HomeMy WebLinkAboutSWG2025-00363 - SWG Application / Design - 9/10/2025 MASON COUNTY 415 N 6TH STREET,SHELTON,WA 98584
SHELTON:360-427-9670, EXT 400
rl{. 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: SWG2025-00363
APPLICANT WILSON GREG & KELLI MICHELLE Phone:
Address: 3316 18TH AVE S SEATTLE, WA 98144
OWNER WILSON GREG & KELLI MICHELLE Phone:
Address: 3316 18TH AVE S SEATTLE, WA 98144
SEPTIC DESIGNER PAULA JOHNSON* Phone: 360-898-2255
Address: 171 E VUECREST DRIVE UNION, WA 98592
Site Address: 81 N Diamond Head Dr
Primary Parcel Number: 323095300028
Permit Description: New 3BR SFR -Gravity Bed
Permit Submitted Date: 09/10/2025
Permit Issued Date: 02/11/2026
Issued By: Jeff Wilmoth
Current Permit Fees Paid: $555.00 (additional fees may be required upon installation of system).
Permit Expiration Date: 09/10/2028 (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/onsite/oss-inspection-request.php or call:
360-427-9670, extension 400.
OFFICIAL USE ONLY
MASON COUNTY DATE RECEIVED: 6Q 1 ��
6141, .‘,. V C D
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AMOUNT RECEIVE ��� RECEIVED BY: �/�
Public Health & Human Services CO m
Environmental Health W-9670,ext.400 or 360-275-4467,ext.400 S W G 9\� — ^ (9.5 N 0
415 N.6th Street-Shelton,WA 98584 ,,�J(
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ON-SITE SEWAGE SYSTEM APPLICATION v
m m
APPLICANT PHONE
r
Greg & Kelli Wilson (206)914-2667 c
MAILING ADDRESS-STREET,CITY,STATE,ZIP CODE � `J E
3316 18th Ave Sco
Seattle WA 98144 0
SITE ADDRESS-STREET.CITY.ZIP CODE O
81 N Diamond Head Dr [L1O Lilliwaup WA 98555 c I CO
NAME OF DESIGNER V PHONE I N
Arrow Septic Designs, Inc , :f e (360) 898-2255
NAME OF INSTALLER v` CrS PHONE v I CO
IO
PERMIT TYPE(select one) 'It DRINKING WATER SOURCE 0
lit RESIDENTIAL OSS L]COMM UNITYOSS ECOMM SS 5 PRIVATE INDIVIDUAL WELL PRIVATETWO-PARTY WELL Z I .
TYPE OF WORK(select one) 7 PUBLIC WATER SYSTEM
�1N0 TABLE X REPAIR
.l NEW CONSTRUCTION/UPGRADES REPAIR/REPLACEMENT OTHER DETAILS(select all that apply) 101
SUBMITTALS 0 SURFACING SEWAGE 0 EXISTING FAILURE 0 SHORELINE
cri
DESIGN FORM(REQUIRED) WISEPTIC DESIGN(REQUIRED) BEDROOMS LOT SIZE WAS LOT CREATED AFTER 4/1/2025? 0
57 WAIVER(S)(IF APPLICABLE) 3 BR .22 acrid 0 YES Q NO 0 1
X I O
DIRECTIONS TO SITE AND SITE CONDITIONS'(ex locked gate)
Go out US-101 N toward Port Angeles. Drive for approx. 22 miles and turn (L) at Colony I O
Surf. Turn (L) onto N Diamond Head Dr. Destination on (L). Yellow sign: "Wilson" r I O
RV on lot-walk down trail on (R) side of lot down to drainfield. -
NIN
SITE MUST BE FLAGGED FROM MAIN ROAD AND TEST HOLES MUST BE FLAGGED WITH TEST HOLE NUMBERS.
