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HomeMy WebLinkAboutSEP2006-00154 ,s! 11..,, Jefferson County Department of Community Development .1!V<c: = . ,� 621 Sheridan St, Port Townsend WA 98368, (360)379-4450 a • y = z `1 SEPTIC PERMIT APPLICATION a 11 _ r •, 1t PROPERTY OWNER )7' )4 'E'b , - Mickg�7/9'"4 r ur/6 I, . .BERM HAUL ERICSEN.•.. 11 ��.RK�.V��.. .���:1∎•∎∎!1, MAILING ADDRESS .9' O( d&< S'TO' �/cl Vt •t , i 0? /0o�2rTaco4JSc.z .vd 11F 81362- s � PHONE Area Code( 3 G a ) 3'S Ili t F'r(4 7v& • ♦/m)ceCL. ,5-€11-711-0/t SYSTEM DESIGNER /3CA,Or 6'/Ql SEA ,p LEGAL DESCRIPTION: Section a'? Township%30 d Range !?/ 0 PARCEL# '6 5-00() v1-3 9 Subdivision Name Mil F s'Qr Division 7 Block Lot(s) 3ssz/ � SITE LOCATION a�0� OM -VioR �/Ql VE Zip Code gcF34.6+ SOURCE OF SEWAGE: Residential X Residential ADU Commercial Community TYPE OF WORK: New X Redesign Upgrade Repair Partial(tank) (drainfield) Expansion Designate Reserve Area Modification Conventional %.,4 Alternative Drainfield Length 2O I ft. Trench Width 3 ft. Number of Gallons/day d Trench/Bed Depth 02(t-30 in. Number of Lines 3 Site Size 19 0 3 c 1. - S6. -6-7 ' Septic Tank size I Coo gal. Pump Chamber size=_gal. Water Source: private public \Q Soil type 3 (ATTACH SOIL EVAL.) Previous eval:(/ no # . s' .60 Application Rate , L gal./sq.ft./day TYPE OF SYSTEM C4 ray 1 L'nv►U).n+.rs nail -+'i'&id- . 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 wi I later obtain permission to build a permanent residence or other structure on this parcel. Any fut r application will separately judged by the rules and laws in effect at that time. dr4)atA-ee \, ,i 1 , dale__ ;72 ,) , -/Owner Signature / Date FOR OFFICE USE ONLY f ' Y 9 21.06 I �� Elf PARTIAL ASBUILT�C /� FI P'I /-3 . A PR Er J ,ilt. , , 11 OCO PRESS/TEST PUD Fire Dist'ct Planning District `nI' School District Zone r� Date 51 Fee Li`)3,LAID Rec# %I Cam) Check# 1:3-13 Case#SEP c G2'� +'3 4 SEWAGE DISPOSAL PERMIT Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend WA 98368 (360) 379-4450 (800) 831-2678 PERMIT #: SEP06-00154 Date Received: 05/22/06 SITE ADDRESS: 202 OAK SHORE DR Date Issued: 06/29/06 PORT TOWNSEND, WA 98368 Date Expires: 06/29/09 APPLICANT: HOWARD B DUGDALE PHONE: 541-788-4311 MARGARET K DUGDALE PO BOX 8100 SISTERS OR 97759 SUBDIVISION: KALA POINT#7 BLOCK: LOT: 354 PARCEL#: 965000239 Section: 27 Township: 30N Range: 01 W DESIGNER: BERNT ERICSEN PHONE: 385-3602 2281 HASTINGS AVE W PORT TOWNSEND WA 98368 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 (unless otherwise stated above) in accordance with Jefferson County Rules and regulations for on- ' sewag ystem , codified 8.15 amended per ordinance no. 08-0921-00. This permit may not be renewed. ORTO, J fferson 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: 201 feet Width: 3 feet Depth: 24 inches Size: 1,000 gallons SPECIAL CONDITIONS APPLY - SEE REVERSE CONDITIONS OF APPROVAL- PERMIT NO.: SEP06-00154 1.) 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. 2.) H -An asbuilt drawing and certification of completion by the Designer is required prior to final approval. 