HomeMy WebLinkAboutSEP2003-00072 Jefferson County Department of Community Development
621 Sheridan St., Port Townsend WA 98368, (360) 379-4450
r SEPTIC PF MIT APPLICATION
PROPERTY OWNER Of1Ad (1-C d1iq ail"- WI 20 2001
MAILING ADDRESS 2'0 (r J 1 La 5 % _ 1 L, - / 1
fDr f-Ijad la ck. IA-
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PHONE Area Code ( ) 39 /_0 G/
SYSTEM DESIGNER e� c11x Q
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LEGAL DESCRIPTION: Section 3 Township 3 ( Range 1 t PARCEL # )6i-D5-607
Subdivision Name I 1 'b an (ti . VU_ Division Block Lot(s) 7
SITE LOCATION 13-7 cr c�) � 1Dln �� f� fT��iic� Zip Code 91301`b
SOURCE OF SEWAGE: Residential X Residential ADU X Commercial Community
TYPE OF WORK: New x Redesign Upgrade Repair Partial (tank) (drainfield)
Expansion Designate Reserve Area
Conventional x Alternative Drainfield Length AI-0 ft. Trench Width .3 ft.
Number of Gallons/day360 FE-4; Trench/Bed Depth i4.2-r/ in. Number of Lines 1
Site Size 5 A Septic Tank size //)0 o gal. Pump Chamber size A)l fI gal.
Water Source: private)C public Soil type _2_,I (ATTACH SOIL EVAL.)
Previous eval: ye / no ISEP93 .2 Application Rate .e gal./sq.ft./day
TYPE OF SYSTEM CON urjti1TZ ak R c Cbj
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 it's employees, representatives or agents
for the purpose of application review and any required later inspections. Access and right of entry to the
applicant's property or structure shall be requested and shall occur during regular business hours.
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
jud ed by4th r les and laws in effect at that time.
I/WO
Owner Signature Date
FOR OFFICE USE ONLY
al lo, PARTIAL 3 -Arsetltt9' S J!b j�� FINAL `�DI f 3
APPROVED PRESS/TEST PUD
Fire District Planning District School District Zone
Date-3/2010; Fee 740°1". Rec # 55 ct 43 Check # ( qZ. Case# SEPO ' ✓
H:\env_health\linda\GD\FORMS\SEPTIC PERMIT APPLICATION.DOC 7/01
SEWAGE DISPOSAL PERMIT
Jefferson County Department of Community Development
621 Sheridan Street, Port Townsend WA 98368 (360) 379-4450 (800) 831-2678
PERMIT #: SEP03-00072 Date Received: 03/20/03
SITE ADDRESS: MIDDLEPOINT RD Date Issued: 06/09/03
PORT TOWNSEND, WA 98368 Date Expires: 06/09/06
APPLICANT: DAVID D BELT PHONE: (360)344-4081
CYNTHIA A BELT
240 COONTZ AVE
PORT HADLOCK WA 98339-9740
SUBDIVISION: MIDDLEPOINT LAND CONSERVANCY BLOCK: LOT: 7
PARCEL#: 101325007 Section: 32 Township: 31N Range: 01 W
DESIGNER: JANET WELCH, RS PHONE: (360)385-5910
SEPTIC SENSE
PO BOX 1221
PORT HADLOCK WA 98339
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.
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 15 amended per ordinance no. 08-0921-00. This
permit may not be renewed. /111
R MARX, Jefferson ounty Environmental 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: 110-CONVENTIONAL TRENCH
No. of Gallons per Day: 360 Type of work: NEW
Drainfield Trench Septic Tank
Length: 150 feet Width: 3 feet Depth: 12 inches Size: 1,000 gallons
SPECIAL CONDITIONS APPLY - SEE REVERSE
CONDITIONS OF APPROVAL - PERMIT NO.: SEP03-00072
1.) Distribution boxes shall be fitted with a riser to grade, constructed of durable materials and
a secured lid, adequately sized to allow visible inspection of the liquid level in the box.
2.) There is an existing septic system installed on this property(SEP93-22)This permit is
being issued based on one of the two systems being classified as an ADU. Currently
there is no residence or use of the existing system.
