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HomeMy WebLinkAboutSWG2026-00294 - SWG Application / Design - 9/11/2026 (2) MASON COUNTY 415N6S ELTON 36A27-96 EXT 400 SH ST REE. SHEL ON EXT400 SELFAIR.360-275-0467,EXT 400 Public Health & Human Services ELMA:360-482-5269,EXT 400 FAX.360-427-7787 On-Site Sewage System Permit: SWG2026-00294 LOU ir( 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 PAYSSE' 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: 09/08/2026 Permit Issued Date: 09/11/2026 Issued By. Rhonda Thompson Current Permit Fees Paid: $570.00 (additional fees may be,enured upon mstallanor-os system). Permit Expiration Date: 09/09/2029 (based on date of nspemmn) Permit Conditions: I 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 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 Form, 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 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. OFFICIAL USE ONLY MASON COUNTY DAiEPECBEpi D7/ OtzoU Public Health & Human Services AMOUMTRECEPJE D REED DBY �r M O r m M Environmental Health 30-427-9670 ea 400 or 350-1S-045J ea,400 �ry� \ /� 415 N.6th Street-Shelton.WA 98584 SWG VIJTY-1 y A � � 0 Z M ON-SITE SEWAGE SYSTEM APPLICATION n p APPLICANT PHONE rR m ROBERT H. PAYSSE 360-507-1498 Z MAILING ADDRESS-STREET CITY STATE.ZIP CODE 3083 E MASON BENSON RD GRAPEVIEW WA 98546 SITE ADDRESS ZIP z 1895 E PICKERING RD SHELTON WA 98584 NAME OF DESIGNER PHONE ROBERT H. PAYSSE 360-426-1803 NAME OF INSTALLER PHONE TBD PERMIT TYPE(siact one) DRINKING WATER SOURCE M I W lvf RESIDENTIAL OSS fT COMMUNITY OSS In COMMERCIAL OSS I7 PRIVATE INDIVIDUAL WELL ff PRIVATE TWO-PARTY WELL z TYPE OF WORK(sNacl one) If PUBLIC WATER SYSTEM H1 NEW CONSTRUCTION IUPGRADES t1 REPAIR I REPLACEMENT OTIERDETAITS(e.Knaur.ampply) ❑ TABLE A REPAIR I - SUBMITTALS ❑ SURFACING SEWAGE ❑ EXISTING FAILURE EJ SHORELINE DESIGN FORM(REQUIRED) SEPTIC DESIGN(REQUIRED) BEDROOMS LOTSIZE WAS LOT CREATED AFTER 4/1/2015] 0 I HJ WAIVER(B)(IF APPLICABLE) 3 1 AC ❑ YES EI NO n DIRECTIONS TO SITEAND SITE CONDITIONS.(W.locked gate) LV N HWY 3. RIGHT ON PICKERING RD. CONTINUE TO SITE ADDRESS ON LEFT. USE 10 ACCESS ROAD JUST AFTER FIRE STATION TO ACCESS, SEE SITE PLAN. a I C IA SNEMUSTBE FLAGGED FROM WIN ROADAND TEST HOLES MUSTS&FAQOED INTN IESTHOLE NUMBERS. - OFFICIAL USE ONLY BELOW THIS LINE UPGRADE I FAILURE SOURCE(for eporting purposed ❑VOLUNTARY []MAINTENANCE/PUMPING ❑BUILDING PERMIT ❑HOME SALE ❑COMPLAINT ❑OTHER' INSPECTOR SOUL LOGS COMMENTS!CONDITIONS I : ' R L4rvlsf �N F borlcM , ttz: Lam, +— ork 1 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 SIGN�R�� I� GATE APPLICATION EXPIRATION DATE APPLICATION APPROVE�UED� DQE THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEBSITE Revised.4114/2025 DESIGN FORM—PACE 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: v Completed design form that has been signed and dated. 