HomeMy WebLinkAboutSWG2026-00196-APPLICATION/DESIGN - SWG Application / Design - 8/14/2029 MASON COUNTY 415 N 6TH STREET,SHELTON,WENT 400
SHELTQN:360-42]-96]0, E%T 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: SWG2026-00196
APPLICANT Ehlert, Jacob Phone: 360-551-3963
Address: 538 SE Dogwood rd Port Orchardq,WA 98367
OWNER CLARK-GETZIN REVOCABLE LIVING Phone: 360-620-9960
TRUST
Address: DANIEL L GETZIN &WENDY A CLARK CO-TRUSTEES PORT ANGELES, WA 98362
OWNER APPLICANT Cryder, Kyle Phone: 3606209960
Address: 12271 Orchard Ave SE Olalla, WA 98359
SEPTIC DESIGNER Jim Zimny Phone: 360-516-7287
Address: 7178 windflower pl nw Seabeck, WA 98380
Site Address: 1552 E Trails End Dr
Primary Parcel Number: 222237790022
Permit Description: New 3BR SIR Gravity WI Class B Waiver
Permit Submitted Date: 06122/2026
Permit Issued Date: 08/19/2026
Issued By: Jeff Wilmoth
Current Permit Fees Paid: $570.00 (additional fees may be required upon installation of system).
Permit Expiration Date: 07/17/2029 (based on data 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 Dutiful 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.
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/environmentallonsiteloss-inspection-request.php or call:
360-427.9670,extension 400.
MASON COUNTY 95N6 SHELTON: ,6427-96 ,EXT 404
SHELTON:36042]-96]0,E%T d00
BELFAIR'360-275-4467,EXT 400
Public Health & Human Services ELMA:360462,5269,EXT 400
FAX:360-427-7787
7 Mason County Asbuilt Form, Record Drawing, and Installation fee must be submitted for
final installation approval.
8 This septic permit does not permit timber to be cut or removed on the property. Cutting of
more than 5,000 board feet of timber(including live, dead and down material) for personal
use only(i.e., firewood, fence posts, etc.) in any twelve-month period will require a Class
IV-General Forest Practices Approval(FPA) from Mason County. Removal of any timber
from the site will require a Class IV-General FPA from Mason County.
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.
-- OFFICIA,.USF ONLY ___ —
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MASON COUNTY D"REGR oce Q- d N
Public Health & Human Services AM� Rw O w o m
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ON-SITE SEWAGE SYSTEM APPLICATION 3 A
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APPLICANT PHONE I L�
KC Home Services Inc 360-620-9960 tin c
MAILING ADDRESS-ST REF r C!TV TATE ZIP!XDE j _.____ N
12271 Orchard Ave SEj Olalla WA 98359 I
SITE ADDRESS-STREET OFF nP CODE ti ..
xxxx E Rasor Rd West, Belfair WA 98528 I
NAMES DESIGVLR PNGNE O
Jim Zimny 360-516-7287NAME O INSTALLER P �~' I�--
T
o m oTJLY
Final Vision Inc 360-801-5681 ≤r,
PERMITTYPE(eka+e! DRINKING WATER..OVRLL o
•RE ILFNI IALOS5 r1 CUMMOINTY055 IiCOMMEHOAL055 ❑ PHVIE INLYVIOVALV€..LL ❑ PRIVATE TND-PARTYV..LL OZIN
PE„F nDRn : r, .Y, 11 PuBLIC WATER sys•EM HaODVTra11SjeUrnnin 5
■NEW CONSTRucTION I U'GRADES n REPAIR.'REPLACEMENT OTHER ISP Tt IT mcrr "> ❑ TABLE z e=PA.R I�j
LeMIrrAI s ❑ SULR ACING SEWAGE ❑ EXISTING FAILLRE O SHORE LN=_
LEI GN bORM HEQUIRELS •5EP1I.JL DDN IREGUIREDI BEL OOMS _O1 SIZE LOT CR E AF EN J V.4" 5 I
■ WAIVER1S I FAP'JCASLL 3 1.06 QYEe flNc 0
D'REOTIDNS O SITE AND 3RE COND'TION5 R. h dwri
From hwy 3 in belfair turn onto WA-1 06 W and drive for several miles and turn left on E I
Trails Rd for 1.3 miles then turn left onto E Trails End Dr and at 0.4 miles turn left onto E r
Rasor Rd and the property will be on the right about .7 miles down. See pink ribbon hanging °
on the trees off of road for trail into test holes (pink ribbon adjacent to mail boxes). This
ribbon also leads to a second parcels test holes (both applications submitted together).
