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HomeMy WebLinkAboutSEP2010-00115i e Jefferson County Department of Community Development 621 Sheridan St., Port Townsend WA 98368,(360)379-4450 SEPTIC PERMIT APPLICATION PROPERTY OWNER Neil M Cavette Jr MAILING ADDRESS P.O. Box 1953 Port Townsend WA 98368-0067 PHONE ( 360 ) 301-0527 SYSTEM DESIGNER Nathan N. Cleaver Designer Phone# (360) 598-6546 LEGAL DESCRIPTION: Section 4 Township 30N Range 1W PARCEL# 999-007-705 Subdivision Name Tibbals Lake Park Division Block 77 Lot(s) tax93 Site address/Directions to site'Parcel D' Between 320 & 534 Cook Ave Ext, Port Townsend 15 5 04(40 SOURCE OF SEjIVAGE/USE TYPE OF,WORK WATER SOURCE Residential �/ New V Tank/s only Private Residential ADU Modification Public Commercial Expansion Community Upgrade Repair SITE SIZE 23,980 +/- SYSTEM TYPE Partial Repair-(tank) (drainfeld) Previous Evaluatio Conventional Designate Reserve Area Yes# Ye5 1 Alternative Redesign No SYSTEM DETAILS Number of Gallons/day 240 Soil type 4 (attach soil eval.) Application Rate 0'6 gal./sq.ft./day Drainfield Length 16.3 ft. Trench Width 16 ft. Trench/Bed Depth NA in. Septic Tank size 1,000 gal. Pump Chamber size 1,000 gal. TYPE of system Glendon BioFilter By signing the application form, the applicant/owner attests that the information provided herein is true and correct to the best of their knowledge. Any material falsehood or any omission of a material fact made by the applicant/owner with respect to this application packet may result in this permit being null and void. I further agree to save, indemnify and hold harmless Jefferson County against all liabilities,judgments, court costs, reasonable attorney's fees and expenses which may in any way accrue against Jefferson County as a result of or in consequence of the granting of this permit. I further agree to provide access and right of entry to Jefferson County and its employees, representatives or agents for the sole purpose of application review and any required later inspections. Staffs access and right of entry will be assumed unless the applicant informs the County in writing at the time of the application that he or she requires prior notice. Inspections shall occur during regular business hours. Initial here if you require notification before entry Appeal—A person aggrieved of a decision of the Health Officer may appeal. Appeals shall be submitted to the Health Division in writing within fifteen days after receiving written notice of the decision. DISCLAIMER-This application is for an on-site sewage system that' meets the state and county standards in effect on the date of application. This application for an onsite sewage system DOES NOT assure you of any other County approvals. For example, it DOES NOT GUARANTEE that you will later obtain permission to build a permanent residence or other structure on this parcel. Any future application will be separately judged by the rules and laws in effect at that time. Property Owner Signature Date FOR OFFICE USE ONLY I PARTIAL ASBUILT 7/2J /lf FINAL 7/2th A VED INSP/PUMP TEST b/hi1/f1( �� PUD 0`6`t!y / ALL HOLD REQ.MET Date CH-16 Fee 643 Rec# (10065—Check# a / Case#SEP �v H:\WEB\PDFs\Septic\septic_permitapp_2008.DOC SEWAGE DISPOSAL PERMIT Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend WA 98368 (360) 379-4450 PERMIT #: SEP10-00115 Date Received: 09/09/10 SITE ADDRESS: 552 COOK AVE EXT Date Issued: 10/06/10 Date Expires: 10/06/13 APPLICANT: NEIL M CAVETTE JR PHONE: 360-379-3975 PO BOX 1953 PORT TOWNSEND WA 98368-0067 LEGAL DESCRIPTION: TIBBALS LAKE PARK BLK 77 TAX 93 BND TGTH THRU BLA#112160 PARCEL#: 999007705 Section: 4 Township: 30N Range: 01 W DESIGNER: NATHAN CLEAVER PHONE: 360-598-6546 CLEAVER SEPTIC DESIGN INC. 1990 KIMBALL ST. NW POULSBO WA 98370 DISCLAIMER- This approval is for an on-site sewage system that meets the state and county standards in effect on the date of application. This approval for an on-site sewage system DOES NOT assure you of any other County approvals. For example, it DOES NOT GUARANTEE that you will later obtain permission to build a permanent residence or other structure on this parcel. Any future application will be separately judged by the rules and laws in effect at that time. ALL CONSTRUCTION AND DEVELOPMENT ACTIVITIES MUST COMPLY WITH ALL PERMIT CONDITIONS, STATE AND LOCAL CODES, AND RECOMMENDED STANDARDS AND GUIDANCE DOCUMENTS IN EFFECT WHEN THE PERMIT IS ISSUED. Permit issued to CONSTRUCT,ALTER, REPAIR OR MODIFY AN INDIVIDUAL SEWAGE DISPOSAL SYSTEM IN JEFFERSON COUNTY,WASHINGTON This permit is issued for a period of three years (unless otherwise stated above) in accordance with Jefferson County Rules and regulations for on-site sewage system , codified 8.15 amended per ordinance no. 06-0719-07. This permit may not be renewed. /j Jefferson County Envirinmental Health Specialist The property owner is responsible for the accurate location of all property lines.Any removal of or major disturbance of soil in the primary or reserve drainfield area may create site conditions that are unacceptable for the installation of a sewage disposal system. Any change in drainfield or tank location may invalidate this permit unless prior approval is obtained from the Jefferson County Environmental Health Division. If during excavation or development of the site an area of potential archeological significance is uncovered, all activity in the immediate area shall be halted, and the UDC Administrator shall be notified at once. HEALTH DEPARTMENT MUST BE CALLED FOR FINAL INSPECTION. SYSTEM DESCRIPTION: 280-GLENDON BIOFILTER No. of Gallons per Day: 240 Type of work: NEW Drainfield Trench Septic Tank Length: 16 feet Width: 16 feet Depth: inches Size: 1,000 gallons SPECIAL CONDITIONS APPLY - SEE REVERSE CONDITIONS OF APPROVAL - PERMIT NO.: SEP10-00115 1.) This approval is valid only with a connection to an approved public water supply. 2.) A 30' setback shall be maintained from the disposal component and reserve area to any downslope footing, curtain or interceptor drain or drainage ditch. 3.) Dry season installation required. 4.) Septic tank and pump chamber to be water tight. Extra protection (i.e. Bentonite)to be used around inlet, outlet, and risers due to high water table. 5.) H - AS PER WAC 246-272A AND JEFFERSON COUNTY CODE 8.15 ALL ONSITE SEWAGE SYSTEMS REQUIRE THAT A RESTRICTIVE COVENANT REGARDING THE MONITORING OF THE ONSITE SEPTIC SYSTEM BE RECORDED TO THE PROPERTY TITLE. THE PROPERTY OWNER SHALL ASSURE THAT MONITORING IS PROVIDED BY AN APPROVED ENTITY AT THE FREQUENCY DEFINED PER STATE WAC 246-272A AND JEFFERSON COUNTY CODE 8.15 AS ADOPTED OR AMENDED. A COPY OF THE RECORDED OPERATIONS AND MONITORING AGREEMENT IS REQUIRED PRIOR TO FINAL APPROVAL OF THE SEWAGE DISPOSAL PERMIT 6.) Health Dept. required to observe pressure test with system designer when system fully installed/complete, 48 hours notice to be provided for scheduling. 7.) Designer must be contacted prior to start of construction and for inspections during installation. DESIGNER IS REQUIRED TO DO A PRECOVER INSPECTION ON ALL TYPES OF SYSTEMS. 