0 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 size: 11"X17" PARCEL IDENTIFICATION Permit Number: SWG Lt, — c D .cj L& Designer's Name: Bob Paysse Applicant's Name Robert H.Paysse Designer's Phone Number: 360.507.1498 Mailing Address: 3083 E.Mason Benson Rd. Designer's Address: 3083 E. Mason Benson Rd Grapeview Wa 98546 City State Zip Grapeview Wa 98546 City State Zip Designer's Email pioneerdlgging©yahoo.com DESIGN PARAMETERS Treatment Device Cl Glendon O Sand Filter O Mound ❑ Sand Lined Drainfield Cl Recirculating Filter O ATU ❑Other Treatment Level(check all that apply): D A D B ❑C ❑BLI ❑BL2 ❑BL3 eE ❑N Drainfield Type V'Gravity ❑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/f{- Orifices Required Primary Area 450 ftr Total Number of Orifices N/A Designed Primary Area 480 }tr Diameter N/A in Designed Reserve Area 480 ft2 Spacing N/A in Trench/Bed Width 3 ft Manifold TrenchBed Length 160 ft Schedule/Class 3034 Elevation Measurements Length 30 It Original Drainfield Area Slope 3 0% Diameter 4 in New Slope,If Altered N/A / Preferred manifold configuration used? F'Yes O No Depth of Excavation Up-sbpe 25 in Transport Pipe from Original Grade Down-slnpc 24 in Schedule/Class a034 Designed Vertical Separation 36+ in Length 85 ft Gravel-based Drainfield Required? gYes O No Diameter 4 in Pump Required? ❑Yes KNo Dosing and Pump Chamber Pump/Siphon Specifications Norther of doses/day N/A Dili in Elevation Between Pump&Uppermost Orifice N/A tt Dose quantity N/A gal Drainfield Squirt Height/Selected Residual(head) N/A ft Chamber Capacity(flood) N/A gal Uppermost Orifice E'Higher D Lower than Pump Shutoff Pump controls: Please check those required. Capacity @ Total Pressure Head N/A gpm O Timer ❑ Elapse Meter ❑ Event Counter Calculated Total Pressure Head N/A It 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 — UOJ-�/Lf DESIGN CHECKLISTS Scaled Plot Plan Scaled Layout Sketch Cross-Section Sketch of Test hole locations Id' Drainfield orientation and layout Reference depth from original grade: er Soil logs V Trench/bed dimensions and Septic tank 2' Property lines critical distances within layout P rtY Drainfield cover 2' Existing and proposed wells Er D-Box/Valve box locations Reference depth from original grade within 100 ft of property Q( Septic tank/pump chamber and restrictive strata: 2' Measurements to cuts,banks,and locations v Laterals, trench/bed,top and surface water and critical areas 9 Observation port location bottom 69 Location and orientation of 2' Clean-out location ❑ Curtain drain collector curtain drain and all absorption e( Manifold placement ❑ Sand augmentation components O Orifice placement Other cross-section detail: V Location and dimension of a Lateral placement with distance 1' Observation ports/clean-outs primary system and reserve area to edge of bed V Buildings Other Information ❑ Audible/visual alarm referenced Yes No V Direction of slope indicator td' Scale of drawing shown on scale of O Design staked out V Waterlines bar O ❑ Recorded Notices attached Roads,easements,driveways, V Elevation benchmark and relative ❑ ❑ Waiver(s)attached parking elevations of system components ❑ O Pump curve attached North arrow and scale drawing ❑ O 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 e'Yes ❑ No e Signature of Designer ' ate 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. (� �i/ ✓ The Onsite Sewage Permit has not expired, the Permit Expiration Date is: I 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 ii DW - �N FUTURE / / \\ BUILDING FUTURE \ AREA 2-PARTY WELL _WL-\--- r i 1 I +1 N. I I / 60'ACCESS& / / UTILITY EASEMENT /k" 'Q / (FROM PICKERING RD) --- \ O' / \ 1 I \ �/ w - I \c:\ x /�2 I PROPOSED 3 BEDROOM / 45' PRIMARY&RESERVE Q = CLEANOUT \ QB = 1500 SEPTIC TANK \ / N \ A / OO, / 11 aP I I R50' 11 II A sawn I I v O ,;heceaerH vasaee I 1 / FUTURE ELFG:-- 1 2-PARTY WELL / 7. CUSTOMER: ROBERT H.PAYSSE I TEST HOLE 1 TEST HOLE 2 /N\ PIONEER 0-65 LMS 0-65 LMS PARCEL: 2 2 1 3 3 . 