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HomeMy WebLinkAboutSWG2026-00043 - SWG Application / Design - 2/17/2026 MASON COUNTY 415 N 6TH STREET,SHELTON, , 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: SWG2026-00043 APPLICANT Acme Septic Design Phone: 3606988488 Address: P.O. Box 2954 Silverdale, WA 893 CONTACT ROYER CHRISTOPHER D &SARA Phone: Address: 11031 NE NORTH SHORE DR BELFAIR, WA 98528 OWNER ROYER CHRISTOPHER D &SARA Phone: 360-535-2333 Address: 4901 NE NORTH SHORE RD BELFAIR, WA 98528 Site Address: 4903 NE NORTH SHORE RD Primary Parcel Number: 222115101022 Permit Description: New 4bd pressure sandlined bed Permit Submitted Date: 02/17/2026 Permit Issued Date: 05/05/2026 Issued By: Rhonda Thompson Current Permit Fees Paid: $1,015.00 (additional fees may be required upon installation of system). Permit Expiration Date: 04/24/2029 (based on date of inspection) Permit Conditions: I 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. 8 Horizontal setbacks per WAC246-272A-0210 must be maintained, unless prior approval is obtained 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. cQ e.S OFFICIAL USE ONLY MASON COUNTY DATE RECEIVED: O`--, I C C/) AMOUFITREGENED: If U RECEIVED BY: Public Health & Human Services am Environmental Health 360-427.9670,ext.400 or 360-275-4467,ext.400 N 415 N.6th Street—Shelton,WA 98584 SWG 1. — c-'W�3 O Z03 ON-SITE SEWAGE SYSTEM APPLICATION z APPLICANT PHONE In M Chris Royer z MAILING ADDRESS-STREET,CITY,STATE,ZIP CODE � 4903 NE North Shore Rd ® Belfair WA 98528 m SITEADDRESS-STREET,CITY,ZIP CODE II 4901 NE North Shore Rd • IL&i ® Belfair WA 98528 NAME OF DESIGNER :: \'11/ PHONE I Rod Left 360-698-8488 NAME OF INSTALLER . PHONE PERMIT TYPE(select one) DRINKING WATER SOURCE ®RESIDENTIAL OSS ®COMMUNITY OSS ®COMMERCIAL OSS PRIVATE INDIVIDUAL WELL Lii PRIVATE TWO-PARTY WELL Z TYPE OF WORK(select one) �I PUBLIC WATER SYSTEM Pleasant Code @]NEW CONSTRUCTION/UPG L1 RADES REPAIR/REPLACEMENT OTHER DETAILS(select all that apply) El TABLE X REPAIR' I SUBMITTat s �� ❑SURFACING SEWAGE 0 EXISTING FAILURE BI SHORELINE W II ^, ®DESIGN FORM(REQUIRED) A�LtSEPTICDESIGN(REQUIRED)' BEDROOMS LOT SIZE WAS LOT CREATED AFTER4/1120269 r 0 Di WAIVER(S)(IF APPLICABLE) 4 0.5 acre ❑ YES ❑✓ NO 0 I V n DIRECTIONS TO SITE AND SITE CONDITIONS:(ex.locked gate) Proposed 3-bedroom house with a 4-bedroom OSS. See map. I • 0 I G I SE 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. ' 3ç\\- : (0 c LS 1-b 63 -ç ,tr : - cs ( S Sit X222 RECORD DRAWING AND INSTALLATION REPORT SOIL CODES: V=VERY G=GRAVELLY S=SAND L=LOAM SI=SILT C=CLAY E=EXTREMELY R=ROOTS REQUIRED FORFINALAPPROVAL. INSPEC OR SIGNATURE 7,N DATE APPLICATION EXPI TION D TE APPLICATION APPROVED!ISSUED BY DATE �V L Lrv�i�� Revised:4/14/2025 THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE DESIGN FORM—PAGE ONE Assessor's Parcel Number: 'l-D fi