HomeMy WebLinkAboutSEP2006-00230 r 4
I', ECEIVED Jefferson County Department of Community Development
621 Sheridan St., Port Townsend WA 98368, (360)379-4450
JUL 1 2 2006 SEPTIC PERMIT APPLICATION
PROPERTY OWNER gyan gacrna-'J
INISOEVE BCD s-i Tc I o-c 5.-.
Par+ m•sen d, w ft 9336 s
PHONE Area Code( 3630 ) 3$5 - 5!c5 3
SYSTEM DESIGNER p a.+kc r. Is. GleatVe'r
LEGAL DESCRIPTION: Section /(6 Township-3O N Range 1 W PARCEL# 9+$ 60 3 96 t
Subdivision Name Ai'&n 6e,s SA/ kiCw Division Block 3�' Lot(s) 1$62
SITE LOCATION/6 "`
�.4x•,,,:.► �-:a,—= S _ Zip Code
SOURCE OF SEWAGE: Residential ✓ Residential ADU Commercial Community
TYPE OF WORK: New ✓ Redesign Upgrade Repair Partial (tank) (drainfield)
Expansion Designate Reserve Area Modification
/
Conventional ✓ Alternative Drainfield Length 150 ft. Trench Width 3 ft.
Number of Gallons/day 36c) Trench/Bed Depth /,2-. in. Number of Lines 3
Site Size /6/400? (c. rtG) Septic Tank size /GOO gal. Pump Chamber size/60O gal.
Water Source: private public V Soil type 3 (ATTACH SOIL EVAL.)
Previous eval: yes /0 # Application Rate , g gal./sq.ft./day
TYPE OF SYSTEM Gat w (jrirn7' -)/ p
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 ap cation will be se ly judge "y the rules and laws in effect at that time.
x �. 7/12/'x'
Owner Signature Date
J /G7 ,PARTIAL/YO %se4T- ILowd- Va 7 FINAL k Y/14/0-7
APPROVED
PRESS/TEST _PUD
Fire District Planning District School District Zone
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Date—C- O6;Fee / 3 Rec# C `z C)e Check# ,4 b Case#SEP No-a
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SEWAGE DISPOSAL PERMIT
Jefferson County Department of Community Development
621 Sheridan Street, Port Townsend WA 98368 (360) 379-4450 (800) 831-2678
PERMIT #: SEP06-00230 Date Received: 07/12/06
SITE ADDRESS: El ENBE1O *.E 155 l-cwISA Date Issued: 09/21/06
PORT TOWNSEND, WA 98368 Date Expires: 09/21/09
APPLICANT: RYAN BARNARD PHONE: 425-239-9435
815 TAYLOR ST
PORT TOWNSEND WA 98368
SUBDIVISION: EISENBEIS BAY VIEW BLOCK: 39 LOT: 1-2+
PARCEL#: 948603901 Section: 16 Township: 30N Range: 01 W
DESIGNER: NATHAN N CLEAVER PHONE: (360)779-5652
22900 STOTTLEMEYER RD
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.
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 sewa• stems, codified 8.15 amended per ordinance no. 08-0921-00.
This permit may not be renewed. `"✓
A GARDNER, Jefferson County 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.: SEP06-00230
1.) This septic permit is for a Conventional Septic System only. This system design may
require a change to an Alternative (pressurized)System due to hydrologic gradient
issues. Jefferson County Environmental Health shall be notified of any change in system
design at the time this need is identified due to the requirement of additional permit
conditions for a pressurized septic system.
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 - AS PER WAC 246-272 AND JEFFERSON COUNTY CODE 8.15 ALL SYSTEMS
REQUIRE MONITORING. THIS MONITORING IS PROVIDED BY AGREEMENT
BETWEEN THE JEFFERSON COUNTY ENVIRONMENTAL HEALTH DIVISION AND
THE JEFFERSON COUNTY PUBLIC UTILITY DISTRICT#1. THIS SEWAGE
DISPOSAL SYSTEM WILL REQUIRE AN ACTIVE MONITORING CONTRACT WITH
THE PUD#1 PRIOR TO FINAL APPROVAL OF THE SEWAGE DISPOSAL SYSTEM.
While the County strongly recommends that the property owner allow inspectors to enter
their property to inspect the system in order to insure that the system is functioning
correctly, the property owner always has the right under the Fourth Amendment and our
State Constitution, to refuse the inspectors access to their property. The property owner
never loses the right to refuse access and can do so despite never having refused access
before.
4.) 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 THREE YEARS AND AT THE TIME OF SALE IF
INSPECTIONS ARE NOT CURRENT.
5.) Designer must be contacted prior to start of construction and for inspections during
installation.
6.) H -An asbuilt drawing and certification of completion by the Designer is required prior to
final approval.
7.) Before final approval is given, the designer shall provide an operations and maintenance
manual to the property owner. 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.
8.) Setbacks to all wells- 100' required from drainfield and reserve areas. 50' required from
tanks and effluent transport lines.
9.) 10'separation required between a Water line and all portions of the onsite sewage
system; effluent transport line, tanks, treatment and disposal components.
10.) A 50'setback from the SR 20 Highway Corridor Right of Way: A 30' natural vegetation
buffer and a 20' building setback.
11.) Setback to surface waters- 100' required from drainfield and reserve areas. 50' required
from tanks.
12.) MAXIMUM TRENCH DEPTH 12 INCHES
13.) A 30'setback shall be maintained from the disposal component and reserve area to any
downslope footing, curtain or interceptor drain or drainage ditch.
14.) All components of the septic system are to be completely protected from vehicular traffic
or mechanical disturbance.
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11/22/19
I:\F_SEP_Permit.rpt
15.) Drainlines are to be installed along the natural contours.
16.) Divert all sources of drainage, including roof drains away from septic tank and drainfield
area.
17.) Any portion of transport line under a driven way is to be sleeved/cased or equivalent.
18.) 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.
19.) 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.
20.) 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.
21.) 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.
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11/22/19
I:\F_SEP_Permit.rpt
NIF
CONVENTIONAL SYSTEM ASBUILT INSPECTION REPORT
INSTALLER - ()/(2/9-) sok ± PARCEL# qi7T 663 'gG/
Permit Owner Rya"? 66/-172 2 Permit #
ABSORPTION AREA:
DRAINFIELD TRENCH 3 TRENCH TANK #OF #GALJ
LENGTH /56 WIDTH DEPTH `2_ SIZE 1006 BEDRMS 3 DAY 342 0
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 INSTALLS AS DESIGNED, PER PLAN APPROVED Y076-?",d Q 7" nA
INSTALLER SIGNATURE DATE NSTALLED
vCONED
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