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HomeMy WebLinkAboutSWG2026-00294 - SWG Application / Design - 9/11/2026 dtAMASON COUNTY 415 N 6TH STREET.SHELTON WA 98584 SHELTON: SHELT9670.EXT 400 BELFAIR.360-2754467,EXT 400 Public Health & Human Services ELMA:360-482-5269 EXT 400 FAX 360-427-7787 On-Site Sewage System Permit: SWG2026-00294 APPLICANT PAYSSE ROBERT H &PATRICIA Phone: 1.360.426.1803 Address, 3083 E MASON BENSON RD GRAPEVIEW,WA 98546-9704 OWNER PAYSSE ROBERT H & PATRICIA Phone: 1.360.426.1803 Address: 3083 E MASON BENSON RD GRAPEVIEW,WA 98546-9704 SEPTIC DESIGNER BOB PAYSSEt Phone: 360-507-1498 Address: 3083 E Mason Benson Road GRAPEVIEW,WA 98546 Site Address: 1895 E PICKERING RD Primary Parcel Number: 221331 290041 Permit Description: New 3bd gravity trench Permit Submitted Date: 09108/2026 Permit Issued Date. 09/11/2026 Issued By: Rhonda Thompson Current Permit Fees Paid'. $570.00 (addmona fees may be rewired upon...dI Ibn or sys,om). Permit Expiration Date'. 09/09/2029 /based on date of inspection) Permit Conditions: l 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 Grainfield installation not to exceed designed ups/ape 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. OFRCIAL USE ONLY MASON COUNTY D"T`"EL`MED' d og zL Public Health & Human Services AMDUNTeeEFIVTDD 7Q �r ar �Tt W N O CO Environmental HealtM13W1,WA96TO,e#AW w36PP5i46T,pR,GpO �q� Ty Z CO aU N.6th Street Shelton,WA 98580 0111/0 VVa-_' O 0 SWG _' ON-SITE SEWAGE SYSTEM APPLICATION a 's APPLICANT PHONE m RI m ROBERT H. PAYSSE 360-507-1498 MAILING ADDRESS-STREET CITY STATE,ZIP CODE 3083 E MASON BENSON RD GRAPEVIEW WA 98546 m SITEADDRESS-STREET CITY.ZIP CODE [d 1895 E PICKERING RD SHELTON WA 98584 ro NAME OF DESIGNER PHONE ROBERT H. PAYSSE 360-426-1803 N NAME OF INSTALLER PHONE TBD PERMIT TYPE(aNBG wre) DRINKING WATER SOURCE H W IiI RESIDENTIAL 055 Fl COMMUNITY OSS tiCOMMERCIALOSS I PRIVATE INDIVIDUAL WELL 9 PRIVATE TWO-PARTY WELL O Y 2 I W TYPE OF WORK(Select ) y., PUBLIC WATER SYSTEM W NEW CONSTRUCTION/UPGRADES tIREPAIR/REPLACEMENT OTHER DETAILS(Select au hat apply) 13 TABLE X REPAIR I I � SUBMITTALS 0 SURFACING SEWAGE ❑ EXISTING FAILURE O SHORELINE F4 DESIGN FORM(REQUIRED) ig SEPTIC DESIGN(REQUIRED) BEDROOMS LOTSIZE WAS LOT CREATED AFTER anrzassT p IN 5 WAIVER(S)(IF APPLICABLE) 3 1 AC YES Q NO n DIRECTIONS TO SITE AND SITE CONDITIONS (ex.IOCMO9ale) x N HWY 3. RIGHT ON PICKERING RD. CONTINUE TO SITE ADDRESS ON LEFT. USE CJ ACCESS ROAD JUST AFTER FIRE STATION TO ACCESS, SEE SITE PLAN. o 1 ° 5th E MUST BE FLAGGED FROM MAIM ROAOAND TEST HOLES MUST 9E FLAGGED WITH TEST/IDLE NUMBERS. I I A OFFICIAL USE ONLY BELOW THIS LINE UPGRADE/FAILURE SOURCE I(or reporting WTMea) ❑VOLUNTARY ❑MAINTENANCE/PUMPING 0 BUILDING PERMIT OH0ME SALE (]COMPLAINT O0THER: INSPECTOR SOIL LOGS COMMENTS I CONDITIONS : 0 -6u Ln cf k 44o ttz : 0 -A LJvS, t+- ow SOIL CODES: RECORD DRAWING AND INSTALLATION REPORT V=VERY G=GRAVELLY S=SAND L=LOAM Si SILT C=CLAY E=EXTREMELY R=ROOTS REQUIRED FOR FINALAPPROVAL. INSPECTOR SIGNATURE DATE APPLICATION EXPIRATION DATE APPLICATIONAPPROVEDI ISSUED 9Y DATE � � qj � � � � l clillIZ,g THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSFTE Revised:4/14/2025 DESIGN FORM—PAGE ONE Assessor's Parcel Number: 2 2 1 3 3 1 2 9 0 0 4 1 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. 