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Home My WebLink AboutSEP2013-00145 Jefferson County Department of Community Development 621 Sheridan St., Port Townsend WA 98368, (360)379-4450 SEPTIC PERMIT APPLICATION Larry & Georgina Batson PROPERTY OWNER / I` +r MAILING ADDRESS 533 Blackhawk loop-Port Angeles,WA 98362 (summer) 225 West First Street;#115-Mesa,AZ 85201 (winter) o 510 4+,+ "¢ Suzanne G Martn +� PHONE ( 360 ) 457-0311 (summer)(480)969-1283(winter) 'LYMI#BgSIGNeer 4, DPI 2)11)15 SYSTEM DESIGNER Suzanne Martin Designer Phone# (360)554-0224 LEGAL DESCRIPTION: Section 1 Township 29N Range 1W PARCEL# 997 900 011 Subdivision Name Villas by the Sea Division Block Lot(s) 11 /, Site address/Directions to site 94 Port Townsend Bay Drive-Port Hadlock SOURCE OF SEWAGE/USE TYPE OF WORK WATER SOURCE ' Residential ✓ New Tank/s only ✓ Private Residential ADU Modification_ Public Expansion_ Community Upgrade, Repair SITE SIZE +/-7893sf SYSTEM TYPE Partial Repair-(tank) (drainfield) Previous Evaluation Conventional ✓ Designate ResArve Area Yes# Alternative Redesign No . I SYSTEM DETAILS Number of Gallons/day 240 Soil type ilia (attach soil eval.) Application Rate n/a qal./sq.ft./day Drainfield Length ilia ft. Trench Width n/a ft. Trench/Bed Depth n/a in. Septic Tank size 1000 min dal. Pump Chamber size n/a gal. TYPE OF Septic tank to community system 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 wil be separately judged by the rules and laws in effect at that time. Property O I Signature Date // >; FO�ROFFICEUSEONLY 3/ / /, PARTIALS `(/i ASBUILT q/2-211 FINAL f 'w APPROV D I � INSP/PUMP TEST G�Q - � PUD D{ �� 1 , /1‘( , ALL HOLD REQ.MET 1/ " Date 9/1 Fee Y Rec# / 7 P t1 Check# 9 2 Case#SEP / !LUS r•\noc11men*s and S=ttin.gs_\Suzann= 'Martin\My Documents\*^y dow*"en*s 2an*v\*"b42o\Jefferson C n*y\Jeffro forms\Suz\2008 SPA.DOC 4y473< 3 ` JEFFERSON COUNTY PUBLIC HEALTH 615 Sheridan Street •Port Townsend•Washington •98368 www.jefferson countyp ub lichealth.o rg Rhone MU-Mb-9444 Fax :itiU-3/9-4473/ ON-SITE SEWAGE DISPOSAL PERMIT PERMIT #: SEP13-00145 Date Received: 12/19/13 SITE ADDRESS: 94 PORT TOWNSEND BAY DR Date Issued: 03/17/14 PORT HADLOCK, WA 98339 Date Expires: 03/17/17 APPLICANT: LARRY G BATSON PHONE: GEORGINA BATSON 533 BLACKHAWK LN PORT ANGELES WA 983628380 LEGAL DESCRIPTION: VILLAS BY THE SEA LOT 11 PARCEL#: 997900011 Section: 1 Township: 29N Range: 01 W DESIGNER: SUZANNE L MARTIN PHONE: 360-554-0224 SEPTICS BY SUZANNE PO BOX 125 CHIMACUM WA 98325 SYSTEM DESCRIPTION: SEPTIC TANK TO COM SYS No. of Gallons per Day: 240 Type of work: Drainfield Trench Septic Tank Length: feet Width: feet Depth: inches Size: 1,000 gallons 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. 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. 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 Systems, codified in JCC 8.15 as amended. This permit may not be renewed. Jefferson County Environmental Health Specialist This permit with conditions must be onsite during all phases of construction HEALTH DEPARTMENT MUST BE CONTACTED FOR FINAL INSPECTION. SPECIAL CONDITIONS APPLY - SEE ADDITIONAL PAGES CONDITIONS OF APPROVAL - PERMIT NO.: SEP13-00145 1.) H-A signed Customer Agreement with the system owner, Jefferson County PUD#1, shall be submitted to this office prior to final approval of the septic permit. 2.) There are existing water and sewer connection points. Any new water or sewer lines that are part of this permit must be cased where they are less than 10' from each other. 3.) Any portion of transport line under a driven way is to be sleeved/cased or equivalent. 