3.) A 30' setback shall be maintained from the disposal component and reserve area to any downslope footing, curtain or interceptor drain or drainage ditch. 4.) Drainlines are to be installed along the natural contours. 5.) Divert all sources of drainage, including roof drains away from septic tank and drainfield area. 6.) 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. 7.) 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. 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. 2 of 2 11/22/19 I:\F_SE P_Permit.rpt INSTALLER I rl C.Ser1 EX C.4-Ucc,1 1►'j PARCEL# 6/6 5 000.23 c Permit Owner 4 4 O l►,J f g.a. !)1.14A cQ 1 k. Permit # Sy 0 b - 16 4 ABSORPTION AREA: V DRAINFIELD TRENCH TRENCH TANK #OF #GAL/ LENGTH 0100 WIDTH 3 DEPTH 02 Li- 30 SIZE I COO BEDRMS 3 DAY .3 6o 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 6- .a.q -Oto i e6 CA. /1- 3 -0(, DATE APPROVED INSTALLER SIGNATURE 1 DATE pf c{i'' 'ID. 5.T O al 121 u K �� 19 44 in Sect.'$LM 6ortS i �V r► -_� L 4 5o x 3 bra.)tillss ehQ-„- ��� t, 8 ' 15-"' r� �N(Q ' 'Cae it u 'A 73)c. !L -�i . C.. a2 •• 3, -N5 1u � C. i SO 13` J 5 4, t 4 O 0 „�.. 161)0 Cia.e". 3 kDt Tam., / �� - 4 w < r y R i F 13' '`V 3c+ 'A„ ,3 - . IT ow 111 L „I WA0 ! I,. 11 �1 lit. BERNT AU ICSEN t1 ■ t 1REe1rvF4n NZo t ',;10 °.111/ 1 ONSITE SEWAGE DISPOSAL ef6,1000 /39 SYSTEM DESIGN Date S'- 17_ ©L Property Owner }-ox} .e2- System Designer j •,d r✓Yl .v, Legal Description: Section g7 Township .k) Range i k) Subdivision Name kab_ Y{„ Division Block Lot(s) 354 I. CALCULATIONS If for residential use: Number of Bedrooms: , x 120 G.P.D. = 3k-, total G.P.D. If for non-residential use, attach calculations used to determine G.P.D. Soil texture waste water application rate t4, G.P.D./ft. squared (see page 214 of the EPA Design Manual) DRAINFIELD SIZING: Absorption area: 603 square feet (total G.P.D. : G.P.D./ft. squared) Trench or bed width 3 feet Trench or bed length .201 lineal feet (sq. ft. :- trench or bed width) II. APPURTENANCES Septic Tank Size 1000 gallons Pump Requirements (If Necessary) Apps`` '" o / t Dab Elevation difference in feet Jo 5 - Friction loss Pump capacity should be — G.P.M. at T.D.H. Number of doses per day — RECE7, ' - Dosing volume gallons 4 Pump chamber size gallons �. _111 AW#1 J • �1 At-BERNT PAUL ERICSEN IC NSEb i Ir i WA H:'home\pincntr\infohlth\sewdsn 411������MIMIIMI~`.��0011� , EXPI•r S s' 11/ • III. DRAINFIELD CROSS SECTION D i / / A 1 a,. am:. Ft..4k NATIVE SOIL B f i E C ..... -2,11DEREAB LE MATERIAL/ SEASONAL SATURATION A. Trench Depth 2q-30 inches B. to inches of drainrock below pipe( Il lag si,Lbs-114-ide- .3 ra.vki LeSS Chonlotr5) C. >36. inches of vertical separation from trench bottom to impermeable material/seasonal saturation D. inches of fill (if needed) E. Trench width 6, inches NOTES: t 9 r --, C.7_, ' ---' t.',-• ..---- ATTACH DET tLED DESIGN OF SYSTEM -.-.--4 40. '-(13 Li 20. c..,.... I-4* 0-- --, Et. 3 ' 0 C) 351) s tor 3-c/a SI-4 S .30 ' ASO 10 Mtn- Si-a f ; • 1 I SO L 47 A IC. e j • A ( 1,1 4 ,x,,Nt Sewer eee- Pnto: IZ;se.rs 44,,Letten;Ais 4"D". 4-, 541 ti 40 4,0w41..