HomeMy WebLinkAboutSWG2026-00011 - SWG Application / Design - 1/9/2026 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,EXT 400
FAX:360-427-7787
On-Site Sewage System Permit: SWG2026-00011 CAI"/t1
APPLICANT BRUEMMER MICHAEL RYAN &SARAH Phone:
ELIZABETH
Address: 2224 11TH AVE E SEATTLE, WA 98102
OWNER BRUEMMER MICHAEL RYAN &SARAH Phone:
ELIZABETH
Address: 2224 11TH AVE E SEATTLE, WA 98102
SEPTIC DESIGNER BOB PAYSSE* Phone: 360-507-1498
Address: 3083 E Mason Benson Road GRAPEVIEW, WA 98546
Site Address: 770 E TREASURE ISLAND DR
Primary Parcel Number: 121055200098
Permit Description: Conforming repair/upgrade 3bd OscarXO2 with local waiver
Permit Submitted Date: 01/09/2026
Permit Issued Date: 02/03/2026
Issued By: Rhonda Thompson
Current Permit Fees Paid: $845.00 (additional fees may be required upon installation of system).
Permit Expiration Date: 01/16/2027 (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.
R
OFFICIAL USE ONLY -
MASON COUNTY DATE RECEIVED: 6 f 6 CI / aoa� cn D ell0
N
AMOUNT RECEI ED: RECEIVED BY: W
f Public Health & Human Services -DQa v y
Environmental Health 360-427-9670,ext.400 or 360-275-4467,ext.400 o
415 N.6th Street -Shelton,WA 98584 S W G a �o O l i 0 m
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ON-SITE SEWAGE SYSTEM APPLICATION
D xi
(m C)
APPLICANT PHONE r
MICHAEL BRUEMMER z
MAILING ADDRESS-STREET,CITY,STATE,ZIP CODE E
2224 11TH AVE E SEATTLE WA 98102 co
xi
SITE ADDRESS-STREET,CITY,ZIP CODE ` V� ..
770 TREASURE IS. DRI (t� A YN WA 98524 I
N
NAME OF DESIGNER ONE
ROBERT H. PAYSSE \\\\ 360-426-1803
NAME OF INSTALLER \\ PHONE 0
TBD � _R
PERMIT TYPE(select one) - v� rn I o
DRINKING WATER SOURCE
O
!vl RESIDENTIAL OSS COMMUNITY OSS fl-DO4MERCIAL OSS bpi PRIVATE INDIVIDUAL WELL PRIVATE TWO-PARTY WELL Z
I 01
I
TYPE OF WORK(select one) pa PUBLIC WATER SYSTEM TREASURE ISLAND
6 NEW CONSTRUCTION/UPGRADES gREPAIR/REPLACEMENT OTHER DETAILS(select all that apply) O TABLE X REPAIR I Cn
SU{BMMIITTALS r O SURFACING SEWAGE Eg EXISTING FAILURE RI SHORELINE
CO
M DESIGN FORM(REQUIRED) Avl SEPTIC DESIGN(REQUIRED) BEDROOMS LOT SIZE WAS LOT CREATED AFTER 4/1/2025? O I N
W- ❑ n I
WAIVER(S)(IFAPPLICABLE) 3 0.27 ❑ YES NO X O
DIRECTIONS TO SITE AND SITE CONDITIONS:(ex locked gate) 1, , - ,
N. HWY 3. RIGHT ON GRAPEVIEW LOOP. RIGHT ON TREASURE IS. RD ACROSS I o
BRIDGE. RIGHT AT TOP OF HILL/INTERSECTION. FOLLOW AROUND ISLAND TO SITE r I
ON RIGHT, ADDRESS 770. - o
Io
CO
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 El HOME SALE ['COMPLAINT El OTHER:
INSPECTOR SOIL LOGS COMMENTS/CONDITIONS
I
7W : 0 - 0 6 S L 1O + rnm-f-+ , z4+ vv6i-i-c-x— vecko4v,..,4-6„..)
cam\
11\ '_ 0 - \-z-) 't(?) ‘2_fit+ vvc4- , ov-t)
(6, 0) 'I
O t V 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.
