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HomeMy WebLinkAboutSWG2026-00232 - SWG Application / Design - 8/6/2026 MASON COUNTY 415N6SHELTON 0427-9N ,EXT 400 S HELTON:360-02]-0670,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: SWG2026-00232 APPLICANT Acme Septic Design Phone: 3606988488 Address: P.O. Box 2954 Silverdale, WA 893 OWNER MCKAY NORMAN D Phone: Address: 101 NE WANDA CT BELFAIR, WA 98528-9443 SEPTIC DESIGNER ROD LEFT* Phone: 360-698-8488 Address: PO BOX 2954 SILVERDALE, WA 98383 Site Address: 101 NE Wanda Ct Primary Parcel Number: 223365400022 Permit Description: Non-Conforming Repair: SFR 2-bedroom gravity system with no designated reserve drainfield area Permit Submitted Date: 07/24/2026 Permit Issued Date: 08/06/2026 Issued By: David Anderson Current Permit Fees Paid: $845.00 (additional fees maybe required upon installation of systeml. Permit Expiration Date: 0713012027 (based on date of hsoecnonl 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 downs/ape 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 Non-conforming septic repair. The septic system may need to be brought into full compliance before future permits can be approved. Detail: Septic system does not have a designated reserve drainfield area. 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 MAYBE 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. MASON COUNTY 415N6 0427-96 7,EXT 400 SHELFAIR 360-O27-9670,ENT 400 BELFAIR:360-2].-446],EXT 400 Public Health & Human Services ELMA.360-49&.369,EXT400 FAX:360-427-]78] 8 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.govlhealth/environmentallonsiteloss-inspection-request.php or call: 360-427-9670, extension 400. OFFICIAL USE ONLY I4 MASON COUNTY �A�' "" o7 (Jx m D C V PECEIVEG: PECEIVEB Bi wm Public Health & Human Services I y SWG o Environmental Health 5fiD4µg9565Is�ex1.<D°OI3fi0D44a5L x1.400ED 415 N. SVeev Shelton, 2 y ON-SITE SEWAGE SYSTEM APPLICATION 3 m PHONE r APPLICANT Bud McKay «, MAILING AO°RESS STREET.CITY 5TATE.2IP CODE S.; O Belfair WA 98528 W 101 NEWanda Ct SITEAD°RESS-STREET LIT'nP CODE , Belfair WA 98528 IN 101 NE Wanda Ct1•1PHONE I N NAME OF DESIGNER 1 360-698-8488 Rod Left G PHONE o NAME OF INSTALLER (n cT) DRINKING WATER SOURCE PERMIT THPE(smoor one) �PRIVATE INDIVIDUAL LL 67 PRIVATE TVV0.EARTY LL Z I � 0 RESIDENTIAL OSS COMMUNITYOSS iJICOMMERCINLOSS PUBLIC WATER SYSTEM LY^M`L°"° TYPE OF WGRH(select One) NEW CONSTRUCTION(UPGRADES ®REPAIR/REPLACEMENT OTHER pr SURFACING SEWAGE o EXISTIfl NG BLE X REPAIR NG FAILURE SHORELINE SUBMITTALS m A ppII Q�II BEDROOMS LOT SIZE WAS LOT CREATE°ARER 4Il2°259 Q DESIGN FORM(REQUIRED) IRu5EPTIC DESIGN(REQUIRED) 2 0.18 Cl rMS 0 YES Qj NO o NIWAIVER(5)(IF APPLICABLE) I O DIRECTIONS TO SITE AND SITE CONDITIONS(ec lovxp.]5am) See map. o IN IN SITE MUST 9E FLAGGED FROM MAIN OP G A ND TES THOS MDLES MUST sE FLAGGED W1TR TEST HOLE NUMBER$. OFFICIAL USE ONLY BELOW THIS LINE VPGMDE I FAILURE SOURCE(far miamons purposes) ❑VOLUNTARY (]MAINTENANCE/PUMPING ❑RDILDING PERMIT ❑HOME SALE ❑COMPLAINT COMMENTS/CONDITIONSR Irv,E SCII`j s� LFS (1 pe4) l3 ? mess ( pe3) to bow i FS (TyR /) 1O Lctl RECORD DRAMNG ANDwsTALLATION REPORT SOIL CODES: REQUIRED FOR FINALAPPROVAL- V=VERY G=GRAVELLY 5=5AN0 VLOAM 51=SILL C=CUY E=E%TREMELY R=POOiS pPTE APPLICATION APPROVED(ISSUED RY INSPECT I TORE DATE APPLICATION EXPIRATIONDATE ZZ THIS FORM MAY BE SCANNED AND AN AVAILABLE FOR PUBLIC VIEW ON T AS COUNTY WEBSITE Revised:4/14/2025 DESIGN FORM—PAGE ONE Assessor's Parcel Number: 2 2 3 3 6 5 4 0 0 0 2 2 Scaled sketch,including all applicable items on checklist. A design will be reviewed when 3 cosies of each of the following are layout e Cross-section sketch,including all applicable items on checklist. Completed design form that has been signed and dateda r size: // X/ Scaled plot plan,including all scanned an ble items on checklist. This form maybe scanned and available for public view on the Masan Cann web site.Maximum L Designer's Name: Rod Left I 00 360-698-6488 permit Number: SWG Designer's Phone Number: Bud MCKay p0 Box 2954 Applicant's Name: 101 NE Wanda Ct Designer's Address: dsle WA 98383 SIIve ox Mailing Address: 