#lt 4 5oN/ SeWar pft ‘1- 6.4-- 0 sev,tragc-' ‘'% r ;Lad for 0% I Appy • Owner: flAvt 4 mairladlusm Parcel# q45 ,2 3 q 5itif Designed by:136(r1+ c_d _ri s c / fen 440 .1•1 •• ....A • • , 1.04...tte -WAS jr. °'..#• ..„A Ec. z s 20 6 %a 349 5100259 1"; "*BERNT PAUL ERICSEN • •C SEb at I NER OA Oak ,s'ijort ExPI-T- 11 _ • for", tiV 7 r n tICV;Fr' Lt " ode• rilik4fPwall e,,t d JEFFERSON COUNTY '!�,,, 4k4.4 1 DEPARTMENT OF COMMUNITY DEVELOPMENT 7'. 11 :: J . 11 1. 621 Sheridan Street• Port Townsend •Washington 98368 i 5100259 �+ 360/379-4450.360/379-4451 Fax .. 6fRNT PAUL ERICSEN 11• .r C N t DE I NER / http://www.co.jefferson.wa.us/commdevelopment/ I����••�•�` �������s�vi =it/ iF f-•e`c4 Stormwater Calculation Worksheet MLA# PROJECT/APPLICANT NAME: 4401044 4i maw yyd—Dkiktie. DETERMINING STORMWATER MANAGEMENT REQUIREMENTS:This stormwater calculation worksheet should be completed first to classify the proposal as"small,""medium,"or"large." The size determines whether a Stormwater Site Plan is required in conjunction with a stand-alone stormwater management permit application, building permit application, or other land use approval application that involves stormwater review. The basic information will also be helpful for completing a Stormwater Site Plan,if required. PARCEL SIZE(I.E..SITE) Size of parcel , ,141' acres An acre contains 43,560 square feet. Multiply the acreage by this figure. Size of parcel in square feet ICI i 39) sq/ft Land-disturbing activity is any activity that results in movement of earth,or a change in the existing soil cover(both vegetative and non-vegetative) and/or the existing soil topography. Land disturbing activities include, but are not limited to clearing, grading, filling, excavation,and compaction associated with stabilization of structures and road construction. Native vegetation is vegetation comprised on plant species,other than noxious weeds,that are indigenous to the coastal region of the Pacific Northwest and which reasonably could have been expected to naturally occur on the site. Examples include species such as Douglas fir,western hemlock,western red cedar,alder,big-leaf maple,and vine maple;shrubs such as willow,elderberry,salmonbeny, and salal;herbaceous plants such as sword fern,foam flower,and fireweed. LAND DISTURBING ACTIVITY,CONVERSION OF NATIVE VEGETATION,AND VOLUME OF CUT/FILL Calculate the total area to be cleared,graded,filled, Answer the following two questions related to excavated,and/or compacted for proposed development conversion of native vegetation: project. Include in this calculation the area to be cleared for: Construction site for structures sq/ft Does the project convert V4 acres or more of q/ft native vegetation to lawn or landscaped areas? Drainfield,septic tank,etc. .i4OO sq/ft Circle: Yes ( Well,utilities,etc. sq/ft Does the project convert 2 Ya acres or more of native vegetation to pasture? Driveway,parking,etc. sq/ft Circle: Yes No Lawn,landscaping,etc. sq/ft Other compacted surface,etc. sq/ft Indicate Total Volumes of Proposed: Total Land Disturbance sq/ft Cut 0 i C � _� [over] Y �, �* ' stormwater calc worksheet—REV.10/1/2003 1 Impervious surface is aFhard surface that either