OFFICIAL USE ONLY BELOW THIS LINE
UPGRADE/FAILURE SOURCE(for reporting purposes)
0 VOLUNTARY 0 MAINTENANCE/PUMPING ❑BUILDING PERMIT 0 HOME SALE 0 COMPLAINT 0 OTHER:
INSPECTOR SOIL LOGS COMMENTS!CONDITIONS
0 ,- - 202;:e* c
uc (et) A 1
RECORD DRAWNG 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 d AP LIGATION A/PPRrOVED/ISSUED BY DATE
ge100 ,3\-yN
OR 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: 3 2 3 0 9 - 5 3 - 0 0 0 2 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. ' Scaled layout sketch,including all applicable items on checklist.
0 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 a o?. -U 03(03 Designer's Name: Arrow Septic Designs, Inc
Applicant's Name: Greg&Kelli Wilson Designer's Phone Number: (360)898-2255
Mailing Address: 3316 18th Ave S Designer's Address: 171 E Vuecrest Dr
Seattle WA 98144 City State Zip Union, WA 98592
City State Zip Designer's Email paulaj@hctc.com
DESIGN PARAMETERS
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 0 BL1 ❑BL2 ❑BL3 ❑E ❑N
Drainfield Type
'Gravity 0 Pressure 0 Trench 21 0 Sub Surface Drip
Septic Tank/Drainfield Specifications Laterals
Number of Bedrooms 3 Schedule/Class 2729
Daily Flow:Operating Capacity 270 gpd Length 45 ft
Daily Flow:Design Flow 360 gpd Diameter 4 in
Septic Tank Capacity(working) 1,200 gal Number 3
Receiving Soil Type(1-6) 3 Separation 3 ft
Receiving Soil Appl.Rate 0.8 gpd/ft2 Orifices
Required Primary Area 450 ft2 Total Number of Orifices --
Designed Primary Area 450 ft2 Diameter -- in
Designed Reserve Area 450 ft2 Spacing — in
Trench/Bed Width 10 ft Manifold
Trench/Bed Length 45 ft Schedule/Class 2729
Elevation Measurements Length 6 ft
Original Drainfield Area Slope 6 % Diameter 4 in
New Slope,If Altered 6 % Preferred manifold configuration used? GI(Yes ❑No
Depth of Excavation 'Up-slope 24 in Transport Pipe
from Original Grade Down-slope 17 in Schedule/Class 3034
Designed Vertical Separation 36+ in Length 80 ft
Gravel-based Drainfield Required? Ili Yes 0 No Diameter 4 in
Pump Required? 0 Yes EfNo 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 0 Event Counter
Calculated Total Pressure Head — ft I imp PrkpR p off —
Comments
FEB 1 1 2
MDSOni r.ni(NTY FNVIRONMENTAL HEALTH
J B1 Revised:4/14/2025
1 &&
DESIGN FORM—PAGE TWO Assessor's Parcel Number:3 2 3 0 9 - 5 3 -- 0 0 0 2 8
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:
0 Soil logs 56 Trench/bed dimensions and 0 Septic tank
Eli
Property lines critical distances within layout Drainfield cover
❑ Existing and proposed wells EZi D Box/Valve box locations Reference depth from original grade
within 100 ft of property 0 Septic tank/pump chamber and restrictive strata:
6Zi Measurements to cuts,banks,and locations 0 Laterals,trench/bed,top and
surface water and critical areas 66 Observation port location bottom
❑ Location and orientation of 0 Clean-out location 0 Curtain drain collector
curtain drain and all absorption 56 Manifold placement 0 Sand augmentation
components 0 Orifice placement Other cross-section detail:
6Z1 Location and dimension of Lateral placement with distance C6 Observation ports/clean-outs
primary system and reserve area to edge of bed Other Information
621 Buildings 0 Audible/visual alarm referenced Yes No
0 Direction of slope indicator g Scale of drawing shown on scale d 0 Design staked out
O Waterlines bar 0 RS Recorded Notices attached
Eg Roads,easements,driveways, p Elevation benchmark and relative 0 Waiver(s)attached
parking elevations of system components 0 12i Pump curve attached
56 North arrow and scale drawing 0 Eff Evaluation of failure
shown on scale bar Non-residential justification
❑ g Waste strength
•
❑ 21 Flow
•
, VAL
The undersigned designer must be notified i rQI llation 0 Yes 0 No
Signatur ti UI:SsCNEit•• Date
�J�S�s�i
The undersigned has reviewed this design on behalf or mason County Public Health and determined it to be in
compliance with state and local on-sit regulations:
(4/ ' 2.- Ic- 02�
E sir ental Health Sp ialist 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: 01,0-2_1
✓ 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
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SURVEYOR'S CERTIFICATE COLONY SURF N0. 4APPROVALS
• I.DAVID C. PAEN>ON,COG ME.(BY CERTIFY TM HE AT T ,XA INED ASO APPPOVEC'HrS DAT%r
PLAT Di ;CLEAT SURF NO.{1S CAGED URON AM ACTUAL 9
SURVEY AND 5600IV1110N CF SECTION 9,TAP 29■.,R. .f
9 R.,W. Y. ,THAT INC DI:MACES,COURSES,ARO
ANGLES apt SRO. ,TEREOM CORRECTLY,TNAT TRE.Yw SEC.9,T 23N,R.3W,W.M. •
VASON CO EA.INC.S.