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 suer ll"X 17" PARCEL IDENTIFICATION Permit Number; SWG �--gyp — C ) % tA Designer's Name: Bob Paysse Applicant's Name: Robert H.Paysse Designer's Phone Number: 360.507.1498 3053 E. Mason Benson Rd. Designer's Address: 3083 E.Mason Benson Rd Mailing Address: Grapeview We 98546 City State Zip Grapeview We 98546 City State Zip Designer's Email pioneerdigging@yahoo.com DESIGN PARAMETERS Treatment Device ❑Glendon ❑Sand Filter ❑Mound 0 Sand Lined Drainfield 0 Recirculating Filter ❑A.T/U ❑Other Treatment Level(check all that apply): D A ❑B ❑C ❑BLI ❑BL2 0 BL3 CJ E ❑N Drainfield Type IeGravity ❑Pressure Trench ❑Bed ❑ Sub Surface Drip Septic Tank/Drainfield Specifications Laterals Number of Bedrooms 3 Schedule/Class 2729 Daily Flow:Operating Capacity 270 gpd Length 40 ft Daily Flow: Design Flow 360 gpd Diameter 4" in Septic Tank Capacity(working) 1500 gal Number 4 Receiving Soil Type(1-6) 3 Separation 9 ft Receiving Soil Appl. Rate .8 gpd/ft2 Orifices Required Primary Area 450 ftr Total Number of Orifices N/A Designed Primary Area 480 ft Diameter N/A in Designed Reserve Area 480 ft2 Spacing N/A in Trench/Bed Width 3 ft Manifold Trench/Bed Length 160 ft Schedule/Class 3034 Elevation Measurements Length 30 a Original Drainfleld Area Slope 3 % Diameter 4 in New Slope,If Altered N/A / Preferred manifold configuration used? IIr Yes 0 No Depth of Excavation Up-slope 25 in Transport Pipe from Original Grade Don-slope 24 in Schedule/Class 3034 Designed Vertical Separation 36+ in Length 85 ft Gravel-based Drainfield Required? ErYes 0 No Diameter 4 in Pump Required? ❑Yes Pf No Dosing and Pump Chamber Pump/Siphon Specifications Number of doses/day N/A Diff, in Elevation Between Pump&Uppermost Orifice N/A ft Dose quantity N/A gal Drainfield Squirt Height/Selected Residual(head) N/A ft Chamber Capacity(flood) N/A gal Uppermost Orifice Er Higher D Lower than Pump Shutoff Pump controls:Please check those required. Capacity @ Total Pressure Head N/A gpm ❑ Timer ❑ Elapse Meter ❑ Event Counter Calculated Total Pressure Head N/A ft If Timer: Pump on N/A ,Pump off N/A Comments Revised:6/11/2025 DESIGN FORM—PAGE TWO Assessor's Parcel Number: 2 2 1 3 3 1 2 9 0 0 4 1 Permit Number: SWG )-c C, — DESIGN CHECKLISTS Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch If Test hole locations V Drainfield orientation and layout Reference depth from original grade: V Soil logs V' Trenchibed dimensions and Q' Septic tank g Property lines critical distances within layout 8' Drainfield cover Existing and proposed wells lr D-Box/Valve box locations Reference