V 1 A design-will be reviewed.when 3 conies of each of following ace submitted: Completed-designform.that-has b�en signed and dated: Scaled layout sketch;including all applicable:items on checklist. Scaled plot plan,including all applicable items on checklist Cross section sketch,inciuding:all applicable items on checklist:. This farm may be scanned and:available for public view an the Masan County.Web site.Marnnum. er sire: 11"X I7" Permit.Number: SWG Oz-000'3 Designer's Name: Rod Left. Applicant's Name: Chris Royer Designer's Phone Number: 360-698-8488 4903 NE North Shore Rd Designer's er.s Address: PO'Box 2954 Mailing Address; gn Belfair WA 98528 City, State Zip Silverdale WA 98383 City State. Zip Designer's Email info.@acmesepfie.Com Treatment Device ❑Glendon m Sand Filter O Mound ❑Sand Lined Drairtheld ❑Recirculating Filter ❑ATU O Other Treatment Level(check all that apply): ❑A 91 B ❑C ❑°.BLI ❑BL2 21 BL3 0 E O N Drainfeld Type ❑Gravity 'Pressure ❑Trench C(Bed. ❑Sub Surface'Drip Septic Tank/Drainfield Specifications Laterals Numberof Bedrooms 4 Schedule/Class 40 Daily Flow:Operating Capacity 360 gpd Length ' 60 ft DailyFlow:Design.FTbw 480 gpd Diameter 1.25 in Septic Tank Capacity(working) -1500 gal Number 4 Receiving-Soil Type(1-6)_ I Separation 2 ft Receiving Soil Appl;Rate 1;.0 gpd/ft2 Orifices Required'Primary Area 480 ft2 Total Number of Orifices 1,q /Z'�[ Designed Piirnary Area 480 ft2 Diameter 118 in Designed Reserve Area 4.80+ ff2 -,Spacing 24 in Trench/Bed Width 8 ft Manifol4 Trench/Bed Length .60 ft Sohedule/Class 40 Elevation Measurements Length 2Q ft Original Drainfield Area Slope 0 %. Diameter 1.25 "ill New Slope,If Altered 0 % Preferred manifold configuration used? O Yes ❑No Depth of Excavation Up-slope 23 in Transport Pipe from.Original Grade Down-slope 23 iii •Schedule/Class 40 Designed Vertical.Separation 18 in. Length ft Gravel-based Drainfield.Required? ❑Yes No .Diameter _ 2 in Pump Required? 5t1•Yes ❑No: Dosing-and Pump Chamber -'Pump/Siphon Specifications- Number of.doses/day 24 Dill,in Elevation-Between Pump&Uppermost Orifice ti ft Dose quantity • . 1.5_ - gal Drain field Squirt Height/Selected Residual(head) 5 ft •Chamber Capacity(flood) 1500- gal Uppermost Orifice l l' igher. ❑Lower than Punip Shutoff Pump controls Please check those required.. Capacity®Total Pressure Head JY.S Spin Rf Timer ❑ B('apse Meter- ❑vEvent Counter Calculated Total Pressure Head 14 If Timer; Pump on sec' ,Pump off 1 hr Comments APPROVED u - r i l\ G Luw - •• . Revised:4/14/2025 MASON COUNTY ENVIRONMENTAL HEALTH .ONLINE FJEALTH.DEPT RET DESIGN FORM—PAGE TWO, Assessor's Parcel Number:22211-51-0102'-- Permit Number: SWG — C7 OC) DESIGN CHECKLISTS_ t � Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch 21 Test hole locations l9 Drainfield orientation and layout Reference depth from original grade: l6 Soil logs [if Trench/bed