED) KJ SEPTIC DESIGN(REQUIRED) BEDROOMS LOT SIZE WAS LOT CREATED AFTER 4/1/2025? O
5WAIVER(S)(IF APPLICABLE) 4 5 AC ❑ YES 'NO C) I
X ICl/
DIRECTIONS TO SITE AND SITE CONDITIONS:(ex.locked gate)
GO NORTH ON HIGHWAY 3, TURN RIGHT ON AGATE ROAD,TURN RIGHT ONTO AGATE LOOP, TURN I O
RIGHT ONTO DANIELS ROAD, GO ABOUT ONE MILE, IRON GATE ON LEFT SIDE OF ROAD, CODE IS 9696,
FOLLOW TO Y,AND STAY TO THE LEFT, LOT 2 WILL BE THE SECOND DRIVEWAY TO THE RIGHT. GO TO O I --'
END,WHITE MARKERS IS AREA OF PROPOSED RESIDENCE, SOIL LOGS ARE WEST OF THE WHITE -i
MARKERS.WE STAKED OUT AN ENVELOPE, NEED TO HAVE SCOTH CLEARED PRIOR TO LAYING OUT I IV
LATERALS. RESERVE SOIL LOG IS ON THE LEFT AS YOU ARE DRIVING IN THE DRIVEWAY.V (ran�, /1I u '
SITE MUST BE FLAGGED FROM MAIN ROAD AND TEST HOLES MUST BE FLAGGED WITH TEST HOLE NUMBERS. tS I li `i t `tv`S I.A'1 I C
OFFICIAL USE ONLY BELOW THIS LINE
UPGRADE/FAILURE SOURCE(for reporting purposes)
0 VOLUNTARY ❑MAINTENANCE/PUMPING ❑BUILDING PERMIT ❑HOME SALE ['COMPLAINT 0 OTHER:
INSPECTOR SOIL LOGS 415COMMENTS/CONDITIONS
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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.
INS- CTOR SIGNATURE DATE APPLICATION EXPI ATIO DATE APPLICATION APPROVED/ISSUED BY DATE
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THIS FORM MAY BE S••NNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE Revised:4/14/2025
IIIIIIII\
DESIGN FORM—PAGE ONE Assessor's Parcel Number: 3 i 2 O T 1 TO 3 1 1 51 0 1 1 2 0
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 75 - 00 3.�- 17 Designer's Name: CINDY WAITE
Applicant's Name: MIKE/BARB MINNER Designer's Phone Number: 360-701-0205
Mailing Address: PO BOX 636 Designer's Address: 80 E PICKERING LANE
SEQUIM WA 98382 City State Zip SHELTON WA 98584
City State Zip Designer's Email cindyewaite@msn.com
DESIGN PARAMETERS
Treatment Device
0 Glendon 0 Sand Filter 0 Mound 0 Sand Lined Drainfield 0 Recirculating Filter 0 ATU 0 Other
Treatment Level(check all that apply): 0 A 0 B ❑C 0 BLI 0 BL2 0 BL3 0 E ❑N
Drainfield Type
Gravity 0 Pressure 0 Trench 0 Bed 0 Sub Surface Drip
Septic Tank/Drainfield Specifications Laterals
Number of Bedrooms 4 Schedule/Class ASTM 2729
Daily Flow: Operating Capacity 360 gpd Length 50 ft
Daily Flow: Design Flow 480 gpd Diameter 4 in
Septic Tank Capacity(working) 1200 gal Number 4
Receiving Soil Type(1-6) 3 Separation - 9 ft
Receiving Soil Appl.Rate .8 gpd/ft2 Orifices
Required Primary Area 600 ft2 Total Number rific ASTM 2729 PERF
Designed Primary Area 600 ft2 Diameter F ti t,. in
Designed Reserve Area 600 ft'- Spacing v 4 d / in
Trench/Bed Width 3 ft 4,: ifold
Trench/Bed Length 200 ft Sche AlaEov0E0 AITE
Elevation Measurements Le h LICENSED DESIGNER ft
Original Drainfield Area Slope 8 % Diameter Lx;',Rts J510, • � in
New Slope,If Altered % Preferred manifold configuration used? d Yes IB'No
Depth of Excavation Up-slope 19 in Transport Pipe
from Original Grade Down-slope ,1,6/ in Schedule/Class 3034
Designed Vertical Separation i b in Length 10 ft
Gravel-based Drainfield Required? El Yes 0 No Diameter 4 in
Pump Required? 0 Yes 66No 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) 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 A P �°R®� D ' (,�
CONCRETE TANK REQUIRED OCT 2 p 2025
t��nSCN COUNTY ENWRC4t tiTD1 HEALTH
Revised: 6/11/2025
RET
DESIGN FORM—PAGE TWO Assessor's Parcel Number` 3( 21 01 1 j 0 31 1T51 01112 O 1
1 . ._ 1
Permit Number: SWG
DESIGN CHECKLISTS
Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch
it Test hole locations V Drainfield orientation and layout Reference depth from original grade:
' Soil logs pr,,„p2, gr Trench/bed dimensions and if Septic tank
' Property lines critical distances within layout V Drainfield cover
V Existing and proposed wells V D-Box/Valve box locations Reference depth from original grade
within 100 ft of property pal e ' Septic tank/pump chamber and restrictive strata:
' Measurements to cuts,banks, and locations ' Laterals,trench/bed,top and
surface water and critical areas l,� Observation port location bottom
vocation and orientation of Il'Clean-out location 0 Curtain drain collector
curtain drain and all absorption faeklanifold placement 0 Sand augmentation
components Elk-Orifice placement Other cross-section detail:
✓ Location and dimension of V Lateral placement with distance It Observation ports/clean-outs
primary system and reserve area to edge of bed
` g Other Information
,,,�,�
I Buildings Audible/visual alarm referenced Yes No
itt Direction of slope indicator 1i Scale of drawing shown on scale 0 V Design staked out
✓ Waterlines page -1 bar 0 0 Recorded Notices attached
✓ Roads,easements,driveways, V Elevation benchmark and relative 0 0 Waiver(s)attached