S TE MUSTS FLAGGED FROM MAIN ROAD MD TEST NOTES MUST BE FLAG OIMP'TEST NOLENI.9 'cR5. I rT
• UFFCIAL USE ONlY ORU0,--1ISi NE -
T�
UPGRADE LAnuRE SOUR
CE ace llo- ePPn, m�.c w� .
V O UNTARY Q MAINTENANCE,PUMPING Q P.TLDING PERM°T Q HOME SALE I]COMPLAINT ❑DIRER
INS PTLTDN=a_. 5 M Mb;LTITDNoI:ICNS
RECORD DRAIMNG AND INSTALLACON REPORT
V=VERY G=GRAVELLY S=SAND L=LOAM 9=SIL1 C-CLAY E=EXTREMELY R=ROOTS REOVIRED FOR FINALAPPROVA:
I SPECTOR 6IONATURE DATE APPLICATION EXPIRATION DATE APP TION APPROVEDI ISSUED BY DATE
? I 7- IV - Z -(4—
I M MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTYWEBSITE RRvised 0110912026
DESIGN FORM—PACE ONE Assessor's Parcel Number: 2 2 2 2 3 7 7 9 0 0 2 2
A design will he reviewed when 3 copies of each of the following are submitted:
Completed design thrill that has been signed and dated. ' Scaled Iucout sketch_including all applicable items on checklist.
Scaled plot plan_including all appliicahie items on checklist. ' Crow-xdinn sketdt_including all applicable items on chakhat.
This form may be scanned and available for public view on the Mawr County Web Ste.llrrrimum pu/Per _-r 1/ 117"
PARCEL IDENTIFICATION
I' niitM1orbm. SW G an -- oo 101 t,Dcxi nr-Name: Jam Zimny
Applicants Name KC Home Services Inc Dcxi n r I hone Nuniher 360-51&7287
Marling Addre . 12271 Orchard Ave SE ])emgner AtIcIrcsz 77i76W,ndfiower PI NW —
Olalla_—_— WA 98359 (,'dc Slate /ip So beck WA 98380
City Stain lip Designers Email apddesignsioloud coin
DESIGN PARAMETERS
Treatment Device
❑Glendon ❑ Sand Filter ❑ Mound ❑ Sand Lined Drainfdd ❑ Recirculating Filler ❑ All ❑Other
Treatment Level wean all that apps.r 0 A ❑ H ❑C ❑ ell U HI3 ❑ HI 3 jF 0 N
Drainticld Type
�llricil' ❑ I'm ensure 'french ❑ I led ❑ Sae Surface Drip
Septic T nk/Drainfield Specifications Laterals
Nilmber iii edrooms 3 Sdi,d tack'his, 3034
I)aih 1 Ioa. ()perming('apaeih 270 girl Length 50 tt
I)Li l I'loa. Uoian I 360 gpd Diameter 4 in
Septic'fank Capacih rnorkuiel 1250 gal Number 4
Receiving Sail l,pc I I-6) 4 Separation 5' Ctc ft
12ca-icing Soil Appl. Rate 0.6 gpd/fr Orifices
ii Ili nPniIIan Area 600 R- 'Lola] Niiiiihern 1 Oril Fes NA
DcigncdI i 1-v 600 rC ])jumneter in
I R 'e Area 600 it Spat i re `Tp in
rcn:hiBcd N ld lh 3 ft 'gym Manifold
I renc1J13ed Lcnath 200 fl ti h dt ihaiti j) NA
Elevation Measurements 1 n ' -
u
Oriin:d UruinGrll Area Slope 11 Uim
Nm, Slel>z_It Altered 11 „ l'rclrred nlanilold conligumtion used 9 C Yc O No
uapai ui laces,an-, rn- iJi 16 in Transport Pipe
Is....Vritnnnl Gmdo Doamelora 12 in Schedule/Class 3034
Designed Vertical Sepambol, 18 in I.cngd, 35 ft
thn,el-laid Unanteld Required.' 0 Yes No Ulmncer 4 in
I'trmp Required'' 0 Ye III No Dosing and Pump Chamber
Pump/Siphon Specifications Number of dosce/day
Dial is I Iccation l3dwacn Pump k Ilppernost Oriticc III Dose yuaNit, gal
Dminlleld Sgalrt lleighV Selected Rcsidualfhead I _ t C'lianiber Capacih lflood gal
flppumost Orifice 0 Hiaha 01 m er than Pump Shutoff Pump controls Please cheek those required.