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WEN'S DAVE BEEN YT, ARO LOT ASO BLOCK CORMAf .I.MI'.. .,. �� •
STARED CORRECTLY ON TIRE GROURCI NAT 1 FLLLT COMA IkNI:I.I.at ..kat. ,•L' v.
PLIED TITN THE ERNING W15 of THE STATUTES AND MASON COUNTY,WASHINGTON ,5111, e..j°` ga/'9"1
REGULATIONS GOVERNING ILATTIIIG AND TNAT IT EON- , 1
FON.TO THE APPROVED PRELIMINARY PLOT 060 THE !I✓I/M'!9'! ✓w'tAon•! ! I O TA D.Pd
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CONDITIONS OF APPROVAL TNEREOr.• Z E /]
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I c..1_ 111 , �,,,REY + `V7 7 0.$ 4 A.IN' OE •no COUNTY TAKES,HERETOFORE
+ 1.' y ✓� l -1 47 !� S LEVIED AGAINST THE PROPERTY
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DESCRIBED HEREON,OCCOROING TO
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1`111 I .•'XA, JIht ` M 1I +'�' _ L. ARO PARALL AND ADJACENT TO,ALL LOT LINES,EXCEPT THAT TMI
,4 iii""" L 3 f f `,j EASEMENT L BE 10 FEET IN WIDTH ALONG LOT LINES.HERE LOTS
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ITIES ARO DRAINAGE AND All LOTS SHALL ALSO SE
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GALIKSp OVER PORTIONS OF ANt RE ROADWAY CURVATURE
'-Z71)3.45 Ate- aN)1*JY 9,T13N•,P3b$'WM "'o• or no.4.2 --- $00000 T To OCCUR.
C M,M*Vt_ 1.130;y.:Y.y a........ .- "R=."Y, _ INGRESS ARO SS EASEMENT OVER ANO ACROSS:f11E FRONT
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COVENANTS LEGAL DESCRIPTION k ' 0 ••N
THESE PAILS,ROTS, 'MAT THE UNUERSIGA,O•
CAULKS SUNNI.,E THE LANG HEREBY PLAT•t!.,
A P.PTI ON OF GOVERMENT LOT N0. 5, SEC: 9, 000. 250.,P,DR. CAULMERE BT V THIS PLOT Aka DEDICATE TO THE USL
Y.Y. DESCRIBED AS FOLLOWS: COMMENCING AT THE MORTHERLT THE COLON T LAND EAST CLUB FOREVER, a STOKE'S,
..L.T LT LUNSMTUCTINE AND YAINTAINIMG ONE THE
CORNER SOUTH SAID SECT IONI THENCE S.0' 17• 20' AAENUS• PL 5,AND SLOPES OCTS, ALSO T - NIGHT TC
HL..I 5 AT•0 AP PWLIC W ALONG THE NWITM •
COLONY
SECTION LINE, RETTIG ALSO MAKE ALL NICE SANY FOR CUTS AND HFILLS UPON
ALL THE THE .ESTE FLY BOUNDARY OF COLONY SURF N0. 2, A DISTANCE OF ALE LOTS, BLOCKS,TRACTS,ETC., SHORN OM THIS+LAT
OWNERS OF Tell LOT. IN S ERE PLAT AND/OR W ,., 1 45 FEET TC THE POINT OF TRUE BEGI MNIMG•BEING ALSO
ALO IM THE ORIGINAL WADING OF ALL STREETS,A.,..
