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HomeMy WebLinkAboutSEP2007-00337 Jefferson County Department of Community Development • 621 Sheridan St., Port Townsend WA 98368, (360)379-4450 SEPTIC PERMIT APPLICATION RI-11 CEIVE D ' PROPERTY OWNER Lawrence Johnson MAILING ADDRESS 8265 Flagler Rd. 0 8 2007 Nordland,WA 98358 OCT t� U PHONE (360)379-8707 •�����SO� �0��� ��� SYSTEM DESIGNER: Michael S. Deeney Designer Phone#: ( 800 ) 395-7296 u! LEGAL DESCRIPTION: Section 3 Township 29 Range 1W PARCEL#942903414 Subdivision Name V. 7 of Lonq Plats, P.33 Division Block Lot(s) Site address/Directions to site 33 W. Co onna Balch Dr., Cailocne, WA 08373 "1 /a133 ,71 /i1 SOURCE OF SEWAGE/USE TYPE OF WORK WATER SOURCE Residential New 405071/1 Y( Private Residential ADU Modification � ✓ Public X Commercial X Expansion Community Upgrade Repair SITE SIZE 3.09 acres +/- SYSTEM TYPE Partial Repair-(tank) (drainfield) Previous Evaluation Conventional Designate Reserve Area Yes#SEP 84-00085 Alternative X Redesign No SYSTEM DETAILS 74 f7 s?6 2r, ''556P1 . TAG, .471'17 Number of Gallons/day 36: Soil type 1 (attach soil eval.) Application Rate 1.0 gal./sq.ft./day Drainfield Length 124 ft. Trench Width 3 ft. Trench/Bed Depth 62 to 68 in. Septic Tank size 1,000 gal. Pump Chamber size 1,000 gal. TYPE OF SYSTEM Pressure Sand Lined Drainfield 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 yo will later obtain permission to build a permanent residence or other structure on this parcel. Any fut e a• ation will i i i-par. ely judged by the rules and laws in effect at that time. Alb'... °urii 'agk.at 10 ..0 3 _ 07 Prope y •wner Signature Date . I.I I Fa FOR OFFICE USE ONLY 2 0 1 1 1 1.'*_/1 1.,1/ " -TIAL ASBUILT t .-(. P INAINA q(zL[oK APPROVED ,i� INSP/PUMP TES1 Q.r di P8t3' 11 2.1 (OV ALL HOLD REQ. MET � / �J Date 1D--`Or7 Fee �F 'r Rec# 85235 Check#cI ) (G2 I Case#SEP C/ 1 —33 \\Mike2\c(mike2)\Data\Wpw\County&State Forms\Jefferson\Septic Permit Forms\Johnson,Lawrence,(Carl's Bldg Supply)Parcel#942903414.wpd SEWAGE DISPOSAL PERMIT Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend WA 98368 (360) 379-4450 (800) 831-2678 PERMIT #: SEP07-00337 Date Received: 10/08/07 SITE ADDRESS: Date Issued: 11/06/07 Date Expires: 11/06/10 APPLICANT: LAWRENCE R JOHNSON PHONE: 360-379-8707 8265 FLAGLER RD NORDLAND WA 983589524 SUBDIVISION: CHALMER'S 2ND ADDITION BLOCK: 34 LOT: 14 PARCEL#: 942903414 Section: 3 Township: 29N Range: 01 W DESIGNER: MIKE DEENEY PHONE: (800)395-7296 CREATIVE DESIGN SOLUTIONS PO BOX 2787 PORT ANGELES WA 98362 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 Thls permit is issued for a period of three years (unl-ss therwise stated above) in accordance with Jefferson County Rules and regulations for on-site sewage - sfems, codified 8.15 amended per ordinance no. 08-0921-00. This permit may not be renewed. , Jeffe on 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: 150-SAND LINED TRENCH No. of Gallons per Day: 360 Type of work: NEW Drainfield Trench Septic Tank Length: 124 feet Width: 3 feet Depth: 62 inches Size: 1,000 gallons SPECIAL CONDITIONS APPLY - SEE REVERSE CONDITIONS OF APPROVAL- PERMIT NO.: SEP07-00337 1.) 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. 2.) 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. 3.) H -the installation of the transport lines to the septic tank and pump chamber must be installed in accordance with the design specifications and must be documented as such on the construction drawings by the septic system designer. 4.) H - AS PER WAC 246-272 AND JEFFERSON COUNTY CODE 8.15 ALL SYSTEMS REQUIRE MONITORING. THIS SEWAGE DISPOSAL SYSTEM WILL REQUIRE AN ACTIVE MONITORING AGREEMENT RECORDED TO THE PROPERTY TITLE PRIOR TO FINAL APPROVAL OF THE SEWAGE DISPOSAL SYSTEM. 5.) 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 PER JEFFERSON COUNTY CODE 8.15 AS ADOPTED OR AMENDED. 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.) Setbacks to all wells- 100' required from drainfield and reserve areas. 50' required from tanks and effluent transport lines. 12.) 10' separation required between a Water line and all portions of the onsite sewage system; effluent transport line, tanks, treatment and disposal components. 13.) Setback to surface waters- 100' required from drainfield and reserve areas. 50' required from tanks. 14.) TRENCH TO BE EXCAVATED AND THEN BACKFILLED WITH ASTM 33 TYPE SAND TO 24"AND UP SIDE WALLS AS PER DESIGN. 15.) When/if designated reserve area is utilized an alternative system providing an additional level of treatment may be required. 2 of 3 11/22/19 I:\F_SEP_Permit.rpt 16.) A 30' setback shall be maintained from the disposal component and reserve area to any downslope footing, curtain or interceptor drain or drainage ditch. 17.) All components of the septic system are to be completely protected from vehicular traffic or mechanical disturbance. 