INSPECTOR SIGNATURE DATE APPLICATION EXPIRATION DATE APPLICATION APPROVED/ISSUED BY DATE
cilIVA1VVr1)11 t/14i6 I ')1k 171 7/13tU I
THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE Revised:4/14/2025
e
DESIGN FORM—PAGE ONE Assessor's Parcel Number: 1 2 1 0 5 - 5 2 - 0 0 0 9 8
A design will be reviewed when 3 copies of each of the following are submitted:
''Completed design form that has been signed and dated. 0 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. .14aximum paper size: 11"X 17"
PARCEL IDENTIFICATION
Permit Number: SWG QCoate" 00011 Designer's Name: ROBERT H. PAYSSE
MICHAEL BRUEMMER Designer's Phone Number: 360-426-1803
Applicant's Name:
Mailing Address: 2224 11TH AVE E Designer's Address: 3083 E MASON BENSON RD
SEATTLE WA 98102 City State Zip GRAPEVIEW WA 98546
Cite State Zip Designer's Email pioneerdigging@yahoo.com
DESIGN PARAMETERS
Treatment Device
O Glendon O Sand Filter 0 Mound O Sand Lined Drainfield O Recirculating Filter 0 ATU OSCAR X02 U Other
Treatment Level(check all that apply): ❑A ❑B ❑C 0 BLI ❑BL2 O BL3 ❑ E n N
Drainfield Type
O Gravity O Pressure O Trench O Bed O Sub Surface Drip
Septic Tank/Drainfield Specifications Laterals
Number of Bedrooms 3 Schedule/Class NETAFIM
Daily Flow:Operating Capacity 270 gpd Length PER MNF ft
Daily Flow: Design Flow 360 gpd Diameter - in
Septic Tank Capacity(working) 1200 gal Number -
Receiving Soil Type(1-6) 4 Separation - ft
Receiving Soil Appl.Rate 0.6 gpd/ft2 Orifices
Required Primary Area 600 ft2 Total Number of Orifices 300 (6@50)
Designed Primary Area 600 ft2 Diameter 0.42 GPH in
Designed Reserve Area 600 ft2 Spacing 6 in
Trench/Bed Width 15 ft Manifold
Trench/Bed Length 40 ft Schedule/Class SCH. 40
Elevation Measurements Length 30 ft
Original Drainfield Area Slope 7 % Diameter 1 in
New Slope,If Altered 7 % Preferred manifold configuration used? [ 'Yes 0 No
Depth of Excavation Up-slope PER MNF in Transport Pipe
from Original Grade Down-slope PER MNF. in Schedule/Class SCH. 40
Designed Vertical Separation 18+ in Length 50 ft
Gravel-based Drainfield Required? O Yes ligNo Diameter 1 in
Pump Required? Fig Yes O No Dosing and Pump Chamber
Pump/Siphon Specifications Number of doses/day PER MNF
Diff. in Elevation Between Pump&Uppermost Orifice 15 ft Dose quantity PER MNF _al
Drainfield Squirt Height/Selected Residual(head) NA ft Chamber Capacity(flood) 1200 «al
Uppermost Orifice i1 Higher O Lower than Pump Shutoff Pump controls:Please check those required.
Capacity @ Total Pressure Head PER MNF gpm It Timer lig Elapse Meter EX Event Counter
Calculated Total Pressure Head PER MNF ft If Timer: Pump on PER MNF ,Pump off PER MNF
Comments APPROVED
FEB 03 2026
MASON COUNTY ENVIRONMENTAL HEALTH- Revised: 4/14/2025
RET
,
DESIGN FORM—PAGE TWO Assessor's Parcel Number: 1 2 1 0 5 -- 5 2 -- 0 0 0 9 8
Permit Number: SWG 2pa.‘ ^ C)0011
DESIGN CHECKLISTS
Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch
IF/i Test hole locations g Drainfield orientation and layout Reference depth from original grade:
EA Soil logs Ig Trench/bed dimensions and g Septic tank
0 Property lines critical distances within layout I2 Drainfield cover
0 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:
O Measurements to cuts,banks,and locations 0 Laterals,trench/bed, top and
surface water and critical areas g Observation port location bottom
O Location and orientation of g Clean-out location 0 Curtain drain collector
curtain drain and all absorption g Manifold placement 0 Sand augmentation
components
[if Orifice placement Other cross-section detail:
O Location and dimension of IRE Observation ports/clean-outs
primary system and reserve area li6 Lateral placement with distance
to edge of bed Other Information
0 Buildings
iii Audible/visual alarm referenced Yes No
Direction of slope indicator Eif Scale of drawing shown on scale C1 0 Design staked out
lili Waterlines bar ❑ II Recorded Notices attached
O Roads,easements,driveways, p Elevation benchmark and relative RI ❑ Waiver(s)attached
parking elevations of system components g ❑ Pump curve attached
O North arrow and scale drawing g 0 Evaluation of failure
shown on scale bar Non-residential justification
❑ RI Waste strength
❑ g Flow
DESIGN APPROVAL
:: ,
The undersigned designer must be notified by installe t time of installation g Yes 0 No 24eA41—.Signature of Designer a� �, 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-site regulations:
.4e&/7 ,4;,
Environmental Health ecialist Date
CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CONDITION:
O The design is stamped"Approved"by Mason County Public Health. I
‘,/ The Onsite Sewage Permit has not expired,the Permit Expiration Date is: \'JI t c (t--7
/ 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
gPPRovE
EXISTING WATERLINE (ABANDON)
FEB 0 3 2026
MASON COUNTYENORONM NEW WATERLINE LOCATION
HEALTH
�N ' � RET TAL H (SEE NOTE)
i a
� EXISTING SYSTEM (FAILED)
PUMP OU
� PER CODET& ABANDON
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2 ` \
2
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FUTURE �O ,. '� �� 2O
GARAGE / 1 ; .. r
DECK ti
LOCATION RI� `� C"4"9,-144 �'F
PROPOSED 3 BED. j \ o'
REPAIR SEPTIC
(PRIMARY& RESERVE) \ /
\
/
NEW OSCAR X02 TANKS N
///
/
/
EXISTING 3 BEDROOM HOME \ // // /
/
APPROXIMATE /
SHORELINE / \
kCASE INLET) w/
NO FOUNDATION DRAIN
•
GRADIENT OF
INSTALL OSCAR X02 AS PER PRIMARY/RESERVEN DRAINFIELD
MANUFACTURER INSTRUCTIONS.