Capacih a Total Pressure I lead gpn, 0 Tinier ❑ Elapse Meter ❑ Iicunt Counter
Calculated l oval Pressure l fwd It It tuner' jut on t} tl
Comnientx
AUG 19 2025
k - ..n_v. . R ,6c& 6/11/2325
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DESIGN FORM—PAGE TWO Assessor's Parcel Number 2 2 2 2 3 7 7 9 0 0 2 2
Permit Number swG cc (-
DESIGN CHECKLISTS
Scaled Plot Plan Scaled layout Sketch Cross-Section Sketch
dl Test hole locations V Drainfield orientation and layout Reference depth from original grade.
Soil logs fIt Trench/bed dimensions and fjd septic lank
J6 Property lines critical distances within loom I( Drainfield corer
Existing and proposed%ells D-Box/Valve box locations Reference depth from original grade
within 100 ft of propene Io Septic tank/pump chamber mid restrictive strata-
Measurements to cuts, banks-and locations � Laterals_trench bed.top and
surface water and critical areas Observation port location bottom
Location and orientation of V Clean-out location O Curtain drain collector
curtain drain and all absorption O Manifold placement O Sand augmentation
,.,r components ❑ Orifice placement Other cross-section detail
p Location and dimension of V Observation ports/cleanouts
Lzteml placement with distance
primary system and reserve area to edge of bed
g Other Information
Buildings O Audible/visual about referenced Yes Nn
jQ Direction of slope indicator 1 ❑ Design staked out Scale of drman town on scale
Waterlines bar � O O Recorded Notices attached
✓ru Roads,casements.drivel m s. � Flcr ation b, h. ad relative ❑ O Wan er(s)attached
parking eleratlnn, y f nponents O ❑ Pump curve attached
✓xi North arrow and scale drawing O O Ey altlatloa of failure
show on scale bar f� Non-residential,justification
4 C' rn � ❑ O Waste strength
DE GN APPROVAL
'fhe undersigned designer must be notified b} ut5(al'cr at Aunc pl installation YJ Ycs ❑ as 7 R ® p r a�
1®/ E - -
Signat gne ure oC e rT Date AUG 192926
The undersigned has reviewed this design on behalf of Mason Count., Public Health and detenameri it -
compiiance 1,idt state and local o 'Ic reeularions JB {
)/k-2CP
Fire—rn n u al Health Spccii I [)ate
CAUTION: DESIGN APPRO AL IS VALID ONLY UNDER THE FOLLOWING CONDITION:
✓ The design is stamped"Approved' by Mason County Public I Icalth.
✓ The Onsite Sewage Penn it has not expired_the Permit Expiration Date is /— !
✓ Drainfield site conditions ha,c not been altered to adverseh 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 maybe scanned and available for public view on the Mason County Web site. kcc,r�b. 0/I I/2025
Not a Survey oesicxee INFO.
Datum NAD83 llm z,n,ny
7178 Wdi"A 3 e0 NW
LEGEND 98380
b.WA
2 APDdeS os_icloud tarn
Bench Mark 3
DEs13NER STAMP'.
— Property Line el 3531
___.. Power line
Water line
170'
TH 1 - U 3b' brawn sandy- loam -Type 4 Sol I 348' TH2 0 34'brown sandy loan l vpe 4 so IH3U-28'brown sandy loam-Tpe 4 soil p491¼
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3 bd APPIcANT INFO
Parking iy manufactured el 328'
L
i home kC Home Services Inc
® /n �,.. .�1s6rm uCRas rRd N'ig Relish,WA 98528
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/ e 324' cwNr.srnmPRosenp or 16
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E Rasor Rd W
el 317'
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APPROVE
AL�v i 9 2026
P
Advantage Perc & Design
Construction Notes for 3 Bedroom Gravity System
Gravity with graveless chambers(Rock and pipe may be substituted).
Install 4ea 50' Laterals.
Use a 6 hole d-box and speed levelers.
Install laterals on 5'foot centers.
Install 16" trench depth on low side of trench and maintain 18" of vertical separation
Install level and along contours.
Install in dry weather only.
Use 1250-Gallon septic and add risers for pumping and maintenance
System designed for typical residential waste strength sewage onty.
41 IlCENE1$J&tJ6t
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APPROVE
fl AUG 19 202S