Loading...
HomeMy WebLinkAboutSEP2014-00068 1 _ � -- : \ 0% i 1_ ,. . ..,, , ,, -,.., F'.' `, Jefferson County Department of Community Development a : 4 11 621 Sheridan St,Port Townsend WA 98368,(360)379-4450 •i . 5100259 Al, SEPTIC PERMIT APPLICATION �/. BERNT PAUL ERICSEN 1. c � $.-", R 7 Ocr A ( DA L.v ,, aea - e_13e1- t' A-L k ��►w_„•.te .�,a ., , z.������ d V r�3 ,, EXPIRES 02111/ MAILING ADD- 9../ NeTfiR T3 W #/'Jz TX e ivekm e©ic ©,( 97/ Y/ PHONE (.CO?3 1 &f A a-79 SYSTEM DESIGNER ER i C$ ) -O -5i GN Designer Phone# LEGAL DESCRIPTION: Section 15 Township;ON Range�U 1 PARCEL# /q O g 00 v©3 r f Subdivision Name CAPE Gel'R to 6 V-r-1 I11 6- Division Block Lots) Site address/Directions to site /0/ ,Y©Cc ik' M Po R r !b a)Ns elk* 6-h9 9 83 L E SOURCE OF SEWAGE/USE TYPE OF WORK WATER SOURCE Residential )4 New Tanks only Private Residential ADU Modification Public A. Commercial Expansion Community Upgrade i SYSTEM TYPE Repair X SITE SIZE II17t?0 Partial Repair-(tank) )C (drainfield) Previous Evaluation Conventional X Designate Reserve Area Yes#9 P 77-12/SOM 77-l2 Alternative Redesign No SYSTEM DETAILS Number of Gallons/day sAlio Soil type (attach soil eval.) Application Rate gal.lsq.ft/day Drainfield Length ft Trench Width ft. Trench/Bed Depth in. Septic Tank size I 000 gal. Pump Chamber size qal_ TYPE of system REPLACE LEAKINE1 TANK 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. 4f// `T-2.,3 -/% Property Owner Signature Date FOR OFFICE USE ONLY I l 1p/ �� PARTIAL C I I/ ASBUILT /d le 1 FIN A /�' APPROVE 1 1 INSP/PUMP TEST PUD �1 ZI l� ALL HOLD REQ.MET / Date 12-}1 Iti Fee I Z4 Rec# ) 501 Check# 13--8(p Case#SEP I u - coo Lo1E) H:\WEB:PDFs\Septic\septic_permatapp_2008.DCC � °d JEFFERSON COUNTY PUBLIC HEALTH ", , 615 Sheridan Street•Port Townsend•Washington •98368 FY tiit7 S.c: www.jeffersoncountypublichealth.org Phone 3 iU-.it3b-9444 1-ax ;itiU-3/9-4413/ ON—SITE SEWAGE DISPOSAL PERMIT PERMIT #: SEP14-00068 Date Received: 05/27/14 SITE ADDRESS: 101 RIDGE DR Date Issued: 07/24/14 PORT TOWNSEND, WA 98368 Date Expires: 10/24/14 APPLICANT: FLO A PALUMBO LIV TRS PHONE: COLETTE C EISELE LIV TRST 4951 NETARTS HWY W TILLAMOOK OR 971419467 LEGAL DESCRIPTION: CAPE GEORGE VILLAGE DIV 4 LOT 3 PARCEL#: 940800003 Section: 13 Township: 30N Range: 2W DESIGNER: BERNT ERICSEN PHONE: 360-301-0324 293 PINECREST DRIVE PORT TOWNSEND WA 98368 SYSTEM DESCRIPTION: SEPTIC TANK TO IND SYS No. of Gallons per Day: 240 Type of work: REP 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, odified in JCC 8.15 as amended. This permit may not be renewed. / Jefferson County Enviro mental 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.: SEP14-00068 1.) This permit was issued to correct a violation of WAC 246-272A for a failing septic tank. The permit must be completed within 90 days of the date of issuance. 2.) H - Existing tank shall be properly abandoned. It shall be pumped and filled with clean fill. Documentation to be provided to Health Dept. prior to final. 3.) A reserve drainfield area will be required to be identified by a licensed septic system designer prior to other permitting on this property. 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 246-272AAND 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.) 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. 7.) Notification of the start of construction shall be faxed or emailed to Jefferson County Public Health ONE WORKING DAY prior to start. 8.) H -An asbuilt drawing and certification of completion by the Designer is required prior to final approval. 9.) 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. 10.) 