depth from original grade within 100 ft of property V Septic tank/pump chamber and restrictive strata: V Measurements to cuts,banks,and locations V Laterals,trench/bed,top and surface water and critical areas Er Observation port location bottom V Location and orientation of V Clean-out location ❑ Curtain drain collector curtain drain and all absorption E( Manifold placement ❑ Sand augmentation components ❑ Orifice placement VLocation and dimension of Other cross-section detail, primary system and reserve area 9 Lateral placement with distance 9 Observation ports/clean-outs to edge of bed Buildings Other Information ❑ Audible/visual alarm referenced Yes No V Direction of slope indicator fif Scale of drawing shown on scale e O Design staked out Waterlines bar O ❑Recorded Notices attached Roads,easements,driveways, frT Elevation benchmark and relative ❑ ❑ Waiver(s)attached parking elevations of system components O O Pump curve attached North arrow and scale drawing ❑ ❑ Evaluation of failure shown on scale bar Non-residential justification ❑ ❑ Waste strength ❑ ❑ Flow DESIGN APPROVAL The undersigned designer must be notified by installer at time of installation eYess O No Signature of Designer flate 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: Environmental Health Spe 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: 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. 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 110' SETACK / FROM WETLAND JTOW __ ��� FUTURE I / / \ BUILDING FUTURE AREA 2-PARTY WELL r ♦ r I I a+ I \� OA I io Rso. \ y O 60'ACCESS & \\ / 1 UTILITY EASEMENT k 'D� / (FROM PICKERING RD) --- \ O' / \(\ ij X PROPOSED 3 BEDROOM IL 45' yI PRIMARY & RESERVE I QA = CLEANOUT - © = 1500 SEPTIC TANK III +I N 1 N OO \ e y 1 / 4, RS I o' I I a>'...RDC5..(F W:ESE •. I I \ FUTURE E;PI�:-' 1 \ 2-PARTY WELL i, CUSTOMER: ROBERT H.PAYSSE TEST HOLE 1 TEST HOLE 2 �N\ PIONEER PARCEL: 2 2 1 3 3 - 1 2 - 90041 0-65 LMS 0-65 LMS DIGGING INC. ROOTS©30 30 ROOTS @30 30 \ A� SITE: 1995 E PICKERING RD ROBERT H.PAYSSE,DESMNER SHEET:SITE PLAN SCALE: 1"=50' OISCLVNER: TNIS u um Sumer. REFERENCES CWOE 3083 E MASON BENSON RD POSCS &Y. GRAPEVIEW WA 96546 T EOFOOSEEIEEEDEVELOPMENT FELOPME TxMMAY 01.4 SUBJECT T TO OTNFR OElta ENTIAGENCCYY REVIEPROVIDED DESIGNER NOT J80i]F1003 I0 F0 I� TO SZPTIO 1500 SEPTIC TANK BM S/T INLET 5/I INLET (21.0) S/T0IRIET 124.0"I I IATERAL1 (240) IATERAL2 (24.0 ) IATERAL3 (2401 4"3034 IArERALa (2ao) D-BOX I WI ACCESS TO GRADE � 5 I 40 PRIMARY W O a- O 1 40'RESERVE J <n 40'PRIMARY b 4" 3034 J 40 RESERVE j I 40 PRIMARY b 40'RESERVE 40' PRIMARY P� . o 2 40'RESERVE sw31 ecee¢rx lSw 08 PORTS CUSTOMER:ROBERT H.PAYSSE TEST HOLE 1 TEST HOLE 2 N\ [:DIGGING IONEER I PARCEL: 2 2 1 3 3 . 