ABANDON EXISTING PARKING AREA THAT ^k",F'"As,.:'
CONFLICTS W/ DRAIN FIELD SPACES. `r
51r00317
RE-INSTALL A NEW WATERLINE W/ INSTALL OF ,f� . ceea,� 2i7, '?i SYSTEM, 1O'+ FROM NEW DRAIN FIELD AS SHOWN. EX;IRE'
AN ASBUILT/INSTALL SIGNOFF FEE WILL
BE CHARGED AT TIME OF INSTALLATION
1 U-[C�I�ILR: MACE BRUEMMER. I I4T I I��LE II TEST HOLE 2: TEST HOLE 3:
' PIONEER. DIGGING, INC..lV I'\RCEL»:12105-52-00098 ;_'�l
+-,- IllI 9- Ill l _ IILI.
J `SEPTIC DESIGNS '\DDS-R\E,S: 770 TREASURE LS.DR. h,`2 I- ,4 L;C;- I9 RL7CH` 22
3083 E(MASON BENSON RD. GRAPEVIEW,WA 98546 I-1 E.SIG V F R: p OBE T H.�7 AYSSE PLATS
THIS IS NOT A SURVEY.REFERENCES INCLUDE APPLICANT/COUNTY PROVIDED
LJ lam. Ul.l�.l 1 L I A 1 JJL TATS OR SURVEYS FIELD MEASUREMENTS AND COUNTY GIS.DESIGN INTENDED FOR SEP'IC
OFFICE-360-426 IH03 FAX 36(1427-2353r 30' URPOSES ONLY PROPOSED DEVELOPMENT MAY BE SUBJECT '0 OTHER
V �H[LT; SITE C,PLAN SCALE 1 = DEPARTMENT/AGENCY REV1EW DESIGNER NOT RESPONSIBLE,OR S=-BACKS .,RE..iTEU'�
SEPTIC COMPONENTS
'INSTALL OSCAR X02 AS PER
EXISTING WATERLINE MANUFACTURER INSTRUCTIONS.
(SEE NOTE ON SITE PLAN)
/ `'
NEW WATERLINE
N. \`� (SEE NOTE ON SITE PLAN)
)
41 .
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�`,.`7S- �� . EXISTING SYSTEM
4c)) ` (FAILED)PUMP
OUT& ABANDON
FUTURE CODE
(CS-5)GARAGE ( 7S-
LOCATION tip / PER
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PRIMARY • / / EXISTING
OSCAR X02 / - � HOME
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(675 SQFT) // ,-
RESERVE /
0
OSCAR X02 / \
(675 SOFT) / X02 TANKS
v
S..' APPROV D
, '�DF Sy' \ FEB 0 3 2026
INSTALL NEW 4" SEWERLINE�ASON COUNTY ENVIRONMENTAL HEALTH
�^0:` RCtA= T� ;�.,-s5E y AROUND EXISTING DECK, RET
d'''_`n_S INSTALL C/O IF NONE EXISTS.