10' separation required between a Water line and all portions of the onsite sewage system; effluent transport line, tanks, treatment and disposal components. 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. 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. SEP14-00068 Page 2 of 2 \\tidemark\data\forms\F SEP_Permitmod.rpt 7/24/2014 CONVENTIONAL SYSTEM ASBUILT INSPECTION REPORT INSTALLER ER t SE.kJ EX. T©b K;I hani) PARCEL# -(3 S'O®OO 3 Permit Owner F L O "PAL U M BO Permit # 5' f tj- - (o g ABSORPTION AREA: DRAINFIELD TRENCH TRENCH TANK #OF #GAL/ LENGTH WIDTH DEPTH SIZE 1000 BEDRMS DAY .240 Tank Shroud/ IF PUMP AND PUMP CHAMBER REQUIRED: Size Screen 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 I CERTIFY THIS ONSITE SEWAGE SYSTEM WAS INSTALLED AS DESIGNED, PER PLAN APPROVED 5- <a 7- `84A,r,f to-30 `!`f DATE APPROVED '®ec jn4r SIGNATURE DATE See. cci-Facts e off. -Ze-ccjr 2 'Drat viik j 1 �Xlstlnc� �txnk a te.®vnm1 J eu� to00 Elan, Sholci, S9'+,c. Tank ins- -L1cQ. 415+111 clatrio-e p box ree1ttc Q. SQeea Ieveltrs 4 riser 1�c Clld Later • ectecQ - p K (FILE NAME FLO PALUMBO LIV TRS.TRV SCALE DATE DRAWN BY 10 Ft/In 10-30-2014 Bemt Ericsen JOB REVISION SHEET 0 NMI 0' 'j/l `940800003 1/1 1/11 This map drawn with TRAVERSE PC,Software Measurements: New"D" A to C= 14'6" Existing Drainfield Box installed A to D= 179" Not Located-See with speed levelers A to E=21'4" SEP77- 12 and riser. BtoC=42' E BtoD=43' BtoE=54'6" I New Septic Tank Connected to existing pipe D at house and reconnected 0 to new D box. :xisting Sep c Tank C 0 •ecommissi. ed. 0 (Pumped,c shed,filled ) L ,,,x3(6,,, C. O. 6' 7' B 08 A/ 1e • e 4 b in l e ° o Existing Home .,e N n yv c. 01, z �('� .. I E L lCN A,I . c —bet e loso ►� wooao..".......... e , •'l _ ,:r 11;:}a';. 52.00' 10-30-14 Concrete Slab in •- o N z Existing Driveway Existing Garage 0 q v N JJ RIDGE DRIVE Pavement N -<— — <— < <— <— <\ <— <— <— <— <— <—<�: < Ac)//' Existing Ditch 4704 E--> N X04 1 Ex.Water Existing ��, 1. 90.00' Meter �� El. Pole r N 87°54'09"W AtI X111 et "Found" Survey Corer,, o .,.:r , pi i • BERNT L ERICSEN 1 sr .C NSE 0 .s Ef"I *ER.ex I Existing Drainfield +-r-r S % 11 Not Located-See i0 ; -�, SEP77- 12 "New"Septic Tank Connected to existing pipe at house and reconnected . 0 0 Existing Septic Tank to"new" D box. O I 0 Decommissioned. o (Pumped, crushed,filled ) C. O. Q o o 7' CO° 1.0 6' W N U) O Existing Home o 0 0 o co � i." N 740: Z 52.00' Concrete Slab Existing Driveway Existing o Garage ,i - 24.00' N o 90.00' "Found" S 87°54'09"E .1 Pipe (-FILE NAME FLO PALUMBO LIV TRS.TRV SCALE DATE DRAWN BY 20 Ft/In 10-30-2014 Bemt Ericsen 0 20' s\ JOB REVISION SHEET � _ _EN `940800003 1/1 1/1 J Ts.:.........a...........:19.-rim n1icocr or' c..a........ 19,01(." RIDGE DRIVE Cep Pavement Mq y NN 466 —<— < /<— <—<—<—<—<—<— <— r,�' >�4:1? c �� Existing Ditch `' h fi�,,ye h x Ex.Water {jam._ Existing o saw Meter �, El.Pole N 87°54'0g'W 00R "Found" Survey Corner AGED c con / ion NI . ed '/ NO building sue, drivew - ; �' access Existing Drainfield or he appurtenance has � * � Not Located-See ,reviewed p f approved SEP77- 12 Jefferson County staff. Install"New"Septic Tank Connect to existing pipe from house and reconnect r } to pipe to drain field. (See Notes) O o .._Decommission Existing OO Septic Tank(See Notes) 0 Ex.Deck Instals C.O. `� o '- T A N C•3 O W f N e O CO Existing Home o 0 0 -4- N N Z — o i;so' 52.00' 0,4 �I Concrete Slab a t+ Ak* 1 to Existing Driveway Existing o �,°.2 BERNT PAUL�E�SEN `�1 :.IVSt)D .. ,. 0 Garage N ..10,......4".0.......,...t.a....