8.) Notification of the start of construction shall be faxed or emailed to Jefferson County Public Health ONE WORKING DAY prior to start. 9.) H -An asbuilt drawing and certification of completion by the designer is required prior to final approval. 10.) Before final approval is given, the designer shall provide an operations and maintenance manual to the property owner and the Health Department. The manual must instruct the owner of the on site sewage system on the ways to properly operate and maintain all components of the system. 11.) Divert all sources of drainage, including roof drains away from septic tank and drainfield area. 12.) Approval/issuance of a sewage disposal permit does not guarantee the approval of other development or a building permit on this site. Compliance with other Jefferson County and Washington State Codes is required. 13.) All construction and development activities must comply with all permit conditions, Washington State and Jefferson County Codes and Recommended Standards and Guidance documents in effect when the permit is issued. 14.) Approval of this sewage disposal permit does not preclude the permit holder from complying with the Unified Development Code for other/future development on the site. 2 of 3 11/22/19 I:\F_SEP_Permitmod.rpt 15.) The project shall adhere to the Best Management Practices (BMPs)to control stormwater, erosion and sediment during construction. BMPs shall address permanent measures to stabilize soil exposed during construction, and in the design and operation of stormwater and drainage control systems. 3 of 3 11/22/19 I:\F_SEP_Permitmod.rpt i JEFFERSON COUNTY PUBLIC HEALTH, 615 SHERIDAN, PORT TOWNSEND WA 98368 .� ASBUILT INSPECTION REPORT For RECORD DRAWING Designer NA14tit3 CI.r=aV Permit# SEP 10 _ OO 1 I♦S Installer G■Ack • By.CAVAT1►J4• tcEV1I4 Parcel # 1I1 • O 1 r 9'O5 Electrician �F'(tep�2■ckS L c flz&L Design Flow 2-40 Property Owner �t�tL M, 0Av .-r e Site Address 552.. CookVr�t.IVE' 'r Answer all questions or indicate NA DATE Tanks, Pumps and Controls INSP. Tank (manufacturer, size, baffles) CoTTo1J RZ.1)I-1141)C� 1,DO() 9A4, '1.GOivlir 3JL i Z014 Pump chamber (manufacturer, size) (n rrAt Q>rol-IVII x� I)COO oat.., 3J01.1 2,014 Screen(s)and/or Pump Shroud (type, location) knv.1 QVMAR 3Suy7O1iv Were Tanks tested onsite for water tightness? Yes / No Panel Model AtIAuAwocix =P&SG Timer Model 5luozo1 Pump 1 — Man./Model Oa,Etarp likF'nO5\t Flow Rate 50 qpm asooltA4 Pump Location (i.e. garage, treatment unit, basement) Puw&e"'C`atJk Float/transducer settings Inches Timer from bottom of tank- On/off- 1,0,1 in. Functions: On 5 0min Veto q in. Off- " ( sec/'hr Alarm - 3L .f in. Veto On - S e/min Storage Above High Water Alarm � gal. Veto Off- sec mi /hr Dose Counter Reading 0000* # gallons/dose 1,4:i+ gal. Elap. Time Meter Reading (TJ:a2,: 20 min/hrs Pump Throttled? Yes ill Dose Drawdown (in inches) NA in. Pump 2 — Man./Model Flow Rate qpm Pun'. Location i.e. •ara•e, treatment unit, basement Float/transducer settings Inches Timer from bottom of tank- On/off- in. Functions: On sec/min Veto - in. Off- sec/min/hr Alarm - in. Veto On - sec/min Storage Above High Water Alarm gal. Veto Off - sec/min/hr Dose Counter Reading # gallons/dose gal. Elap. Time Meter Reading min/hrs Pump Throttled? Yes / No Dose Drawdown (in inches) in. If additional pumps-complete the info in this table for each and attach. Other Timer functions & settings (e.g. override on/off) Sz(q- � .t s to-r'OC 1z ZZ.vosiEs. H:\WEB\ONSITE\Asbuilt_Report_Form.doc 04/28/10page 1 of 2 Pre-Treatment Date Ihpap Sandfilter basin high water alarm shuts down pump to Sandfilter Yes / No `_' ' Sandfilter Basin size/location Sand Fill met design spec? Yes / No ATU (manufacturer, model) Alarm tested Yes / No Disinfection Unit (manufacturer, type, model) Independent Alarm Yes / No Drainfield Transport Pipe size, schd, diameter I"SCH to Manifold size/schd 1054140 0 3J*2aMM Orifice size NA Lateral Size/schd I" SGM 40 aSoozo14 Barrier Material P.M Cover Material/Depth ?121:La1_E4.1OoK __ ._2014. Residual Head (lat.