4.) Final approval of the sewage disposal permit will be given at the time our office has written notification by the PUD and/or the designer that inspections have been made and the installation meets their satisfaction. 5.) 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. 6.) H - AS PER WAC 246-272A AND JEFFERSON COUNTY CODE 8.15 ALL ONSITE SEWAGE SYSTEMS REQUIRE THATA 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 246-272AAND 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 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 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. 13.) This parcel is within a no shooting area per JCC 8.50. 14.) 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. 15.) Health Department is to be contacted for a final inspection of the septic tank prior to covering. 16.) 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. 17.) This approval is valid only with a connection to an approved public water supply. 18.) 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. SEP13-00145 Page 2 of 2 \\tidemark\data\forms\F_SEP_Permitmod.rpt 3/17/2014 r�� CONVENTIONAL SYSTEM AS-BUILT INSPECTION REPORT Installer: Shold Excavating (Evan Neville) Parcel # 997 900 011 Permit Owner: Larry&Gina Batson Permit# 13-00145 Designer: Suzanne Martin Design Flow: 240 gpd Site Address: 94 Port Townsend Bay Drive-Port Hadlock,WA 98339 ABSORPTION AREA: DRAINFIELD TRENCH WIDTH TRENCH DEPTH TANK SIZE #OF BEDRMS #GAL/DAY LENGTH Community Drainfield 1000 Cotton Tank 2 240gpd IF PUMP AND PUMP CHAMBER REQUIRED: Shroud/Screen Tank Size: Float Arrangement High water float—distance to top of tank/emergency storage Dose drawdown(#of inches) #Gallons/Dose Timer/Dose Counter info Pump Size/Manufacturer COMMENTS (inspection notes, changes from design or deficiencies installation)Attach additional sheet(s) if necessary Installed 2 compartment, concrete septic tank with outlet filter installed. All OSS Component installation have met or exceeded State and local codes and regulations. Users Manual Provided to Homeowner mailed 17Sept14 Date ATTACH ASBUILT DRAWING signed by Designer or stamped/signed by a Licensed Professional Engineer I CERTIFY THE INFORMATION PROVIDED ABOVE WAS VERIFIED BY INSPECTION, THE SYSTEM WAS INSTALLED AS DESIGNED AND APPROVED by JEFFERSON COUNTY (DATE)OR THAT CHANGES HAVE BEEN P NOTED AND THIS SYSTEM IS IN COMPLIANCE WITH WAC 346-272 ,;' i�'', 17 September 2014 5100342 *NV- „/ Design r Signature Date License# 5? 'y Suzanne L Mann +, `von 3 vnns 5 cn <-r I 0 (n (n 0 CD 0, c- CD CD C X CD Mp CD -p CD 0 0 .-i- N d O O = CD n •-i- ,-+ C CD d 0 c- 77 7C 0 * CD � 3 n ' 5 o c_ -- = � -4 i O \ -' O CD (n o -' b C D r+te ,+ O p CD .(f) O tea. �' • ' 4• - ---1 C-AJ co 2, 3 ._ ._ .0,‘k_ Sfillii ■.• 0 �No11\ � j ,A q\ i . CD♦ \i„, • \ ;' * --v. ■ o bn lik , \ * - \ <<‘ ON--4L---------,_ --------- r ... 0D- ce.p ,„ ---_______ --- 3 o irflO - o X O Cu N O CD -1. CD _ O N O a CD * 3 O - Q CD -� CD C ' h C CD D CQ CD0O O C, r-r N X * N a : _. 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R m ,.s w . v I I O u',go X ,..qio W 0 DT g N ••FY.q,; ,� O o m v a o so w - i 3 D Page 1 of 1;Batson; Tank Cross Section- Not To Scale parcel#997 900 011 (For illustrative purposes only, actual tank configuration may vary, tanks must be on list of approved products.) SECURED LID WITH GAS TIGHT SEAL 1 ACCESS RISER FINS ISH GRADE — -71611 ► to sewer line FROM SEWAGE SOURCE FLOATING MAT APPROVED EFFLUENT FILTER SEDIMENTS maximum 3/16"filter SEPTIC TANK (TYPICAL) 5111 ,G=DISPOSAL ESIrN Approved for Co struction Dote