dimensions and Qf Septic tank S Property lines critical distances within layout iii' Drainfield cover ❑ Existing and proposed wells S D-Box/Valve box locations p P Reference depth from original grade within 100 ft of property S Septic tank/pump chamber and restrictive strata: Gd Measurements to cuts,banks,and locations Grr Laterals,trench bed,top and surface water and critical areas S Observation port location bottom ❑ Location and orientation of Q1 Clean-out location O Curtain drain collector curtain drain and all absorption S Manifold placement ❑ Sand augmentation components 9 Orifice placement Other cross-section detail: S Location and dimension of Q1 Lateral placement with distance 9 Observation ports/clean-outs primary system and reserve area to edge of bed g Other Information xi Buildings Q( Audible/visual alarm referenced Yes No Bj Direction of slope indicator 9 Scale of drawing shown on scale O d Design staked out Waterlines bar O 5 Recorded Notices attached S Roads,easements,driveways, El Elevation benchmark and relative ❑ 9 Waiver(s)attached parking elevations of system components 6 O Pump curve attached 56 North arrow and scale drawing O 5 Evaluation of failure shown on scale bar Non-residential justification ❑ ❑Waste strength ❑ ❑Flow DESIGN APPROVAL „r s The undersigned designer must be notified by inst her at time- f installation d Yes O No Sigiá1ure 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-site regulations: �61'✓� � I�P 1 Environment 1 Health Speci list Date CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CONDITION: ✓ The design is stamped"Approved"by Mason County Public Health. l I v' The Onsite Sewage Permit has not expired,the Permit Expiration Date is: V A4 O /�I ✓ 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. . i 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 Pump Selection for a Pressurized System -Single Family Residence Project ROYER/22211-51-01022 Parameters Disci Assertiy5¢e 200 ids 160 Traspor Ls 1 35 fed TognlPipeCla s 40 TraspatLine5¢e 200 rclrs DvdvdNodd Nme 140 MacE6—AmLit 9 bd MafddLegh 14 fed MaiddFClass 40 MaiddFipe5¢e 200 idEs NuTtadla peCdl 4 120 LatedLegh 60 fad LataaiPipeciass 40 Lat3aiPpeSze 125 idEs Ori6ceSze 1I6 irdEs orifice 2 bd i 100 RBiHead 5 bd Q PFSOOr FbwMet3 Nme Indies Fdd 1 FrmLosses 0 t Calculations x 80 MlrfmrnFbvRabpaOri&e 043 t NurtbEd0dkxspErZme 124 Tc FbwRabpaZme 54..4 wn NuntedI speZa 4 . 60 %FkwDi6 e-MIsLwtOrlbce 5.1 % H Traspat\FicriJ 52 fps Frictional Head Losses 40 Losstra4,Disdage 5.9 bet LossinTraspat 1.7 fad —— — — —— — — Lmstm.5ivthe 0.0 bd k LcssinMaidd 02 fad LossInLatrais 06 bd 20 Lcsstra.FbnnEl3r 0.0 bd Pddcf FridimLasses 0.0 fad Pipe Volumes ddrraspotiie 63 gds 0 v 0 10 20 30 40 50 60 70 80 VddNtridd 24 gds Net Discharge(gpm) Vdcilab-4spazme 18.6 gds Tddvdure 27.4 g3is Minimum Pump Requirements PumpData Legend Deskg1FbNRals 54.4 xn PF5W7Hi rHeadE9uetPurp SystrnCuve TedDynaricHead 224 bd 50GPK34HP Z' I0Wiz,2D2 460V3fd60Hz RnpCuve PurpOjt Raga — OpaefrgPdrt O APPROVED CrCENS. ! NER onncossrsterire• 'L t.: RE6 1211512 APR L 3 0 2026 '^ wV6e PAASON COUNTY ENVIRONMENTAL HEALTh RET Mason County WA GIS Web Map Vfl ftr1J1 \ 5555 w . 