# & ft. Head) 1174 The laterals/pods were balanced C3/ No 3.1‘,U-4014 Source/Manufacturer of Drainrock/Gravelless chambers CvA-V0k3 '-S'Oki\1\X. Drainrock Clean? 40 No If no, what action taken? Mound/Glendon Site Prep O-PO1D Drainfield Length UO•3 ft Width kG, ft Depth WA inches Caps for measuring residual head stored (location) NA COMMENTS (inspection notes, changes from design or deficiencies in installation) Attach additional sheet(s) if necessary Health Department Inspection issues resolved Yes / No / NA If yes how? Users Manual Provided to Homeowner :j �(. Date 7/1/ 1 Tank/component Decommissioning Report Attached Yes / No /5 ,// Installer Certification attached/signed Yes / No ATTACH RECORD DRAWING stamped/signed by Designer or Licensed Professional Engineer I CERTIFY THE INFORMATION PROVIDED ABOVE WAS VERIFIED 13Y INSPECTION, THE SYSTEM WAS INSTALLED AS DESIGNED AND APPROVED by JEFFERSON COUNTY i 4/i° (DATE) OR THAT CHANGES HAVE BEEN NOTED AND TH Y . �s� S S PLIANCE WITH WAC 246-272. 21/ x/66 2-/ Designer Signature Dat License # H:\WEB\ONSITE\Asbuilt_Report_Form.doc 04/28/10page 2 of 2 _.,.- 10' NoBuild RECORD DRAWING " „ SCALE: 1 = Soil Log THIS IS NOT A - Building Envelope -- Setback - Existing Componet Tree MEASUREMENT TABLE ;y lean out CP 08.0' 21.0' A 07.0 21.8' : Septic Tank B 24.0' 32.0' /% C 28.0' 35.5' ,A I Filter Sock D 30.5' 31.0' ,A CO 92.0' 89.0' , Pump Tank E.1 107.5' 82.0' /- E.2 127.0' 98.0' '/ / Splitter 1 108.0' 83.0' %: 2 127.0' 99.0` \A`- , tendon Size Detail � w 21(3-, 16' zv./ / / 4 /5.'t 5f V y i 6'x 10' Basin w'. l v,p ,[?• / , ,, \ �� ° /// /j , 0.550 acres Patits 1 H% Shut-off I'''; ' ' ' ' -'9''' / %7 APP I ,Z.()/' �� Approx. H2O Meter . SFR I <,; , Clean Out I � j / Port (CO) !% "e © ;; cn CP I M io � -- o�'L. ' ,5,,W.:.�.,��� 10'No Build/,. / A �/ A_,�4.46_,-: No Disturb , ��� - �, /4;/ 0-2') i P 01lj,,,, 1■i t 11 ;,,,...4 d0.: ; 36' •1►ISI,ihlIorKif, ' I, 5' Setback ii I 125' N 88°23'28"W 235.86' 100%Primary (7■ 1t'V 1R Z' .. END ii7a) 7 10' No Build SCALE: 1"= Soil Log THIS IS NOT A —— Building Envelope Setback • —-- Existing Componet Tree (A) Clean Out (B) Septic Tank 7 (C) Filter Sock / /, (D) Pump Tank / (E) Splitter / ,,,-'-''' .•-- _, / / 216 3Iendon Size Detail 16' N. !::' // h` 6'x 10' Basin ,,, i • Ste /jc' nn� / , / •<<',' , ' 0 -7,. - '- , +'` \. ��/\ \ �'�� / 0.550 a'res P, � . . / L, . / CO€ Exi frig Driveway : . . . ■ Approx. H2O Lin / a —Approx.H2O Meter Approx.H2O Spigot , ............ •o', \ CO / so, E _ D 0� A M / cart' '�'�. ■,.��� 10' No Build/ 1,1 i / c5, /‘`'C°,' , , ,�•`1�Adin No Disturb 13-29,16� #P4 36 \ ---..........210 le41 -•_.•∎�-a.A����46 5'Setback 42 N 88°23'28" W 235.86' -.4 126' 100%Primary t M (71 1 R'Y 1 C, 3' 1 ri 10/Pacania Araa IV • n v • F ro CD . NO /\ _ � 0 n ° -z 0r+ ti 0 I u IIm = = n r —I c) rf n > o > 0 x � o C 0 NN • Z Z Dj 5 O m S m n CD co oZO O A 0 �� O Z w N Cr) O n '^J n z N o aii cu. us C (1 _ 1 1 to L S O 0 y 00 00 \) z < 0 oV m OV'AA nI in . T Ci 1 f"F V• I LL �� 7 m � ■ 0.)..0 r Z 0 ..