HomeMy WebLinkAboutSWG2026-00271 - SWG Application / Design - 9/2/2026 MASON COUNTYIaWie NaSHELTON 3SHELT96 EXT400
SHELFAIR 360-47 467,EST 400
BELFAIR'.360-275-4467.EXT 400
Public Health & Human Services ELMA:360-482-5269,EXT 400
EAX:360-427-7787
On-Site Sewage System Permit: SWG2026-00271
APPLICANT LUSCOMBE REAL ESTATE LLC Phone:
Address: 5812 54TH ST W UNIVERSITY PLACE, WA 98467
OWNER LUSCOMBE REAL ESTATE LLC Phone.
Address. 5812 54TH ST W UNIVERSITY PLACE, WA 98467
SEPTIC DESIGNER CINDY WAITE* Phone: 360-701-0205
Address: 80 E PICKERING LANE SHELTON, WA 98584
Site Address: 351 E Canyon View Rd
Primary Parcel Number: 222215200057
Replacement/Upgrade: SFR 4-bedroom pressure system with
Permit Description: primary and reserve drainfields located on parcel 222215200055
(AFN: 2245076)
Permit Submitted Date: 08/18/2026
Permit Issued Date: 09/02/2026
Issued By: David Anderson
Current Permit Fees Paid: $845.00 (additional lees may be req cored upon installation of system).
Permit Expiration Date'. 08/2112027 (bared on date 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 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 Four, Record Drawing, and Installation fee must be submitted for
final installation approval.
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 AMC 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.
• OFFICIAL USE ONLY
MASON COUNTY °" U �� / S /:>c?
AMOIIMPECEN D'. PECENEDBV',
Public Health & Human Services
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Environmental Health 360A27-96]°,ext.400 or 360-2]&440),eat.400 O
415N.6th Street - Shelton,WA 99584 SWIG — Qt�`?I �f
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ON-SITE SEWAGE SYSTEM APPLICATION
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APPLICANT -_ ,.,. PHONE OR
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LUSCOMBE REAL ESTATE KK ,1 919-593-6281 z
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MAILING ADDRESS-STREET CITE,STATE ZIP CODE
5812 54TH AVE ST W r - 1 UNIVERSITY PLACE WA 98467 R1
SITE ADDRESS STREET Ortv ZIP CODE
351 CANYON VIEW / BELFAIR WA 98528 I N
NAME CFDESIGNER PHONE
CINDY WAITE C'-IT J ` 360-701-0205
NAME OF INSTALLER L---- --' PHONE I
TED I .___ :__ O
- . .--
y N
PER (select TYPE lent MY DRINKING WATER SOURCE
L O
II RESIDENTIAL OSS rl COMMUNITY055 19 COMMERCIAL Ff PRIVATE INDIVIDUAL WELL ❑ PRIVATE TWO-PARTY WELL z
TYPE OF WORK(seen me) 8 PUBLIC WATER SYSTEM TAANOH FALLS Ws
ITT NEW CONSTRUCTION,UPGRADES L9 REPAIR I REPLACEMENT OTHER DETAILS(selectall t?8r.1111) ❑ TABLE X REPAIR I �
SUB
MITTALS I� V SURFACING SEWAGE V EXISTING FAILURE 0 SHORELINE
L DESIGN FORM(REQUIRED) r15EPTICDESGN(REQUIRED) BEDROOMS LOT SIZE WAS LOT CREATES AFTER 41140251 O I
jam] WAIVER(s)(IF APPLICABLE) 3 .29 AC ❑ Yes Q No 0 O
DIRECTIONS TO SITE AND SITE CONDITIONS.(as.locked gale)
GO OUT BROCKDALE ROAD, STAY ON MCREAVY, TURN RIGHT ON DALBY, TURN I o
RIGHT ONTO 106 THEN TURN RIGHT ONTO TWANOH FALLS DRIVE, TURN RIGHT
ONTO CANYON VIEW, GO TO THE END, PARCEL IS ON THE LEFT SIDE OF THE S I o
ROAD, GO BEHIND THE HOUSE AND GO TO THE NEXT ADJOINING PARCEL.
DRAINFIELD IS STAKED OUT IN THE
y/FENCED
I[NAREEA 01
SITE I
SITE MV M S THE FLAGGED FROM MA ROADAND TEST T![AA WITN T�T JCEAOMBENG� I J
OFFICIAL USE ONLY BELOW THIS LINE
UPGRADE FAIwRE SOURCE ltcr resting o...osea)
❑VOLUNTARY 0MAINTENANCE/PUMPING D BUILDING PERMIT ❑HOME SALE ❑COMPLAINT ❑OTHER.
INSPECTOR SOIL LOGS COMMENTS'LORI
$o( 10+1:0 MI v6LMd 5 Cryr3)
I4( a1361, 47 mat carne.