1 #i 'mil:'. � � ( .} tH �Q-,• - / / \ ± - .-:.. -,,: 1r -: if i ss4 { O fa / APPROVED APB 30 2096 MASON COUNTY EaMRONf�fh1TAL H�1TH a i RET 4/8/2026,4:09:41 PM 1:6,120 0 0.05 0.1 0.2 ml County Boundary 0 0,07 0.15 0.3 km- No Filled D Tax Parcels (Zoom in to 1:30,000) Sources:Esd,HERE,Garmin,Intermap,Increment P Corp.,GEBCO,USGS, FAO,NPS,NRCAN,GeoBase,IGN,Kadaster NL,Ordnance Survey,Esd Japan,MET!,Earl China(Hong Kong),(c)OpenStreetMep contributors,and the GIB User Community Mason County WA GIS Web Map Application Mason County disclaims accuracy,reliability,or timeliness of website info,not liable for losses from reliance on it.httpsJhvww.masonoountywa.gov/disclaimer.php SOIL LOG#1 *INSTALLER CANNOT SWAP THE PRIMARY WITH THE RESERVE USE SJE RHOMBUS PANEL MODEL TDW914H4D8AC21E SOIL TYPE: OR IFS11W114H4AD8AC17J AND FLOATS. PROPERTY OW ER NOTE: 1 a°>°q1"' v u°m m�r`eap e�"lotwan°a""p+lo IY'-24":OLD FILL *PROPOSED 3-BR HOUSE WITH A4-BR OSS Ne IwnelOilRy of Na propeM owner. 24"-65"REDDISH BROWN COURSE SAND&GRAVELS SOIL LOG#2 O'5'10' 20' 30' 50' 75' 100' SOIL TYPE:1 0"-12`.OLD FILL I SCALE(FEET) 12"-65"LIGHT BROWN COURSE SAND&GRAVELS SOIL LOG#3 APPROVED 0°-15":OLD FILL I»E �i 15"-48"LIGHT BROWN COURSE SAND&GRAVELS ICE DESIGNER 10 12l15 APR 302026 0 2026 SOIL LOG#4 SO 12":OL:1 MASON COUNT`(ENVIRONMENTAL\-IEALTH 0°-1 Z":OLD FILL 12"-48"LIGHT BROWN COURSE SAND&GRAVELS RET 674.00' -- - C-. - 1 .50' G t :;a'• EIIST07a t144"ra'•w:?: _ 4�c�p' ad><.�' OAMOE �lv ,I,•• '� .'� TAN1. ", .. •.•.::� • taNq B0TFD,foN€..;':. O J 'O b 11'11 00�-_...•i.._• :.:�i.-;,,.._ °Q�° 2V ,`.d'. '. ffi -':;%R:.•.r...••••: Q-per �•F- F.�: o '1i a? 1 41m 70p.,5REli-51 q ''•�: l p PARCEL 2427,-57-0104/ �� I ��$' •••'�°:,• 'ar'="ern-,�%_ � •_ o 1se.D R' -1 667.52' PRIMARY DRAINFIELD PARCEL 22211-01-01022 ELEV,4' TH/C I. NOT A C /FZV Y ALL PROPR7Y L/NES/BUNOAR/ S 1-1.4 t' I WATER USE DISCLAIMER: BEEN OEMONSTRATEO BY THE OWNERS)ANC'/OR THE/R AGENT(S)_ Era1ERLkMMOr5ElflRIpgoPARD0EARA.0S OW I TA RIPY THAT wATHR ulue LopATION AT TIMH or INaTALL ME@rB ALL oop@�ea @r . ks REE04TOSERELOG7oo,RAWRFASONH74EDEnER T 19 THH RE9P N9I BILITY or O NCR/ HP RHB ENTINa AOHNT TO PROVIp@-ro CIV1fl IN WRITING COES0YESAILFRMCPLRESFONS OSW ANY ANO ALL INFOR TION P RTINHNT TO THH O VELOPMHNT OP 9QPT10 FHASIBI LITY ANp/OR OEBION INCLUOINO ALL GRAY/BIJ\CK WATQR STUB OUTS,UTILITY LOCATIONS,PROPERTY pIMHN9 ONS LEGEND' MEN910Ns,EAs@MHNTS,BUPP@RB ANO 9@TBACK9 REOUIR@p BY OOV@RNINO OR R@OULATING ENTITI@s AC M E D E S I G N 'RY W@ATHQR INSTALLATION ANp BITE PREP RHOUIREO. I - OT PRIMARY ANp RQS ERV@ pRAINPIELO