prevents or retards the entry of water into the soil mantle as under natural conditions prior to development. A hard surface area which causes water to run off the surface in greater quantities or at an increased rate of flow from the flow present under natural conditions prior to development. Common impervious surfaces include, but are not limited to roof tops, walkway.pati s, driveways, parking lots or storage areas, concrete or asphalt paving, gravel roads, packed earthen materials, and oiled,madam :; other surfaces which similarly impede the natural infiltration of stormwater. its. v'`• s1 t STORMWATER CALULATIONS–IMPERVIOUS SURFACE EXISTING Structures(all roof area) sq/ft Structures(all roof area) sq/ft Sidewalks sq/ft Sidewalks sgfft Patios sq/ft Patios sq/ft Solid Decks sq/ft Solid Decks sgfft (without infiltration below) (without infiltration below) Driveway sq/ft Driveway .sq/ft Other sq/ft Other sq/ft Total New sgfft Total Existing sq/ft TOTAL NEW+TOTAL EXISTING* sq/ft This amount will be used to check total lot coverage. The following questions will help determine whether the proposed project is considered development or redevelopment. DEVELOPMENT v.REDEVELOPMENT Divide the total existing impervious surface above by the size of the parcel and convert to a percentage: % Does the site have 35%or more of existing impervious surface? Circle: Yes No FURTHER INSTRUCTIONS: If the answer is yes, the proposal is considered redevelopment and the attached Figure 2 should be used to determine the applicable Minimum Requirements. If the answer is no,the proposal is considered new development and the , attached Figure 1 should be used. At this juncture,the applicant should refer to the applicable Flow Chart to determine the Minimum Requirements for stormwater management. DCD staff will help verify the classification of the project and the application requirements. For proponents of "small" projects who must comply only with Minimum Requirement #2—Construction Stormwater Pollution Prevention—an additional submittal is not required. The proponent is responsible for employing the 12 Elements to control erosion and prevent sediment and other pollutants from leaving the site during the construction phase of the project. Pick up the Construction Stormwater Pollution Prevention (SWPP) Best Management Practices(BMPs) Packet. Proponents of"medium"projects—those that must meet only Minimum Requirements #1 through #5—and for "large" projects—those that must meet all 10 Minimum Requirements—are required to submit a Stormwater Site Plan. DCD has prepared a submittal template of a Stormwater Site Plan, principally for rural residential projects. Complete the template in the Stormwater Site Plan Instructions and Submittal Template or prepare a Stormwater Site Plan using the step-by-step guidance in the Stormwater Management ManuaL APPLICANT SIGNATURE By signing the Stormwater Calculation Worksheet, I as the applicant/owner attest that the information provided herein is true and correct to the best of my knowledge. I also certify that ttlip..,appligatton 11S'tteing made with the full knowledge and consent of all owners of the affected property. A + ;, '> it14.4 1 so(LANDOWNER OR AUTHORIZED REPRESENTATIVE SIGNATURE) "� " 4.