parking elevations of system components 0 0 Pump curve attached
V North arrow and scale drawing 0 0 Evaluation of failure
shown on scale bar Non-residential justification
❑ 0 Waste strength
❑ ❑ Flow
DESIGN APPROVAL
The undersigned designer must be notif by installer at time of installation E214Yes 0 No
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Signature ofiDesi ner Date
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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 regulations:
(o(2 li
Environmental Health Specialist Date
CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CONDITION:
✓ The design is stamped"Approved" by Mason County Public Health. I I
/ The Onsite Sewage Permit has not expired,the Permit Expiration Date is: L
✓ 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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APPROVED i
OCT 20 2025
MASON COUNTY ENVIRONMENTAL HEALTH I id/ r I , 30i i
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APPROVED
OCT 20 2025 .
MASON COUNTY ENVIRONMENTAL HEALTH
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Installation Notes
Gravity Distribution System:
XXX W Lone Fir Dr 32010-31-50120
1. The prepared site plan is not a survey. It's the owner's responsibility to verify property
lines, utility lines (water, sewer, power, phone and gas) prior to installation.
2. Install cleanout between residence and septic tank
3. Gravel based drainfield required
4. Install system during dry weather with acceptable soil conditions
5. Keep wheeled vehicles off the drainfield area before, during and after installation.
Tracked equipment only
6. All ground, surface water and roof drains must be diverted away from the septic tanks
and drainfield. Ensure the final grade slopes away from these areas and water doesn't
collect on or around them. Use swales, berms, catch basin and tight lines, curtain drains,
etc. to divert all waters.
7. Curtain drains can be no closer than 10' upgradient and 30' down gradient of the
drainfield
8. Exposed restrictive layers, cuts, banks, etc. can be no closer than 50' downhill from the
drainfield.
9. Install access risers on the septic tank, D-box and observation ports.
10. Make sure septic tank risers are epoxied or caulked to cast in riser rings on tank.
11. Lids must form a water and gas tight seal with the access risers
12. Install effluent filter at the septic tank outlet.
13. This system must be installed by a Mason County Certified Installer.
14. Deviation from this design without prior approval from the designer and Mason County
Health Department will make this design null and void.
15. This design was sized per Washington Administrative CodeWAC246-272A-0230. The
operating capacity is based on 45 gallons per day per capita with two persons per
bedroom. The minimum design flow per bedroom per day is the operating capacity of
ninety gallons multiplied by 1.33. This results in a minimum design flow of one hundred
twenty gallons per day. This creates a surge factor of 33% but anticipated flow is ninety
gallons per bedroom per day.
16. Install laterals or bed with contour of the ground
17. Install trench bottoms level and always maintain a minimum of six inches into native soil
18. Filter fabric required over drain rock prior to backfilling. I e drain-rock extends
above the original grade, run the filter fabric at least 2 i down the trench wall
APPROVED
ROVE® Z..4 AS411 4 (
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MASON
OCT 2 0 2025 h�P � 2�
COUNTY ENVIRONMENTAL HEALTH 0 C NOY E 'NRITE /�f
RET LICENSED DESIGNER C( '
System Owner Responsibilities:
1. Operation and Maintenance is required by Washington State Department of Health and
Mason County Health Department.
2. The septic tank should be pumped every three to five years or as needed.
3. System owners are responsible for having maintenance performed every three years as
per WAC246-272A.
4. System owners are responsible for responding to septic issues in a timely manner.
5. System owner agrees to read and abide by information regarding their system in the
User Manual provided by Mason County Public Health.
6. Keep the flow of sewage at or below the approved design operating capacity.
7. Keep waste strength at residential waste strength parameters.
8. Spread loads of laundry through the week.
9. Do not use excessive bleach or detergents with added whiteners.
10. Do not shower, do laundry and dishwasher at the same time
11. Antibiotics can kill or impair the biological process in the septic tank.
12. Leaky plumbing can hydraulic overload your on-site septic system.
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