1 2 - 9 0 0 4 1 DIGGING INC. ROOTS @ 30 ROOTS @ 30 A� SITE:1895 E PICKERING RD ROBERT H.PAYSSE.DESIGNER SHEET:SITE PLAN SCALE: 1"=50 OISCIPINER. THIS u NOT A Sumer. REFERENCES INCLUDE:EPPLICANTIGOUXry PROVIDED RATS OR 3083E MASON BENSON RD n FIELD a OOUN ON GRAPEVIEW WA B95i9 FOPOSEGOEVELOPNENT MAYBE SUEJECT TO OTHER DEPu ENTUOEcY REVIEW- DESIGNER 3 O.4261SO3 I 1 Ii I 2 REFFROID 1E FOR SETOAGES UNRE4RO TO SED,IC COMPONENTS. O 1500 SEPTIC TANK RM=S/TINLET 5/T INLET (21.0") S/TOUTLET (240") LATERALS (240') IATEAL2 (240") IATERAL3 (240") LATERAL 24.01 4" 3034 D-BOX WI ACCESS TO GRADE r 5' 40'PRIMARY I I W Q a OJ - 1 40'RESERVE 0) En 40'PRIMARY G 4"3034 40' RESERVE 1 40' PRIMARY 1 o I40'RESERVE u�. 40'PRIMARY -�N`"'""°+•. - 40'RESERVE n RCB=_ 4`n NEEE OS PORTS CUSTOMER: ROBERT H.PAYSSE H TEST HOLE 1 TEST HOLE 2 /N\ PIONEER S S PARCEL: 2 2 1 3 3 - 1 2 - 9 0 44 1 ROOTS 30 ROOTS@30 DIGGING INC. SITE:1895 E PICKERING RD ROBERT H.PAYEBE,DESIGNER SHEET: DF DETAIL SCALE: 1"•10' PLICn TrcOuxTV PROVIDED FLATS OR 3083 F MASON BENSON RD SURVEYS FIELD MEARUPEIEME AND COUNTY 0 S. DE616N INTENDED FOR SPTlC YORWRES x NOT GRAPEVIEW WA 8546II PROPOSED ER EPARTMEMPO£NCY REVIEW 301.426-1808 NE8PW6 B E FOR SETMCK6 VIIEIAROE O SEPTIC COMPONENTS CL HREADDoRE AST &sL DTo FINISHED HGi COOADDPEs CAP NSU RINBN FINISHED GRADE TO PUMP ?,YT;.4:" uB •,�+� TANK OR GF , FROM BUILDING WATER-TIGHT •• JOINTS F 15MUGALLON SI SROVED TANK : uTON SXe MTALL•4 4'ORENCO / OUTLET FlLTER ' IIrr 7 I.F FOLx E srnon OB. PORT E Q:..^aCC` F W'E6E..... -`p ORIGINAL & RISER/LID /F FINISHED GRADE TO FINISHED GRADE USE FILTER SPEED FABRIC I LEVELERS TO D-BOX N EQUALIZE FLOWS I - I TOO FINN T SHH ED GLUED TEE FINI I I GRADE I WASHED ROCK 36" I I I I I I O I D-BOX F VERIFIED DEPTH I CUSTOMER:ROBERT H.PAYSSE TEST HOLE 1 TEST HOLE 2 N PIONE'E'R 0-65 LMS 0-65 PARCEL: 2 2 1 3 3 - 1 2 - 9004 1 ISIS / DIGGING INC. ROOTS Q 30 ROOTS©30 30 \ A� SITE: 1895 E PICKERING RD ROBERT H.PAYSSE.DESIGNER SHEET:DETAIL SCALE: NA THIS A SUIT. R 1 cuaICoUNLY PROVIDED PUTS OR 3063E MASON BENSON RD SURVEYS.FIELDMEASUR MMLMENT AND CWH1Y GIB. DESIGN IIYRNDED FOR SEPTIC PURPOSES WLY. GRAPEVIEW WA BEA6 POPOEED DEVELOPMEWT MAY BE SUMECT TO OTHER OEPARMENTIAGENCY REVIEW. DESIGNER NOT 38GA1418G6 0 10.5 IRESPONS1SLE FOR BETIWHI 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 rp for 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 10ft 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 30ft downslope and 1 Oft 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 verify 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 may or may not meet other requirements. CUSTOMER:ROBERT H.PAYSSE s''oz Pxyy PIONEER PARCEL: 22133 - 12 - 90041 DIGGING INC. SITE: 1895 E PICKERING RD IT H ROBERT0ME N.PANNE SONRER �y F[6FRTF WY88E ' zoGANtnsow WAps54 Ro SHEET; NOTES SCALE: NA GM 3 O42518O3 uo�za+ao> EEFInt3