1 2 - 9 0 0 4 1 0-65 LMS 0-65 LMS INC. ROOTS©30 ROOTS @ 30 AJ SITE:1895 E PICKERING RD ROBERT N.PAYSSE,DESIGNER SHEET: DF DETAIL SCALE: 1"-10' DMCLAIM THIS M REx INCLUDE:NOT A SURVEY. REFEOES LUDE KPtICANTICOUNTY PROVIDED a IE OR 3083E MASON BENSON RD SURKYs FIELD MEASDREMEYTS NNW COOMY DIS DESIGN INTENDED FOR SEPTIC PURPOSES ONLY. CRAPEVIEWWA OSMO PROPOSED DEVELOPMENT ]O.428-18O33 10 U.5 11 —12 RESPONSIBLEFR BETEVCKS UNRELATED TO SEPTIC COMPONENL6 ExigGENCY REVIEW DESIGNER N. CLE NOOTav ExSURREv SERISS &ELDID TO FITO TANK&-E-IQ GRADE FINISHED?RA DE TO PUMP GHT GONNECFIONI__\\ TANK OR OF FL DOGBUILDINGWATERTIGHS >• JOINTSALlON5EJTIC TANKEt STATE NIK uno1iw KRER UREcTio�ER4 ORNCO2. Y d Kr( OB. PORT Ate.,:: it P; �" ORIGINAL& RISER/LID FINISHED GRADE EAFn TO FINISHED GRADE USE FILTER SPEED I FABRIC � I LEVELERS D-BOX N I y .X .I n TO j EQUALIZE FLOWS TO FINISH TO FINISHED GLUED TEE GRADE I WASHED ROCK I 36 I I I O O D-BOX I VERIFIED DEPTH I CUSTOMER:ROBERT H.PAYSSE TEST HOLE I TEST HOLE 2 �N\ PIONEER PARCEL: 2 2 1 3 7 - 1 2 • 9 8 D g 1 0-65 LMS 0-65 LMS DIGGING INC. ROOTS©30 ROOTS @30 \ A� SITE: 1895 E PICKERING RD ROBERT H.PAVUBE.DESIGNER SHEET:DETAIL SCALE: NA Ee: Tnu I.NOT A ORVEY.. R e uxlwx DT,eourm RROVIOED Pars OR 3083E MASON BENSON RD SURVEYS,F EASUREMENTS AND COUNLV OI5. DESIGN INTENDED FOR SEPTIC PURPOSES ONLY. GRAPEVIEWWA 0846 PROPOSO DEVELOPMENT MAY BE SUBJECT TO OTHE0.tNETMEMUOENCY REVIEW. NOT 360426-180360426-1803p,i Ii 2 RESPONSIBLE FOR SETBACKS UNRELATED TO SEPTIC COMPONENTS. General 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 EW 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&lines, unless approval within design/permit provides a reduced setback. Additional sleeving&install details may apply on reduced setbacks granted. 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 Soft downslope and loft upslope of drainfield areas. 12. Field staking and measurements taken are approximate. Installer may need to re-stake/layout drainfield laterals/beds prior to installation, level w/contours using a laser level in order to maintain the approved depth of excavation. Contact designer w/any problems related to drainfield layout prior to attempting installation. 13.All onsite septic systems require regular maintenance to verity 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 received after installation approval. 14. System owner should be cautious of landscaping around septic components. Root intrusion can cause premature failure of the drainfield area. In addition, bushes and trees should be kept away from lids and other septic maintenance points. 15. Changes made at time of installation may Impact designer calculations, pump sizing,and compliance w/county and state requirements. Contact design prior to install w/any proposed variations from design. Changes may result in additional fees& permitting. 16. 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 mayor may not meet other requirements. CUSTOMER:ROBERT H.PAYSSE PIONEER PARCEL: 22133 - 12 - 90041 " DIGGING INC. SITE: 1895 E PICKERING RD „>n aoeEal x.rnrvs,oesiosEn SHEET: NOTES SCALE: NA �>; Fee=_ar wrasE 3W3EMASONBENSONa HRE'RY _Y " GRAPEVIEW WA B5ifi aeouctew as EY,FIn