AN ASBUILT/INSTALL SIGNOFF FEE WILL \
BE CHARGED AT TIME OF INSTALLATION
CUSTOMER: MIKE BR[.IEMMER TEST HOLE I: TEST HOLE 2: TEST HOLE 3:
PIONEER DI��IN�, INC. 24 0+ 0-1",CSI
PARCEL# 12105 52-O0098 �+ FILL l9+TILL ?2+TILL
SEPTIC DESIGNS ADDRESS: 770 TREASURE IS.DR. Roo iS 2-I ROOTS-19 ROOTS-22
�L yCc
3��iiJ E.'ALAS.-)N E3EN�L N RD C,R.Af'E:�,IE\\.Ati'�85— DESIGNER: ROBERT T H n. A SSE DISCLAIMER THIS IS NOT A SURVEY. REFERENCES INCLUDE.APPLICANT/COUNTY PROVIDED
PLATS OR SURVEYS.FIELD MEASUREMENTS AND COUNTY GIS.DESIGN INTENDED FOR SEPTIC
OFFICE-300-42c,!h'0J ",\ lo()-1,_)" 'j'jj SHEET: DF DETAIL SCALE: 1°=10' PURPOSES ONLY PROPOSED DEVELOPMENT MAY BE SUBJECT TO OTHER
DEPARTMENT/AGENCY REVIEW DESIGNER NOT RESPONSIBLE FOR SETBACKS UNRELATED TO
SEPTIC COMPONENTS.
X02 Tanks
Pre-cast Concrete Pre-cast Concrete
Septic Tank Discharge Tank
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LOWRIDGE ONSITE TECHNOLOGIES DRAWING ID: X02 Tanks SCALE: NTS
DRAWN BY: DBM CK BY: DAVE LOWE DATE: rv: 02.22.2023
SUBMITTAL DATA SHEET
Thermoplastic
Reinforced Thermoplastic motor bracket and discharge with built-in guide bearing.This 1/2 HP pump has a stainless
steel top bearing and motor coupling. These are assembled with our A.Y. McDonald stainless steel motors. Two wire
single phase models include pump, motor, and 10' lead.
This four inch submersible is supplied with grounded leads meeting the National Electrical Code(N.E.C.)specifications.
The performance curve below will assist you in choosing the pump that meets your needs. A
APPROVED
MODELS I E-30 GPM FEB 03 2026
MASON COUNTY ENVIRONMENTAL HEALTH IMO
E - 30 GPM RET
B
300 SHUTOFF HEAD
1/2 HP 122 FT. • 53 P.S.I.
Ei
= 200
S
1/2 HP•
F- 100 4 STAGES
Simplex 0 5 10 15 20 25 30 35 40
Duplex 0 10 20 30 40 50 60 70 80
Fourplex 0 20 40 60 80 100 120 140 160
FLOW GPM
Specifications
Model HP Material Volts Phase A B Wt.
LOT-30 1/2 Plastic 115 1 10.94 9.53 23
M'EST.1156
McDonald
SUBMITTAL INFORMATION
•
- Stainless steel pump shell and pump shaft - Powered by A.Y.McDonald submersible motors 1/2 HP.
- Reinforced Thermoplastic diffusers and impellers - 1 1/4" FNPT Discharge
- Thermoplastic intake screen and cable guard
NO-LEAD:The weighted average of the wetted surface of this no-lead product contacted by consumable water contains less than one quarter of one
percent(0.25%) lead.
Lowridge Onsite Technologies, Inc. Toll Free: 1-877-476-8823 dave@lowridgetech.com
P.O. Box 1179 Fax: 1-425-335-3622 oscaronsite.com
Lake Stevens,WA 98258
A.Y.McDonald considers the information on this assembly drawing correct when published.Item and option availability:including specifications,are subject to change without notice.
Submitted by: 1/2022
Installation & 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.
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 loft to waterlines with all septic components. If less than loft 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 loft 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 operation and maintenance
information, refer to Mason County Public Health Homeowner's Manual, which should be receivA ppiipllation approval.
14. System owner should be cautious of landscaping around septic components. Root intrusion r U V E
D
can cause premature failure of the drainfield area. In addition, bushes and trees should be kept FEB 03 2026
away from lids and other septic maintenance points. MASON COUN ENVIRONMENTAL HEALTH
15. Changes made at time of installation may impact designer calculations, pump sizing,and ET
compliance w/county and state requirements. Contact designer prior to install w/any
proposed variations from design. Changes may result in additional fees and permitting. N� 0F Ws1•}y
t r n IlT� A I�I A�\1Elt MQL BRUEMMF_R
PIONEER DIGGING, INC. I x:12105 52-00098 •
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DHIGN \DDRESS: 770 TREASURE IS.DR. �r Z4:;2e;
311,8 3 E.�t-i_�`�BFN : P.1) (,R VA, 0851) DESIGNER: ROBERT H.PAYSSE Ex In_s
� HC.1 300 120 I8,)$ L A\ 3ok1 +?"?3s' SFIE_I I: NOTES SCALE NA