18.) H - Permanent barriers are required along/around primary and reserve drainfield areas to protect from parking, driving, and other land disturbing activities prior to final. 19.) Drainliries are to be installed along the natural contours. 20.) Contact designer prior to installation for staking of drainfield area. 21.) Divert all sources of drainage, including roof drains away from septic tank and drainfield area. 22.) Any portion of transport line under a driven way is to be sleeved/cased or equivalent or installed per design specifications. 23.) 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. 24.) Pump chamber shall be water tight and a minimum capacity of 1,000 gallons. It shall be equipped with a control panel outside within line of sight of the pump chamber. The panel shall have an audio and visual alarm, a cycle counter and a riser to grade. It shall be UL listed and meet L&I requirements. 25.) A screen shall be provided either at the outlet of the septic tank or around the pump or at both locations.A pump shroud is required if only an outlet baffle filter is used. 26.) Dose counter and elapsed time meter are required in the control panel for all system components. 27.) Risers are required to grade with secured lids over both compartments and over the outlet of the septic tank for inspection and maintenance/monitoring. Minimum 20" riser over inlet. 28.) H - Recorded easement required for primary and/or reserve drainfields. Easement recorded 528063 with the Jefferson County Auditors office. 29.) 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. 30.) This onsite sewage system is designed for domestic strength wastewater only. Disposal of any other waste strength is considered a violation of this permit. 31.) This system as designed and approved is sized for only one single family residence. It is not sized for an Accessory Dwelling Unit(ADU). The minimum daily design flow per residence is 240 GPD. 32.) 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_Permit.rpt it JEFFERSON COUNTY COMMUNITY DEVELOPMENT- 621 SHERIDAN ST, PORT TOWNSEND WA 98368 CONSTRUCTION INSPECTION REPORT ,-- County Inspector(to be filled in by County) Date Inspected by County Designer /v7/ite t>EE./G"j-) / Permit# SEP d?- 4'0337 Installer "f JQS' ' /Sas'Ai Parcel # q4 2- g".3 .jam Electrician Design Flow a c ' Property Owner L/44/2 grove'.tr. mac)A/AIsm Site Address /0'7 3 3 X�Y''i- '2,/ P2T t t/ A'L , / t.'-4 9 a3'. ITEM -7--wo SIZE/MANUFACTURER/CLASS/SCHEDULE DATE Tank(size, baffles, risers, etc) /©■4 4.4.1 Z c "- 4il�B4tFx'ef -' e 'tZ07- F/e 7E 2-q-e 4.2-aa-t.25 Pump chamber(size, baffles, risers, etc) /9t' ''4L �-9--og Screen(s)/Pump Shroud PlifrIP v'iU¢T o/ 'TO 'Z- r'/L7',€2 7-s-4S Float arrangement /9011/400ie5C rle,INS.L>r9e'4-.92. 2-rr o$ Second pump -- Emergency Storage Above High Water Alarm (# gallons) 3 7 t 2 - `t-e*> Pump #1 PF-3ev os7/ Pump#2 Z-9-0 S Anti-siphon device Sandfilter basin high water alarm shuts down pump to Sandfilter Yes No Dose Counter Reading 15 Elap. Time Meter Reading 1b' ". Ye sec "Z-Z© 8 Dose Drawdown (in inches) t, 4- 2nd Basin Z-7e-G>8 #Gallons/dose 3D 2nd Basin 2-2®-d8'' Panel Model Ado/law j/ Timer Model /' 4'd0449c '}C 2-`i-0/9 Timer Functions: On time /53 5 arc Off time ZHis S".-47,,a 7ssc674/+/.v`7src) Z-2o,oa- Other Timer functions & settings (e.g verrid a on 2-70°caa X s 7- .if-,-, I •I'5 T.trre,cg-c. /2 ewd, 'c�.='F Transport Pipe /%Z ii3Gfr g'' Manifold 1-//Se-M. 2 2-9-©F Orifice size %" Lateral 14-n 3'c# 4e 2-�-o S Barrier Material 6-P4t-`�Ez,ersS' ceboinftrigs Cover Material/Depth 24 am If s'•-1.-- -2- -4 Residual Head(lat.#&ft. Head) Lo "-2"4LL L47'5 Z-za-cam Sand Fill (met ASTM?) Sandfilter Basin Mound Site Prep Drainfield Length / Z4- ft Width 3 ft Depth 62 &is inches COMMENTS (inspection notes, changes from design or deficiencies in installation)Attach additional sheet(s) if necessary /94r.P-Wc',2ye 3./2r9nexp•tacir .s'0)`0 Zs"/9Bdv.�FLov12 cr),c 7-�9,-/ _ /9 47 co/52t../©rz)c t...1-�.1 t_ s&-P1,`</k-f4..S : 1,°fr,-7,e,-/- V9,e7c G.9;; tf/4, f,92Ai2,-. Ve ova./ 2(3>eL� 2,4,61 y6sir7-@ z3.4'i &' 7 zg.0`) £ 4)-1 /=-d / / gloss 0g/ /10)-ocGA....0 = 1 .z>405 I Users M mual Provided to Homeowner W')W 46-r.="i1> 3>P4r4P14 & Date ATTACH RECORD DRAWING signed by Designer or stamped/signed by Licensed Professional Engineer I certify the information provided above was verified by inspection (with exceptions as noted, if any). I also certify that this on-site system was installed in accordance with the approved design and verified through periodic observations of; construction such as site plowing for mounds, pressure testing with all system components exposed (no backfili,except over transport pipes), and final inspection of the completed system (with exceptions as noted, if any). 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