Al.ADDITIONAL PLATS TOOT WT RE SEA0E0 THE CE T[R Of Y10 SECTION, THENCE 5.R9.21•{0•L.ALONG PLACES, TRACTS,•'_.SRLAM HEREON, ALSO '0LTN00 LC'S
▪ SAID STREETS,AID Tot OBLIGATION TO THE EAST WEST QUARTER SECTION LIRE, BFIMG ALTHSO THE SOUTHERLY 10 DRAIN ALL S.M.TS OVER ANC,ACROSS ANY ACT OR LC'S
NAINTA I■SHALL BE CCNCUMNENTLY TOE OBLI• AMANDA.'OF COLONY SURF M0.2,000.00 FEET, THENCE 5.22• WHINE CATER MIGHT TAKE A NATURAL COURSE LATER•.E
CATION OF AN•CORPORATION IN MICR TITLE BI �-Wr 425.00 SILTS THENCE 5.11.21' {0•E.r 1561 500
' TPEET CR ST RE.T5 AR CPI INa.L'Y GRADED. •
W >•HO IpaOS alp Sr REE ra WY WE HELD. FEET, THENCE 5.50.31.20••.• 170.00 FEET, 'HENCE 5.61•SB• Illyyy .E
IN THE EVENT TRAY'THE GRIEFS Of ANT LOTS 30~Jr 190.00 4.201 .,550 S.00 21.51•{0•C.,210.00 140-1 y}��5S,, l``1a
SERVED BY THE ROAD.OR STREETS OF THIS THENCE S.T, TREACE R. 550.00 Ftt1, 1Ht NCE N,2.2t•{0•W., (UYE,f v"? e/r �C(J�0•.rt
PLAT SHALL PET IT'OM THE BOARD OF COUNTY 260.00,EFT, TMEKE M.60. SLAW., 1BO.17 ffFT{THENCE an OF RT B. _ G T Y
N.0.1T,20•E.,ALONG THE NORTH SLUT.1 1,;1PTER SECTION LINE �.NO
COW 15SIOHERS TO "'CLUCK THESE ROADS DRO OE POINT or TRUE IM .NG, NRi SI]ENT '' ///JJ fS(C'-':Y` ',I:r �R}.:I..:4'
STRUTS IN THE PUBLIC ROAD PTSTEAF, SAID Ya50MOCLUNTY,TNSHINGTOF. b:E >IIUATE IN /E/NE/ DENT
PETITIOR[RS SHALL WE CILIGLTE0 TO 11160 A'1VR�
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THE SANE TO COYNTT HONG STANOAROS IN ALL
RESPECTS, INOLWIN.DEDICATION OF RIGHT STATE ON ETON ) jjr
CF RAY,PRIOR TG ACCEPTANCE NY THE COUNTY. COIN..OE, ) h' .
THE YLE OR LEASE W LC+J 1..A ANGLE THIS IS It Tf THAT'OE TMIS_[_JAT C,� •
LOT IN ANT SUBOIVISION'PLATTED MD FILED FILING RFC.ORR ••►14"S't 1969•REFD HE DE%ISIONHO, •rl OTARTrs,•CL-. aQ
UNDER THIS ORDINANCE IS EXPRESSLY IRON l• Y PERSONALLY 03 P RFD ROB!RI A.
