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HomeMy WebLinkAboutSWG2026-00250 - SWG Application / Design - 9/10/2026 SHELTON:960-427-9MASON COUNTY 415 N 6TH STREET, 0427-9N,WA 98584 6➢0.EXT 400 BELFAIR:360-275-4467.EXT 400 Public Health & Human Services ELMA:360-482-5289,EXT 400 FAX:360-427-7787 On-Site Sewage System Permit: SWG2026.00250 APPLICANT RAICHLE LIVING TRUST MARCUS E & Phone: 314-303-9340 MARY E Address: MARCUS E & MARY E RAICHLE CO-TRUSTEES BELFAIR, WA 98528 OWNER RAICHLE LIVING TRUST MARCUS E & phone: 314-303-9340 MARY E Address: MARCUS E & MARY E RAICHLE CO-TRUSTEES BELFAIR, WA 98528 SEPTIC DESIGNER MICAH HALVERSON* -Olympic Phone: 360-490-6365 Construction Address: PO BOX 698 ELMA, WA 98541 SEPTIC INSTALLER JOHN GILLILAND* Phone: 360-898-4388 Address: 1510 E MCREAVY RD UNION, WA 98592 Site Address: 17511 E State Route 106 Primary Parcel Number: 222125800017 Permit Description. Repair: SFR 3-bedroom OSCAR X02 with OS-50 coils and Declaration of Covenant for OSS (AFN: 2245387) Permit Submitted Date: 08/0712026 Permit Issued Date: 09/10/2026 Issued By: David Anderson Current Permit Fees Paid: $1,015.00 laddmonal fees may be required„Pon installation of system). Permit Expiration Date: 0811012027 (based on dale oL,-I­) 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 un s prior written authorization from Mason County is obtained. pL/\ 4 Drainfield installation not to exceed designed upslope and down lope depth specified on design form. 5 Installer is responsible for obtaining Mason County installation approval prior to backfill of system components. THIS PERMIT MUST BE ONSITE DURING INSTALLATION OF 055. 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/healthienvironmental/onsite/oss-inspection-request.php or call: 360-427-9670, extension 400. MASON COUNTY 416Nfi SHELTON 0427-9N ,EXT 400 BH STREE.360-427-ON EXT400 BELFAIR'.360-275-4467, EXT 400 Public Health & Human Services ELMA 360-482-5269 EXT 400 i_IFAX'.360-427-7787 6 Installer is responsible for obtaining Septic Designer/Engineer installation approval prior to backfill of system components. 7 `Before installing utilities that cross a state highway or road in Washington, you must obtain a permit directly from the Washington State Department of Transportation (WSDOT). No physical work or utility placement is authorized on state highway right-of- way until the permit is fully executed. 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.gov/health/environmentallonsite/oss-inspection-request.php or call: 360-427-9670, extension 400. OFFICIAL USE ON IV-- - MASON COUNTY °"L°"t"LD- AMnuNTPECDvm.. RECDVEDBY: W W Public Health & Human Services peuF 0 z y 415 N- mentre11 1lton,W 9670 WE 400 or 360-2754467,ext 4W SWG & o).