`" (DATE) Est-0222 em .,. _ ��... ...�,..�.,.�._>_�_..._ .e .,_..: .._ �L �` C�. . � , . a rmwater calk worksheet—REV.10/1/2003 2 Owner: • . Parcel# q65 060 ,:. Designed by: bcozi-Ericse,n 1 KALA 0 7 #, ., po INT Div:10N , . # t, pr-p-T-rTy, r,,,,=-: SEC. '777 IT "7,fl M p ! \At w!%.,.! i ..4- JEFFERSON COUNTY, WASH INK;TON ,,,,,,,,,..„... 1 ! 1 ::1" -LV:-;M:' a,ie.ii.;FY I L 1-•,! r! . ! ! ,, ---- ;#.!.t-t ..t# :1 ' - ''.., - ', ''-:- •,:',„ I — I ! .4:2j ..i',i,`,i,., . . ■ , i 7-',7- t----::-,..`,, '. ---- I I IF, ..„. ! ! 1 !..tti ■ t,,-- . — . . --6----' i I ! 1 1 :...,.:.- .... ..._ c.. ? . „ f 7 : i ! ' i'. #9, • 1 !-- I 444t4-I'.400 1 . . „ . i. zi, 46., Li i': ; ,-,,..,•.: , . . , p r',, I,. I 1 I 1,i I' ,1 ,r1,,,,, -• . 4.7-,.... .....g.t4Nfr'.=77*,. 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'''. 0 ----, .,-'.',47 '''''''- .,,,,- t -(V --- ----_ , -.si.,:.;: 7 ;' 1 '41 I - d4.. ,,,,, 6, 41 0 46 RE CE in E ), , 4 , .4' i e.' ‘!!zi.. `'e41'15 4 7,4 1 , t —,,,,,,..,..y , NY 0 •0 -.rtr. ., ., (6 .,, irrsc `: 1 :i!',11V nrn d i:t r 1 ,- .,:, ,,, :i!,1+ i ''' JEFFERSON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT 621 SHERIDAN ST., PORT TOWNSEND ,WA 98368, (360) 379-4450 - -___. SOIL EVALUATION f � c PROPERTY OWNER -{']Oi,Iter�Q. , Pa.04•5, e '1i,(3ia.ie. SYSTEM DESIGNER t-YtCSe, LEGAL DESCRIPTION: Section ,27 Township 3OA.) Range 21u) Parcel # qra 0000,2 3, Subdivision Name Kai, Q.E Division 7 Block Lot(s) _154 Date Logged: j-13—Of, Logged By: Ze....rivb EY t ase4 Include soil textural characteristics a d the depths at which significant changes occur. Be sure to include depth where mottling or impermeable layers 'ccur. il SOIL LOG #1 SOIL LOG #2 C) to h in. d � to II in. r, to )-,2 in. &r L.,5./..-611.4,. .e5.�. u,, .5 . -r /4-. 3 to ,22, in. Ar. L.5.1-4,4-' .5.1-t'i, Silk. Tot 4-A.. to 4,1 in. Tart 4i,e, in IL T'3. A to Gs in. `Ztr►-Ci.L. 'rn , , r3. 'L to 6-2-in. ?dm. -ant, n1e s,t.e• 17.1.13/ to in. Anticipated water table>L tin. J 16(P Anticipated water table>6.5"in. Roots to �S inches (% Roots to 52 inches Health Dept. Comments V h Health Dept. Comments SOIL LOG #3 SOIL LOG #4 0 to 3 in 1j 0 to 3 in. ""DiteE 3 to lets in. ZttiA 4w Stuff. T3, i�I, 3 to i in. �.. G.S, /.�•Sw2. T.3/y to in. N., i, . t. to 31, in. Tom, ■ii, $k.2, 7.3, to in. t„ 1� 3t to (,S in. Too -r!-wail, 5,4. t 7-813 Anticipated water table>a in. t1 r . ,, ."l`'.,'1∎ Anticipated water table?Gg in. Roots to 4 9 inches i3�,7 t a.. �� h 1 Roots to 41 inches Health Dept. Comments •y 100259 �,; Health Dept. Comments Arc„.. BERNT PAUL ERICSEN j 11 . •C:ENSED DE I NER 1 SOIL LOG #5 ' "ER S 02/11/ 0 SOIL LOG #6 0 to 3 in. TbtE 5-4-04 to in. 3 to 1� in. of, c.c./4.5. 7 3Ai to in. _ IX- to 3b' in. Tan nt.. ,S . T3 j to in. .39 to 4g in. Tap, din‘,-we.&. sn42. T a fr�� to in. Anticipated water table in. ` ` Anticipated water tab in. V' Roots to inches ,� �J(� 1 Roots to in Health Dept. Comments W 1 Health Dept. Comments H:\ ' OHLTH\SOIL.FRM1/00 n{ r fr . UEi 4{ d I UN FY. [11:5 •