�r�, EXPIRES°02/11 >-i 5'43 If - 24.00' 0 90 "Found" S 87°54'09" o Pipe /FILE NAME FLO PALUMBO LIV TRS.TRV SCALE DATE DRAWN BY 20 Ft/In 5-22-2014 Bemt Ericsen 0 20' I\ JOB REVISION SHEET 1111111_ •1.1 ,\940800003 111 1/1 J n.;.. -a............ Tae%I D O o..a.......... qt./16/000o 3 I 1 i''). • K=sew :: k4r . I2V _. s ,� 27, 4. --n nf,. e,- 1f m �f re. u s t 6tt 1 fj C --;;=- } h .- _ �° �! �-: I _ TO D BOX v _ -: L Li 4 0. �'s i `Pr �t 01 Al ip gip` 4. 0.4 . - a 1 jib i T sioo 5c �`C'�ed �V AT- BERM'PAUL sErt ��a � n PP �o .r�'. •udEINttb bE 1�{m- 0 _ Q a�ar►�.`�aa�►�w1010M•►M►oawi:' s ;. . S-O2/11/r� Trench Profile ( No Scale (See Notes For Dettails) Finish Grade ote;ctile Filter Fabric Nacre Backfill Inspection Po .1 N 21.2.. - 4%T:< -,w... 5., .Y Y ,C`-S Y Y .r.-;a'-.X-F�Y°a' .+.• ZX ,:x Y .+~ ".^'4 u .'"'u` %. = Y_: Ur; � Y i yys s, +e t yr ,1*:4'1c=.-. -1 rf''y ;y` v'5 ,tom.42; :x.-� = s t x"~a`t- End Trench Finish Grade Box 4°ASTM D2729 d To Draintield wrilre-114 303 4 (Solid) rom Septic Tank i_ r �-� 1.3 ' ; 3l4to11/2° ; k , Clean Drainrock , -:���V�r 'x. 6"Min.Under Pipe ' vasIGA redfo .04\ �, C •at MAY 2 7 2014 x �r `y `# � y -L, 00 Flo Paluri rsat. county '' 94080 ' 3nment , Heath 1=BERNTPAU ERiCSEN�' Project Description "' " 5-13 .14 Decommission existing tank ( which was found to be leaking ) See SOM77 — 12. Install "New" Septic Tank. Septic Tank Install 1000 gallon two compartment septic tank. Install water tight risers to grade on all tank lid openings. Install outlet baffle filter ( Orenco FTiP 0418 —W ) or equivalent. Tank to be set on 6" of "Pea Gravel". Fill with water prior to "Designers" inspection. Seal tank inlet, outlet pipes - i - h Ben • 1' - Transport Line Reconnect to existing sewer pipe from building ( Install C. O. ) @2% minimum grade and reconnect to existing pipe to "D" box @ 1% min. Inspections Designer needs to be contacted for a pre-construction meeting prior to construction to discuss details and to set up schedule for inspections. Designer is responsible for submitting "Record" drawing, and must be called prior to backfilling system. General Construction Notes 1. The work described herein consists of construction of an on-site wastewater system. 2. The contractor shall be knowledgeable and experienced in the construction of this type of wastewater system and shall hold a valid certificate from Jefferson County.Division of Environmental Health. "Approved" septic plans must be on site during construction. 3. If during the installation of the system the contractor finds soil conditions that may lead to premature failure of the system, construction shall be terminated immediately and the designer notified. Such soil conditions may include groundwater, fill, clay, highly compacted soil, bedrock or excessively permeable soils. 1. Any inconsistencies, errors, or omissions that, in the opinion of the installer, would compromise the quality of the wastewater system shall be reported to the designer prior to construction. 1. Backfill in traffic areas shall be pitrun gravel and compacted. All gravity pipe shall conform to ASTM D 3034. All gravity and transport pipe shall be bedded, using native or imported material free of rocks, debris and sharp k Ef objects. MAY 2 7 2. All exposed soil shall be seeded and mulched prior to thelal insion. Seed shall be spread at an approximate rate of 10 lbs. per 5,(10(rgr, ` ' 'unty 3. The installer shall be responsible for constructing the system aardingitio plans and conditions of permit and shall be responsible for its proper operation and function for one year. The owner shall be responsible for operating and maintaining the wastewater system in accordance with WAC 246-272A-0270. 