-( — oVl z 0 415 N-6th Environmental Street ,Shelton,WA QB504 ON-SITE qFWAflF SYSTEM APPLICATION m PHONE m APPLICANTr RAICHLE LIVING TRUST flfl 314 882-3395 c MNIMGAODRESS STREET.CI]?STATE.ZIP CODEIi PO BOX 3271 E� Belfair Wa 98528 SITE ADDRESS STREET CITY ZIP CODE 17511 E STATE ROUTE 1 Belfair Wa 98528 N NAME OF DESIGNER PHONE Micah Halverson �� cP _ 360-490-6365 C—� HONE p N NAME OI INSTALLER JOHN GILLILAND 360-490-4388 PERMIT TYPE(s&Z,U one) DRINKING WATER 60URCE 0 AI RESIOENTlAL 05S rI COMMUNITY OSs IT COMMERCIAL 058 IT PRIVATE INDIVIDUAL WE LL ❑ PRIVATE TNq PARTY WELL IZ IN TYPE OF woR%(saect one) I2 PUBLIC WATER SYSTEM flNEW CONSTRUCTION I UPGRADES IJL REPAIR/REPLACEMENT OTHER DETAP.S(selad all lhat apply) ❑ TABLE X REPAIR I � ❑ SURFACING SEWAGE 10 EXISTING FAILURE IA SHORELINE SUBMITTALS T O srl DESIGN FORM(REQUIRED) SEPTIC DESIGN(REQUIRED) .7 eEONOOM5 LOT WAS LOT CREATED AFTERmvx025P WAIVER(S)(IF APPLICABLE) 3 .74 ❑ YES QI NO O DIRECTIONS TO SITE AND SITE CONDITIONS (ax locke09atey Approx. .33mi east of sunset beach grocery. Test holes are marked with pink ribbon 0 o SITE MUST BE FLAGGED FROM MAN ROAD AND LEST HOLES MUST BE FLAGGED WITH mST ROLE NUMBERS.. v OFFICIAL.USE ONLY BELOWTHIS LINE— - -__ -- - UPGRADE I FAIT URE SOURCE tor repoflg purr Seel ❑VOLUNTARY OMAINTENANCE/PUMPING LI BUILDING PERMIT ❑HOME SALE OC0MPLAINT DOTHER. ,I COMMENTS)CONDITIONS INSPECTOR SOIL LOGS rirc (r pe-!) 7N i32 42' &cc ((iMRGcftsr( Res* Z7 QCS+ A}47 ' `"( Mph TI}L. 0"s3 SsI_ (TY{ c) fo bo{forq fIf3=U- II " F3h1 11-41 " (15L tII`a .% (isc (om$gcftd 'Mbcfbn RECORD DRAWING AND INSTALLATION REPORT SOIL CODES'. REQUIRED FOR FINAL APPROVAL. V-VERY G=GRAVELLY S=SAND L-LOAM Si SILT L=CLAY E=EXTREMELY R=ROOT$ INSP OR SIGNATURE DATE APPLICATION EXPIRATION DATE APPLIL APPROVEDI ISSUED BY DATE 3(10/ 7r l6 WO/20z7 to THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE Revised:4/14/2025 DESIGN FORM—PACE ONE Assessor's Parcel Number: 2 2 2 1 2 - 5 8 - 0 0 0 1 7 A design will he 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 dew on the Mason County Web site.Maximum paper size: 11"X17' PAR f�CEL IDENTIFICATION Permit Number: SWG 2c i-Ia _C�O(s(,a' Designer's Name: Micah Halverson Applicant's Name. RAICHLE LIVING TRUST Designer's Phone Number: 360-490-6365 Mailing Address: PO BOX 3271 Designer's Address: PO Box 1519 _ BELFAIR WA 98528 Chy State Zip Shelton Wa 98584 City State Zip Designer's Email halversondesignIlc@outlooks DESIGN PARAMETERS Treatment Device ❑Glendon ❑ Sand Filter 0 Mound ❑ Sand Lined Drainfield ❑ Recirculating Filter ❑ ATII X02 U otheP5car Treatment Level (check all that apply): ❑ A ❑ B ❑ C ❑+ BL I C BL2 71 BL3 l F ❑N Drainfield Type ❑Gravity ❑ Pressure ❑Trench O Bed ❑ ub S ce Septic Tank/Drainfield Specifications Laterals Number of Bedrooms 3 Schedule/Class Oscar FCF(� '�F Daily Flow:Operating Capacity 270 gpd Length Daily Flow: Design Flow 360 gpd Diameter in Septic Tank Capacity(working) 1000 gal Number Receiving Soil Type(1-6) 4 Separation ft Receiving Soil Appl. Rate .6 gpd/ft2 Orifices Required Primary Area 600 ft2 Total Number of Orifices Oscar Designed Primary Area 602 ft2 Diameter in Designed Reserve Area 600 ft2 Spacing in Trench/Bed Width 16.5 ft Manifold Trench/Bed Length 36.5 ft Schedule/Class Oscar Elevation Measurements Length ft Original Drainfield Area Slope 20-26 % Diameter in New Slope, If Altered 20 % Preferred manifold configuration used? D Yes No Depth of Excavation up-slope 13 in Transport Pipe from Original Grade Down-slope 0 in Schedule/Class Sch40 Designed Vertical Separation 