3.) As per Jefferson County Code 8.15 all onsite sewage systems require monitoring.
Monitoring shall be provided by an approved entity. THIS SYSTEM IS REQUIRED TO BE
INSPECTED EVERY 3 YEARS.
4.) An asbuilt drawing and certification of completion by the installer is required prior to final
approval.
5.) 10'separation required between a Water line and all portions of the onsite sewage
system; effluent transport line, tanks, treatment and disposal components.
6.) Contact designer prior to installation for staking of drainfield area.
7.) Divert all sources of drainage, including roof drains away from septic tank and drainfield
area.
8.) 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.
9.) Approval of this onsite sewage permit that includes an accessory dwelling unit does not
assure that a building permit for an accessory dwelling unit will be approved. Building
permit applications are subject to the requirements at the time of application, of the Jeff.
Co. Building Code, Zoning Ordinance, Comprehensive Land Use Plan and Land Use
Procedures Ordinance as well as any other environmental approvals duly adopted by
Jefferson County, the State of Washington or any other agency with Jurisdiction.
10.) 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.
11.) 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.
12.) The application was reviewed by the Jefferson County staff on May 16, 2003 for the
potential presence of Environmentally Sensitive Areas (ESAs) under the provisions of the
Unified Development Code(UDC). After an initial Geographic Information Systems
mapping review and an investigative site inspection, the following ESAs were confirmed to
be present on the subject property: Eagle, landslide 1 &2, seismic, SUSC aquifer
recharge area, Coastal SIPZ.
13.) Geologically Hazardous Areas in Jefferson County are characterized by slope, soil type,
geologic material, and groundwater that may combine to create problems with slope
stability, erosion, and water quality during and after construction or during natural events
such as earthquakes or severe rainstorms.
14.) A vegetative buffer of 30-feet shall be permanently maintained from the top or edge of the
Landslide Hazard Area. All buffers shall be measured perpendicularly from the top or toe
of the Landslide Hazard Area.
2 of 4
11/22/19
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3"PPP SENSE
JEFFERSON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT
I , 621 SHERIDAN ST., PORT TOWNSEND,WA 98368, (360) 379-4450
SOIL EVALUATION MAR 20
PROPERTY OWNER 774 v/4 6--C` ' J iZ ip I3 EL!
SYSTEM DESIGNER .017..0 S'ENSL-
LEGAL DESCRIPTION: Section Township Range Parcel # ( 47- 5.007
Subdivision Name ,A41 0,,a L Pv, Division Block Lot(s) 7
Date Logged: -y, .Oi, y/9"),3 Logged By: jtj
Include soil textural characteristics and the depths at which significant changes occur. Be sure to include depth
where mottling or impermeable layers occur.
SOIL LOG #1 SOIL LOG #2
0 to /0 in. /S / G to /7 in. GS
/ t05-0 in./vs- w/ 5-le/ices se s /� to (�' in.
So to A'7U in.
yv to 7p i ..to in. /izio3 to in.
Anticipated water table 23 in. Anticipated water table in.
Roots to (/ inches Roots to inches
Health Dept. Comments Health Dept. Comments,,
SOIL LOG V SOIL LOG #4
G to,O in. /J 0 to/x in. /r.
Z to 65 in.✓n5fl6 nn /? to (_in. �g n
6 5 to 7 in. Nocieem i"e% f�dc 3A, to$? in.�ns.'S r9t.f (/l7T, t3
to in. to in./cer n 4
Anticipated water table.,/Jin. Anticipated water table>gO in.
Roots to inches Roots to '/D inches
Health Dept. Comments Health Dept. Comments
v
SOIL LOG #5 SOIL LOG #6
O to do in. �/5 to in.
JO to0 in.IS, 6k, 1)//e/Lref.Y6-6 to in.
to j_in. 6RS 610 to in.
to in. to in.
Anticipated water table,40 in. Anticipated water table in.
Roots to 5v inches Roots to inches
Health Dept. Co ments Health Dept. Comments
H:IINFOHLTH\SOIL.FRM1/00