ARPJas FROM ANY VHHIOLQ TRAFFIO. �' SOIL LOO N OATION sPOILa OR BU RNINO ON p ---• �NO BUILO 20NE -OUQ TO UN PORES ECN WATER TABLES,A CURTAIN@O RAIN MAY BE RCOUIREp. -oEPENpINO UPON PINAL @LQVATIONS.A PUMP MAY HE RQOUIREO. CLEARING LIMITS DATE- 8 APRIL 2026 OT ALL pOWnISPOUT/SURPAGH WATER AWAY FROM oRA1NFIHLp ARE'AB. r LOW AREAS iF OF LAT@RALB OR MOD E9 ARE pHPICTEp EY AR@ APPROXIMAT@ ANO MAY VARY, ,�� TREES r,a-CIA P.O.BOX 2954 PROVIOHp THQY RQMAINLIN THH pCLINP.ATEO CP AREA. NAME- ROVER SILVERDALE, W WA. -ALL WELLH WITHIN'I00 PEE-OP PROP.BOUNOARIH9 FIAV@ D@@N©MOWN caob•PGR cLA99_B WA vHRT. (D =CLEAN OUT 98383 CXCEPT POR THH OIBP@R9AL OOMPONCNT.ALL SEPTIC OOMPONHNT9 MUST BQ AT@RTIOHT TO'9URPAp@. TAX ID- 22211-51-01023/22211-51-01022 WATER LIN@ MUST BC A MINIMUM OF,o•FROM ANY sQPTIC coMPON@NT. Q =1500-GAL SEPTIC TANK _ O•BHTBACK p0 NSLOPH OP I_PIT9.MINI UM OF 1O•SETBACK LFPBLOPH oP I_PIrB. 4901&4903 NE N0RTIISN0RE RD QEO ANp MULCHH PINAL pRA FIELO COVER IMMHOIAT@LY UPON ooMPL@TION. =15OO-GAL PUMP TANK STREET- TEL.360-698-8488 pHP@NOINO ON THH TYPE OF ATU VB@p,ATRA9H Ti3P.P MAY BH REOUIR@p. � _ RAL9 MAY o CLOSER THAN--ON------(MAY OIPPHR WITH B pB1. O =SPLITTER SCALE: 1 =40' SITE PLAN INF0@ACMESEPTIC.00M IF WATER ANp S R LINES CR09s,THEY MUST BH CONSTRUCT@O IA LINTY COON. 4SflNEfl ACME DESIGN EXPIRES 121i51.i,) DATE- 8APRIL2028 P.O.BOX 2954 NAME- ROYER SILVERDALE,WA. TAX ID- 22211-510102322211-51-01022 98383 STREET- 490184903 NE NORTHSHORE RD TEL.360-698-8488 SCALE:1"=60' SITE PLAN INFO@ACMESEPiCCOM v m av�v vm tm SCALE(FEET) 674 00' /i:___ __ __ ___ 'r eetm• rnaMrcuvos,n /Mt6t>7rdiam] ,mod APPROVED APR 302026 MASON COUNTY ENVIRONMENTAL HEALTH RET ACME DESIGN 8' X 60' BOTTOMLESS SANDFILTER DATE- 8 APRIL 2026 P.O.BOX 2954 NAME- ROYER SILVERDALE,WA. FINISHED GRADE TAX I D- 98383 22211-51-01023/22211-51-01022 STREET- 4901&4903 NE NORTHSHORE RD TEL.360-696-8468 INF0@ monitoring ports ACMESEPTIC.00M PERCENT SLOPE IN PRIMARY: 0"/0 /b 12"INFILTRATOR OR GRAVEL BED AND DISTRIBUTION LATERALS MAXIMUM TRENCH DEPTH: 23 Inches /[�/���� IIII���''J 17 �oawxuoPeuoeuraunurtxtsl y LL I] Q VERTICAL SEPARATION: �r�° Inches ' TRENCH WIDTH: 96 Inches 18"VERTICAL SEPARATION ADDITIONAL COVER REQUIRED: InU:es APR 3 0 2026 RESTRICTIVE LAYER E� � L'M F81eNEq MASON COUNTY ENVIRONMENTAL HEALTH EXPIRES t2ils ORIFICE SPACING 24 " 60' 12"INSET FROM SIDEWALLS 12"INSET SPLITTER OOOOOOCOOOOCCOOOCCOCOCS 1.25" PVC TERAL 2"PVC MANIFOLD O•--MONITORING PORTS LA MONITORING PORTS--►Q $' 30 MIL PVC LINER TRAN PORT LIN II ORIFICES ON 2'CENTERS AT 12 O'CLOCK WITH ORIFICE SHIELDS 4°MONITORING PORT &BLOW OUT 4" MONITORING PORT 3/4"MINIMUM, PRESSURE TREATED PLYWOOD(OR EQUIVILANT) BACKFILL CU GRADE �TO TOP OF BOX 30 MIL PVC LIN LI BACKFILL 12" INFILTRATOR OR GRAY L BED AND DISTRIBUTION TERALS 24" 24"APPROVED SAND FILTER MEDIA 47 „ 18"+VERTICAL SEPARATION POSSIBLE WATER TABLE