18+ in Length 300 ft Gravel-based Drainficld Required? ❑ Yes Ed No Diameter 1 in Pump Required? lKYes D No Dosing and Pump Chamber Pump/Siphon Specifications Number of doses/day Oscar Diff.in Elevation Between Pump&Uppermost Orifice 35 ft Dose quantity gal Drainfield Squirt Height/Selected Residual (head) N/A ft Chamber Capacity(flood) 1000 gal Uppermost Orifice Rf Higher 0 Lower than Pump Shutoff Pump controls: Please check those required. Capacity Oa Total Pressure Head N/A plan [1'f Timer O &lapse Meter ❑vEvent Counter Calculated Total Pressure Head N/A ft If Timer: Pump on Oscar ,Pump off Oscar Comments Revised:4/14/2025 DESIGN FORM —PAGE TWO Assessor's Parcel Number: 2 2 2 1 2 -- 5 8 -- Permit Number: SWG_____________________-- DESIGN CHECKLISTS Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch A Test hole locations [9 Drainfield orientation and layout Reference depth from original grade: 11 Soil logs Ef Trench/bed dimensions and G' Septic tank 0 Property lines critical distances within layout [Z Drainfield cover 56 Existing and proposed wells [9 D-Box/Valve box locations Reference depth from original grade within 100 ft of property Rl Septic tank/pump chamber and restrictive strata: m Measurements to cuts, banks, and locations IZ Laterals,trench/bed,top and surface water and critical areas 10 Observation port location bottom m Location and orientation of E9 Clean-out location ❑ Curtain drain collector curtain drain and all absorption Ed Manifold placement O Sand augmentation components � Orifice placement Other cross-section detail: Location and dimension of R1 Lateral placement with distance Ed Observation ports/clean-outs primary system and reserve area to edge of bed g Other Information R1 Buildings E6 Audible/visual alarm referenced Yes No 9 Direction of slope indicator m Scale of drawing shown on scale li≥( ❑ Design staked out 56 Waterlines bar Ed O Recorded Notices attached RJ Roads, easements,driveways, p Elevation benchmark and relative ❑ if Waiver(s)attached parking elevations of system components O Pump curve attached 19 North arrow and scale drawing I:d ❑ Evaluation of failure shown on scale bar Non-residential justification ❑ if Waste strength O Rf Flow DESIGN APPROVAL The undersigned designer must be notified by installer at time of installation E6 Yes 0 No M1c41 7Y el 7/03/2O24 Signature of Designer Date The undersigned has reviewed this design on behalf of Mason County Public Health and determined tit*'{7S,in compliance with state and local on- v ulations: Environmental Health Specialist Date CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CONDITION",/-' ✓ The design is stamped"Approved" by Mason County Public Health. (Mf ✓ 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 maybe scanned and available for public view on the Mason County Web site. Revised:4/14/2025 / It , Tabloid lix 17' cm on- - - = - \ ( .ry \/ - - = / � � � \\ � � Cr } \ _ \ e > 0 } \ ; ! c \ C CD ~ ^a a /( ( I (5 (\ c J§ - a � \ . �w1 fa/. � \\ \ WCD ( \ < 11 CD • = zs , : no � , _ : ` _ . _ ! iTi \ j ° Or � \ Ti & \ } } \ ' § 7 \ O �. . . 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