01:0-3811 vu /Ad�
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RECORD DRAWING AND INSTALLATION REPORT
601E CO
V V G GRAVELLY 5=SAN° L=LOAM 51=SIIT C=CLAY E=EXTREMELY R=ROOTS REQUIRED FOR FINAL APPROVAL,
IN PECTORS NATURE DATE APPLICATION EXPIRATION DATE APPLIC N APPROVED,ISSUED BY DATE
8,,z 07b /zl (loz 7 z /zoz6
SF MMAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE Revised:4/14/2025
DESIGN FORM—PAGE ONE Assessor's Parcel Number 1 22 2 2 1 1 1 5 2 1 0 0 0 ' 5 7
A design will be reviewed when 3 conies of each of the following are submitted:
v Completed design form that has been signed and dated. v 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 torm may be sunned and avallabla for bllc view on the Macon County WS etb.Maximum paper size: Ii"X l7"
PARC I.IDENTIFICATION
Permit Number: SWG p .L - G'LD, ' ( Designer's Name: CINDY WAITE
Applicant's Name: LUSCOMBE REAL ESTATE LLC Designer's Phone Number: 360-701-0205
Mailing Address: 5812 546TH AVE ST W Designer's Address: 80 E PICKERING LANE
UNIVERSITY OK City State Zip SHELTON WA 98584
City State Zip Designer's Email cindyessaeCmsn.com
DES GN PARAMETERS
Treatment Device
❑Glendon ❑Sand Filter ❑Mound ❑ Sand Lined Dreinfield ❑Recirculating Filter ❑ATU O Other
Treatment Level(check all that apply): D A OS DC ❑BLI ❑BL2 ❑BL3 Pf E ❑N
Drainfield Type
❑Gravity VVPressure BtTrench O Bed ❑Sub Surface Drip
Septic Tank/Drainfield Specifications Laterals
Number ofBedrooms 4 Schedule/Class SCHEDULE40
Daily Flow: Operating Capacity 360 gpd Length 26,33,34,34,37,37 ft
Daily Flow:Design Flow 480 gpd Diameter 1.25 in
Septic Tank Capacity(working) 1200 gal Number 6
Receiving Soil Type(1-6) 3 Separation 5
ft
Receiving Soil Appi.Rate .8 gpd/ft' Orifices
Required Primary Area 600 & Total Number o ri 43
Designed Primary Area 603 (yr Diameter 3116 in
Designed Reserve Area 600 ft2 Spacing 60 in
Trench/Bed Width 3 ft ''
nifold
TrenchBed Length 201 ft Schell ass. 'i `s SCHEDULE 40
y 5nan.l9
Elevation Measurements Len o= riyo' r +Aire E 1-2 ft
uCFN51' ,';GONER
Original Drainfield Area Slope '1 / Di ter.: -_.. xcscab in
New Slope,If Altered % Preferred manifold configuration used? gYes O No
Depth of Excavation Up-slope 11 in Transport Pipe
from Original Grade Dorm-sIope 11
in Schedule/Class SCHEDULE 40
Designed Vertical Separation 24 in Length 5 ft
Gravel-based Drainfield Required? P1Yes O N Diameter 2 in
Pump Required? C1 Yes O No Dosing and Pump Chamber
Pump/Siphon Specifications Number of doses/day 6
Diff.in Elevation Between Pump&Uppermost Orifice 6 ft Dose quantity 60 gal
Drainfield Squirt Height/Selected Residual(head) 2 ft Chamber Capacity(flood) 1300 gal
Uppermost Orifice R(Higher D Lower than Pump Shutoff Pump controls:Please check those required.