4. Any changes, substitutions, or deviation from these plans shall be approved by the designer and by the Jefferson County Environmental Health Department. 5. The installer shall grade to divert all surface water runoff away from tanks and drainfield/reserve areas. 6. The bottom of the trench or bed may be inspected by the designer prior to placing drain rock and shall not exceed +1- %" from level. Place filter fabric over drain rock prior to backfilling. 7. Setbacks to all known water lines shall be a minimum of 10'. No crossing of water lines with any septic component shall be allowed, except as included in septic design approved by Jefferson County Health Department. 8. Setback from the house foundation wall shall be 10' minimum to drainfield, 5' minimum to tanks and 2' minimum to non-perforated sewer pipes. Water saving appliances, fixtures, and practices are to be used. 9. The septic and pump tanks, drainfield and reserve areas are to be protected from vehicular traffic or mechanical disturbance. 10. The designer is to provide the as-built and letter of certification. 11. This system has been designed in accordance with WAC 246-272-A- 0270 and the most current Department of Health "Recommended Standards and Guidelines for Pressure Distribution Systems," and has been approved by the Jefferson County Health Department. Nevertheless, negligence or improper action on the part of the users could result in the premature failure or malfunction of the system or its components. LP-v0l 47s ifY,6"C,.:L..'. i: S I rs MAY 2 7 - - 1 .'e Jeffers(); CAPE GEORGE VILLAGE MITT vlronment«r Hem . SECTION 13 - 730 N - Az W-W At t!? crviER serrxys'.o 0.-445 aa 3s ✓$FFERSON COUNTY, WASHINGTON a s 7r ss—=s .as'ss ..:4,,— ;a'j.•,c b?:=,€4E_/-'-? ;_".-T-•; 47.47..53:4/- _ DEN 116' s er-/ 56 BLVD zszis -- /1000 ao s R g- yes — ‘-c 1 /3v3sj s r-s•3r k,pa . ... ,,. t 65 sow o gysto- -a s.-sr .� _,?s! -" ,�ppa' au's1s Aar. q�ecerysrnr.e i `•a fs _ . 35 Teo" `¢ 4 - . ;' e-4r��,y .0-4,-.2-41.- -sew go' g 79 i 23 0 oft ` y _ 64 »=a , , o' ''',:\;1 20 $ d.f� -_�� Is% war �\ f8 $ 's> 4f0 ` 62 88 78 \\ * �3 �` 48 E 6/ $ 1 ,K 3s' , '4. `a �, te" bf# X69 .j 1+0d •::::' - .. \ .. 2T 38 --4'v.% 49 t �, t ° a, t., 70 111 K+ �"a A /5 ° 28 - 37 .S'0 59 . If'` mz ` r t, xd0•R'£... 1 -R r k `;, .``K,' R pars!:-pro saw, K r_ 5 ,�•� . : k 52 �,-J it ° �T0 -' sire 3. easvc3-rs'` a,4.973s 3 .rmiarr7 r AID ikrA'r dAP.SsaYE.e. 6` • S ,catea3.9-E. Ney'K'z ' l _ 73 ` • g '�„al' _ 4 d'3'p�AY ,A_IAPrJ'.317K'Y kt i '' a Le 5/ 53 S6 -,our szr e NI i a. �NSY64orz •NS704rvssx} $ N. AZ 74 m zr, ., q .03404 tihe ijam oar _ 2 // $ } 32 33 il ,-' SS 4.1-- P3Ot00 y 4°214.-- )ry-�- .rersZou T`, - �''�wwttp /.3000 y y;∎∎ X3HQ? /36GV b$1 ,96.e6 '{- RIDGE++ .rsr'ss a9'hr -- - - - 9b COO t 4 l0 9 8 7 6 5 4 3 $ 2 / 1 ``'--Pa Tv.-�? WC OP „ . ,. . . - $4200 BR 7.5 ,7706 334v N.67.54'09'A, S60.3/ 460 70 T ,. �ATTEC D£SCRIPT/ON This PAW of CAPE •EO.PCE Y/e'ZAGE DII/4 Ai-.bowie e the PAW'of Lbpr 68ory•ti//gyr pie 3 redo//n *1 41 ,, the 9707-Jbrrest q ,-' '- of Ace southeast r finewd offY17/s(byes£9f60 4744/47 Abe'trca.-4& of....t.f7o-savr Lam; Ike /70,-70"7.57'gvvaa.t9 of rile .se #eosf Qrvrfe' of.sea tYssh/gsbn 0979'in 91/,5k• -ts#e»sf f409 ,-of At-durhi not /3,Tosrasbip 30Abrf4, A'one 2/Yea", /Yfri ono'C0/2/0h7.1-MO/ Qaorfer Iyrray woof of Coon y Rood/01.40 less Motpolrtion gr'e• of sc,—,ed o9 fa//orrs; A//of/he rArr'1tivesf Qarvtler lyirzy .�sold/u/of of a ar o arorye Y//laye Oir.Z. of the soufheost Qorvrfer-foss /he Plot of Cope esew.yym !/i//oye O/r£2 r-ercorag.d.ter Yea/.4r of P/ofs,lire 44 4079'/ems SWEET/or e 5