RI TED UNLESS LEO IATIL a FORMAL REPLAY I I[FDLOJA RECORD aT]CIE'WE IU$ANOr 140• R� IDIOT,`NC ROBERT ISLN A. MCi A,HEAI:.•.,ivi:'I I I—
SHALL NAYE BEEN SIIP'ITT(0 AN0 APPROVED AS TIMUT I i,TAT.Cv ♦5- a•u T * OE Or, YE ...Lax IC Be T N +.CA.,.H
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STRI CTIOIA SMALL NCT BE CONSTRUED TO PRO- ANO'vLL- raN• Cr .N.U.IC I•- - a
WAIT THE CCMINaT10N CF THE TWO PARTS Of •C J. IHI RI.M NA MT:CR,.
ONE LCT Ai TN THE TAE MACE or LOTS. Va C COUxiY UGHTUP
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MOT APPLY TO THE SALE OF UNDIVIDED "` " N�.aiL�L/ •CW6/�OYo
INTEREST IN A LOT.
RESTRICTIONS NLTA.• ,
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I Su rF,E JNEFTAN/Of/
SEE IROTARRR CBINaNT5 RECORDED UNDER AUDI TORS
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O 0 14 O Cleanout JIM
'• v N 9 O2 1,200 Gallon Septic Tank
5,1,,, cp $6J1 2-Compartment with Effluent Filter
Si O3 D-Box with speed-levelers
pi&,aPas Efl and cover to surface
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**Note to installer**
Sleeve waterline when within 1 0'
of septic transport line. Maintain
- vip*A4,p4 a £tic pR 10' minimum between water
y. line and septic tanks/drainfield.
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Note: (Typical Bed Layout)
0=Observation Port-to be 4"perforated 61-5-I'S-
PVC pipe from bottom of bed to finished
grade. A removable cap shall be installed on
"' observation port pipe. Glue"T"on bottom
so pipe can't be removed.
Minimum of 2 in system, one in each corner.
Laterals are to be centered in trenches.
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S .LL 1 2 MASON COUNTY ENVIRONMENTAL HEALTH
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APPR0t
FEB 112126
MASON COUNTY ENVIRONMENTAL HEALTH
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**Note: Septic Tanks must meet standards required by WAC chapter 246-272C
and manufacturer must be on the Dept of Health list of registered sewage tanks. **
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Wixom Septic Deo iglus, (Inc. Inis . 4,
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INSTALLATION & MAINTENANCE
Gravity Distribution Systems - Bed 5100349
u -' PAULA JOY JOHNSON '.
'a."L'M�N5 _DE '`i�GNE�
1. Install Laterals with contour of the ground. EXPIRE rim► '
2. Install bed bottom level. G�
3. Install locator tape or rebar at each end of all drainfield laterals.
4. Install observation ports as indicated on the detailed drainfield layout. Minimum of 2
required at diagonal corners of bed drainfield with bottom extending to the
drainrock/native soil interface. Glue "T"to bottom so Observation Port cannot be easily
removed from ground. Install removable cap on top of port at final grade level.
5. Install drainfield during dry weather and soil conditions; any soil smearing must be
eliminated by hand raking.
6. Install riser over d-box with access to the surface.
7. Use distribution box with speed levelers. Divert incoming pipe down with 90-degree
angle to prevent short-circuiting.
8. Filter fabric required over drain rock prior to back filling. If the drain rock extends above
natural grade, run the filter fabric at least 2 inches down the trench wall.
9. Waterlines must be a minimum of 10' to any tank or drainfield (a reduction to 5' may be
obtained with a State waiver on lots that meet minimum lot size). Encase all water lines
within 10' of septic transport lines and under any driveway/parking areas.
10. Divert all storm water runoff away from on-site sewage system.
11. No curtain drains allowed within 10' of the up-slope edge or 30' of the down-slope edge
of the drainfield and reserve area.
12. No vehicular traffic over drainfield area or tanks.
13. Install Bio-Tube or equivalent effluent filter at outlet end of septic tank.
14. All manhole lids and access, sampling or inspection ports must have locking covers and
be located at ground level.
15. Inspect tank and clean filters every 6-12 months as needed.
16. Have the septic tank pumped or professionally inspected every 3 to 5 years.
17. All materials and workmanship must meet County and State regulations.
18. Deviation from this design without prior approval from the Designer and Mason County
Environmental Health Department will make this design null and void.
19. Homeowner is responsible for all property lines and easements.
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