■1 1) m ` X n C o Cm t-h f O A r - a� v - o o T U' N ; < Q° CO s m n O CO H N Q W N O 0 7 0 cn of N 'Z'O o co cu co C)00 J nxo . 5 0 DJ � Icfl I ) o y � a• "S CD 1 1 �* pp = 7 o 01 p CP c ) I o O rn C7 e2 y 'v. < •-c SD % 1 r-l• v F V1 0o w o P o En p Ci) 1/4< Cl) CD o � o m �. cn oo �c rt pp CD CD N —P F 8 5 CD CD 2")rr+, d -r W o .1:1141 P •,y 6F b 'z i i-. i .i".r. V ""-CS O 0 1 I" 0 O, CD P. ..' -- — — — .- — .d R = ° In 0 ti I C 0 0 ` 5a � 0 = x Cann A � q �(v �TD ' o 'cS A) coo ° G) c:::C o- cu d o. a co C 8 t" �' C -°'- o CD'� a �° r 4- = N 0 ,* 0 Eii 7'" '" 11 1 1 1 0 NN,N,% \ P',2-.N m o m , �> N •� 0. C• 5 .R D1� o m r I-I a n I I-m F - O r.� /,'•,a: •� n n'zN r r rr II III l III III, • `° ,.os° "- ��.:�_, 0 CD 1 ` 0 Nathan Cleaver Septic Design Inc. Contractor Registration#: NATHACS940O2 9/24/2008 Soil Logs j 1 J Re: Cavette, Tax Parcel#: 999007603 &999007502 Soil Logging done on 9/9/2008,& 9/24/2008 t Soil Log#1 1 (� ��� 0-2"Duff �� � �� 2-20"Brown Sandy Loam 20-32"Mottled Compact Very Fine Sand Soil Log#2 0-2"Duff 2-20"Brown Sandy Loam �20-32"Mottled Compact Very Fine Sand \ Soil Log#3 0-2" Duff 2-20"Brown Sandy Loam 0-28"Mottled Compact Very Fine Sand `\, Soil Log#4 0-2"Duff 2-20"Brown Sandy Loam 20-32"Mottled Compact Very Fine Sand geolisawoffi r 0-2"Duff 0-'' rO' +`r _ :....n - :) pti,/ 2-21"Brown/Grey Loamy Fine Sand y y- � , 6 ` 21-43"Fine Sand w/pockets of Mottling&Compaction f ' r Roots to 43" (.0 K 18 f litmelsegt 0-2"Duff 0 --1 i 2-21"Brown/Grey Loamy Fine Sand 21-42"Fine Sand w/pockets of Mottling&Compaction Roots to 21" l�4 Ce s fD NO L1""1 0-2"Duff 2-20"Loamy Fine Sand 20-30"Fine Sand w/pockets of Mottling&Compaction Roots to 20" : 1)3A_ 01 6,4 20 14. H o or Address: Telephone: 360-598-6546 1990 Kimball St. NW Fax: 360-598-6548 Poulsbo, WA 98370 Email: nathan @nathancleaver.com Please call ahead to make an appointment if you would like to meet with me. Nathan Cleaver Septic Design Inc. Contractor Registration#: NATHACS94002 9/24/2008 Revisited The Site: 6 July 2010 Soil Logs Re: Neil M Cavette Jr. Tax Parcel#: 999-007-705 \i )(11 Soil Logging done on 9/9/2008 &9/24/2008 Application Rate: 0.6 Soil Log#5 6-)61)\.1 )\° 0-2"Duff 2-21"Brown/Grey Loamy Fine Sand 21-43"Fine Sand w/pockets of Mottling&Compaction Roots to 43" Soil Log#6 0-2"Duff 2-21"Brown/Grey Loamy Fine Sand 21-42"Fine Sand w/pockets of Mottling&Compaction Roots to 21" Soil Log#7 0-2"Duff 2-20"Loamy Fine Sand 20-30"Fine Sand w/pockets of Mottling&Compaction Roots to 20" 2 October 2008 These Soil Logs were inspected at the time of the Boundary Line Adjustment(BLA). See Case Number: SUB08-00031 Please feel free to call with any questions. Thank you, Nathan N. Cleaver Licensed Onsite Wastewater Treatment System Designer. Address: Telephone: 360-598-6546 1990 Kimball St. NW Fax: 360-598-6548 Poulsbo, WA 98370 Email: nathan @nathancleaver.com Please call ahead to make an appointment if you would like to meet with me. ;i , .,,,,,1g7TN., / ''''''-Ali , �n:�., �`a 1r} 3 It 0 S RE o ;',...47 r 1 (i) -i ) % , --k, ;1-..,,„ c.:-„,.'t.,, ,,,....„,,,,,,,„,..\ „,...,..1 , - .k.. _ • f /.47, , . 47 rt.,,a :,,,,..1 .3,. 47, "_' ' & , �ry r �r /> ' yam} a ° '44�w ° r 4w i ' 4, i .I , 100%Primary Area ' � " v �.. B= (2) Glendon Biofilters ' i {F«. �. ''. \ -,a 1:t. ,,,,,,, ,,,/,,,i, .,--, , i\ sue" *° ��� '' >"° y84R ,�Ar ,4?ce' 5' 17-) -ti '',,,,-.0%,--.,r.'",,e,„t,.. - ,- .. . , ' , „, *. m■,....*,, , 6,, 4 2 th IA' -.';'t,r ' 4,C) - Zil, , -'''. ,' . ' :1 0Q%:(0-Nk',4 —›' i; eserve , , . '"Af ° , E A .' ,,,t,7.e A - cmii-A r �y � *4 . ELM S d � -E g °= 14111