Capacity @ Total Pressure Head 25.37 gpm P1 Timer 19 Elapse Meter Ili Event Counter
Calculated Total Pressure Head 2Q55' ft If Timer: Pump on Pump off
Comments
PUMP CONTROLS TO BE SET AT TIME OF INSTALLATION. INSTALLER TO CONTACT DESIGNER
PRIOR TO INSTALLATION
Revised:6/11/2025
DESIGN FORM—PAGE TWO Assessor's Parcel Number- 2 2 2 21 5 2 0 0 ' 0 : 5 , 7
Permit Number: SWG )1') )
DESIGN CHECKLISTS
Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch
V Test hole locations t' Drainfield orientation and layout Reference depth from original grade:
V Soil logs V Trench/bed dimensions and d Septic tank
içf Property lines critical distances within layout tt Drainfield cover
Existing and proposed wells Or D-Box/Valve box locations Reference depth from original grade
l within 100 ft of property 9 Septic tank/pump chamber and restrictive strata:
Ua teasurements to cuts,banks,and locations j'I,/ r''1 Y
Laterals,trenchibed,top and
surface water and critical areas Or Observation port location bottom
A6-Location and orientation of Ef Clean-out location Cl Curtain drain collector
curtain drain and all absorption y' Manifold placement O Sand augmentation
components
V Orifice placement Other cross-section detail:
V Location and dimension of V' Lateral placement with distance O Observation ports/clean-outs
primary system and reserve area to edge of bed
6e Buildings Other Information
Er Audible/visual alarm referenced Yes No
V Direction of slope indicator shown g "
U' Scale of drawing o scale S' ❑Design staked out
Or Waterlines bar V ❑Recorded Notices attached
V Roads,easements,driveways, iX Elevation benchmark and relative ❑ ❑Waiver(s)attached
parking elevations of system components U' 0 Pump curve attached
er North arrow and scale drawing O ❑Evaluation of failure
shown on scale bar Non-residential justification
❑ O Waste strength
Cl ❑Flow
DESIGN APPROVAL
The undersigned designer must be no by installer at time of installation eyes O No
Signatur 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-sit lotions:
11720y
En nmental Health Specialist Data
CAUTION: DESIGN APPROVAL IS VALID ONLY UNDER THE FOLLOWING CONDITION:
✓ The design is stamped"Approved"by Mason County Public Health. O/z r/ 2O. 7
1' The Onsite Sewage Permit has not expired,the Permit Expiration Date is: o
V 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:6/11/2025
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ORIFICE SPACING 5
Lateral# Length Length Orifice # Distance from Distance from end Length#
# (Feet) (Inches) Spacing" Orifices feeder line of end of lateral
1 26 312 60 6 0.5 0.5 26
2 33 396 60 7 1.5 1.5 33
3 34 408 60 7 1.5 1.5 33
4 34 408 60 7 1.5 1.5 33
5 37 444 60 8 1 1 37
6 37 444 60 8 1 1 37
201 43 210
TRANS LENGTH .S"'
GPM 25.37
K (2"SCHEDULEN 40) .5
FRICTION LOSS 1.142_' 22
Squirt I 2
Elevation difference 6
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Installation Notes
Pressure Distribution System:
22227-52-000057 351 E Canyon View Rd
1. The prepared site plan is not a survey. It's the owner's responsibility to verify property
lines, utility lines (water, sewer, power, phone and gas) prior to installation.
2. Installer to contact the designer prior to starting installation.
3. Installer to contact the designer for final inspection
4. Extreme care to be taken on clearing the property
5. Concrete tanks required
6. Gravel based drainfield required
7. Keep wheeled vehicles off the drainfield area before, during and after installation.
tracked equipment only
8. All ground, surface water and roof drains must be diverted away from the septic tanks
and drainfield. Ensure the final grade slopes away from these areas and water doesn't
collect on or around them. Use swales, berms, catch basin and tight lines, curtain drains,
etc. to divert all waters.
9. Curtain drains can be no closer than 10 upgradient and 30' down gradient of the
drainfield
10. Exposed restrictive layers, cuts, banks, etc. can be no closer than 50' downhill from the
drainfield.
11. Install access risers on the septic tanks, valve box and ends of laterals.
12. Make sure septic tank risers are epoxied or caulked to cast in riser rings on tank.
13.Septic tank can be moved but must meet required setbacks.
14. Pump controls to be set at 360 GPO
15. Lids must form a water and gas tight seal with the access risers.
16. Install effluent filter at the septic tank outlet.
17. This system must be installed by a Mason County Certified installer.
18. Deviation from this design without prior approval from the designer and Mason County
Health Department will make this design null and void.
19. This design was sized per Washington Administrative CodeWAC246-272A-0230. The
operating capacity is based on 45 gallons per day per capita with two persons per
bedroom. The minimum design flow per bedroom per day is the operating capacity of
ninety gallons multiplied by 1.33. This results in a minimum design flow of one hundred
twenty gallons per day-This creates a surge factor of 33% but anticipated flow is ninety
gallons per bedroom per day.
20. Install laterals with contour of the ground.
21. Install trench bottoms level and always maintain a minimum of six inches into native
soil..
22. Filter fabric required over drain rock prior to backfilli . the drain rock extends
above the original grade, run the filter fabric at least me down the trench wall
into original grade. Air
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System Owner Responsibilities:
1. Operation and Maintenance is required by Washington State Department of Health and
Mason County Health Department.
2. The septic tank and pump tank should be pumped every three to five years or as
needed.
3. System owners are responsible for having maintenance performed annually.
4. System owners are responsible for responding to septic issues in a timely manner.
5. System owners shall not at any time change or alter settings in the control box.
6. Keep the flow of sewage at or below the approved design operating capacity.
7. Keep waste strength at residential waste strength parameters.
8. Spread loads of laundry through the week.
9. Do not use excessive bleach or detergents with added whiteners.
10. Do not shower, do laundry and dishwasher at the same time
11.Antibiotics can kill or impair the biological process in the septic tank.
12. Leaky plumbing can hydraulic overload your on-site septic system.
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