98528 City State Zip 6ellair WA info®acmexplic.rnm State Zi Designer's Email Ci Treatment Device / other O Glendon ❑Sand Filter ❑Mound ❑Sand Lined DO n eld❑ BL2 OBL3 0 Rec c g Filter ❑ T E ❑N RU O Treatment Level(check all that apply)' ❑A C B Drainfield Type ❑Bed ❑Sub Surface Drip ❑Pressure ❑Trench Gravity Laterals Septic Tank/Drainfield Specifications 40 2 _ Schedule/Class _ 0 ft Number of Bedrooms - Length in Daily Flow:Operating Capacity gpd Diameter 4 Daily Flow:Design Flow 240 Number �—5 ft Septic Tank Capacity(working) gal Separation �� Receiving Soil Type 0-6) 4Orifices Receiving Soil Appl.Rate gp 06 @ft' n1a 400 ft Total Number of Orifices Required Primary Area nla in 400 ft Diameter Designed Primary Area nla in Fla he Spacing — —' Designed Reserve Area 3 ft Manifold Trench/Bed Width n/a la ss �--- it Trench/Bed Length 135 ft Schedule/C �� Length n/a in Elevation Measurements 5-15 % Diameter �- a Original Grainfield Area Slope 5-15 preferred manifold configuration used? ❑Yes ❑No New Slope,If Altered 38 in Transport Pipe Depth of Excavation UP-11Oe40 from Original Grade Down-slope 30 in Schedule/Class 40 ft 36 in Length in Designed Vertical Separation 20Diameter ��-- Gravel-based Drainfield Required? fd Yes O No 4 Dosing and Pump Chamber ❑Yes 56No Flu Pump Required? NumberofdosSday a pump/Siphon Specifications nla gal pill.in Elevation Between Pump&Uppermost Oritice_fi Dose quantity — gal —ft Chamber Capacity(flood) Dminfield Squirt e Heigh Higher Selected Residual(head) Pump controls:Please check those required. Event Counter Capacity Orifice❑ O Lower than PShutoff pm Cl Timer ❑ Elapse Meter Capacity @ Total Pressure Head ,pump off Calculated Total Pressure Head �--- B I£Timer: Pump on Comments Replacing a root bound system Revised:6/11/2025 DESIGN FORM—PAGE TWO Assessor's Parcel Number 2 2 3 3 6 5 4 0 0 0 2 2 Permit Number: SWG ye� �� -JZ DESIGN CHECKT.ISTS Scaled Plo7trty Test Layout Sketch Cross-Section Sketch 21Test hoV Drainfield orientation and layout Reference depth from original grade: 21 Soil log2! Trench/bed dimensions and Qf Septic tank critical distances within layout V Drainfield cover o Property21 D-Box/Vaive box locations Reference depth from original gradeil Existins Se tic tank pump chamber and restrictive strata:within p locations V( Laterals,trench/bed,top and ❑ Measurements to cuts,banks, and surface water and critical areas Qj Observation port location ❑ Location and orientation of ❑ Curtain drain collector Clean-out location ❑ sand augmentation curtain drain and all absorption ❑ Manifold placement components ❑ Orifice placement Other cross-section detail: Location and dimension ofQ( Observation ports/clean-outs 0 Lateral placement with distance primary system and reserve area to edge of bed Other Information Ql Buildings 0 Audible/visual alarm referenced Yes No 21 Direction of slope indicator ul Scale of drawing shown on scale ❑ 9f Design staked out Ql Waterlines bar 0 i!Recorded Notices attached ❑ 2(W aiver(s)attached id Roads,easements,driveways, V Elevation benchmark and relative ❑ 6(pump curve attached parking elevations of system components ❑ Q(Evaluation of failure 21 North arrow and scale drawing Non-rgsidential justification shown on scale bar ❑ ® Waste strength ❑ Q(Flow DESIGN APPROVAL The undersigned designer must be notified by installer at time of installation Qf Yes 0 No Si ature of Designer Date dt'•"rte, The undersigned has reviewed this design on behalf of Mason County Public.iie th and ine br n compliance with state and local on-site rpu4atonS: Environmental Health Specialist CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CONDD1"1'It1N, : ✓ The design is stamped"Approved"by Mason County Public Health. ✓ The Onsite Sewage Permit has not expired,the Permit Expiration Date is: ✓ 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 Mason County WA GIS Web Map o � N R al M1+s1 12/22/2025, 9:29:15 AM 4'` `e-' ] 1:6,118 0 0.05 0.1 02mi County Boundary 4UC196 1` ` 0. •' • �� 0 0.00 7 0.15 0.3 km No Filled 16 Tax Parcels (Zoom Into 1:30,000) SnumeetEvl.HERE.Gams,Ntenn,alnrv.menlPG0R_GFBCO.uSGS. 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