HomeMy WebLinkAboutSEP2014-00030 t
Jefferson County Department of Community Development 4,p
621 Sheridan St., Port Townsend WA 98368, (360)379-4450 o
SEPTIC PERMIT APPLICATION cvz.,
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Lincoln & Leina Manahan
PROPERTY OWNER
MAILING ADDRESS 1810 201st PI SW ,,
Lynnwood,WA 98036
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PHONE
( 206 ) 290-8046 'ttora " !,,
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SYSTEM DESIGNER Suzanne Martin Designer Phone# (360)554-0224
LEGAL DESCRIPTION: Section 22 Township 28N Range 1 E PARCEL# 983 400 407
Subdivision Name Paradise Bay Estates Division Block 4 Lot(s) 8
Site address/Directions to site 50 Hemlock Street Port Ludlow
SOURCE OF SEWAGE/USE , TYPE OF WORK WATER SOURCE
Residential ✓ New Tank/s only Private
Residential ADU Modification_ _ Public ✓
Commercial. Expansion_
Community Upgrade, _
Repair SITE SIZE +/-5663sf
SYSTEM TYPE Partial Repair-(tank) ✓ (drainfield) Previous Evaluation
Conventional ✓ Designate RPsPrve Area ✓ Yes# SEP13-00129
Alternative Redesign No
SYSTEM DETAILS
Number of Gallons/day 120 Soil type 4 (attach soil eval.) Application Rate 0.60 qal./sq.ft./day
Drainfield Length ex ft. Trench Width ex ft. Trench/Bed Depth ex in.
Septic Tank size 1000 min gal. Pump Chamber size n/a gal.
TYPE OF Tank only for pre-permit 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 ors Tres 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 a lication will be separately judged by the rules and laws in effect at that time.
)./ 101 /4
roperty Owner Signature 1Qy►� Date ,,J _
FOR OFFICE USE ONLY` n(�((� �✓ J µ cCF�/ IQI'/ ,A • ,/
PARTIAL ASBUILT` �L"� . ��/� FINAL. 1J�/rj�
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JEFFERSON COUNTY PUBLIC HEALTH
615 Sheridan Street •Port Townsend•Washington •98368
www.jeffersoncountypublichealth.org
Phone 3bU-3t3b-9444 Fax 3b0-319-4481
ON-SITE SEWAGE DISPOSAL PERMIT
PERMIT#: SEP14-00030 Date Received: 03/10/14
Date Issued: 05/28/14
SITE ADDRESS: 50 E HEMLOCK ST Date Expires: 08/28/14
PORT LUDLOW, WA 98365
APPLICANT: LINCOLN C MANAHAN PHONE:
LEINA M MANAHAN
1810 201ST PL SW
LYNNWOOD WA 980367060
LEGAL DESCRIPTION: PARADISE BAY ESTATES BLK 4 LOT 8
PARCEL#: 983400407 Section: 22 Township: 28N Range: 01 E
DESIGNER: SUZANNE L MARTIN PHONE:
PO BOX 179
PORT HADLOCK WA 98339
SYSTEM DESCRIPTION: SEPTIC TANK TO IND SYS
No. of Gallons per Day: 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, codified in JCC 8.15 as amended.
This permit may not be renewed.
Jefferson County En ronmental 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.: SEP14-00030
1.) This permit was issued to correct a violation of WAC 246-272A for a leaking septic tank. The permit
must be completed within 90 days of the date of issuance.
2.) H - The existing concrete poured over the drainfield must be removed from over the drainfield as
per plan.
3.) H - Permanent barriers are required along/around primary drainfield area to protect from parking,
driving, and other land disturbing activities prior to final.
4.) H -The existing water line must be re-routed 10 or more feet from any septic component. No
crossing is allowed by this permit.
5.) H - Cover over the existing drainfield must be brought up to a minimum of 12" for all areas of the
lateral.
6.) Construction of a new home or expansion of the existing home will require a septic system that
meets current on-site sewage code. The existing system does not meet current code.
7.) 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.
8.) 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.
9.) Notification of the start of construction shall be faxed or emailed to Jefferson County Public Health
ONE WORKING DAY prior to start.
10.) H -An asbuilt drawing and certification of completion by the Designer is required prior to final
approval.
11.) 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 246-272AAND 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
12.) 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.
13.) Divert all sources of drainage, including roof drains away from septic tank and drainfield area.
14.) Any portion of transport line under a driven way is to be sleeved/cased or equivalent.
15.) 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.
16.) 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.
17.) 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.
SEP14-00030 Page 2 of 3
\\tidemark\data\forms\F_SEP_Permitmod.rpt 5/28/2014
18.) 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.
SEP14-00030 Page 3 of 3
\\tidemark\data\forms\F_SEP_Permitmod.rpt 5/28/2014
t , .
SEp 1
014
CONVENTIONAL SYSTEM AS-BUILT INSPECTION REPORT
Installer: Bernt Erickson Excavating(Tim Thomas) Parcel # 983400407
Permit Owner: Lincoln&Leina Manahan Permit# 14-00030
Designer: Suzanne Martin Design Flow: 120 gpd
Site Address: 50 East Hemlock Street-Port Ludlow
ABSORPTION AREA:
DRAINFIELD TRENCH WIDTH TRENCH DEPTH TANK SIZE #OF BEDRMS #GAL/DAY
LENGTH ex ex ex 1000 1 120gpd
IF PUMP AND PUMP CHAMBER REQUIRED: Shroud/Screen
Tank Size:
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
COMMENTS (inspection notes, changes from design or deficiencies installation)Attach additional sheet(s) if necessary
Installed 2 compartment, concrete septic tank. Risers, clean-out, and outlet filter have been installed. All OSS Component
installation have met or exceeded State and local codes and regulations. Tank was bedded in pea gravel. Old tank has been
decommissioned. Barriers have been set to protect the drainfield area. Concrete over drainfield has been cut and removed.
cover has been placed on drainfield area.water line has been re-located to more than 10'from drainfield.
Users Manual Provided to HomeownerMailed 12September14 Date
ATTACH ASBUILT DRAWING signed by Designer or stamped/signed by a Licensed Professional Engineer
I CERTIFY THE INFORMATION PROVIDED ABOVE WAS
VERIFIED BY INSPECTION, THE SYSTEM WAS INSTALLED
AS DESIGNED AND APPROVED by JEFFERSON COUNTY
(DATE) OR THAT CHANGES HAVE BEEN ,,
NOTED AND THIS SYSTEM IS IN COMPLIANCE WITH WAC 346-272 �� h'' /
11 September 14 5100342
Designe Signature Date License# 5z° 4
`. Suzanne L Martin #,
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Page 1 of 2;Manahan;
Parcel#983 400 407
JEFFERSON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT
621 SHERIDAN ST.,PORT TOWNSEND .WA 98368, (360) 379-4450 %�,
SOIL EVALUATION !�' I +''+
PROPERTY OWNER Lincoln Manahan '`
., . +
„ Suzanne L Martin • +,
7
SYSTEM DESIGNER Suzanne Martin r, E ��¢H;H5
LEGAL DESCRIPTION: Section 22 Township 28N Range 1 E Parcel # 983 400 407
Subdivision Name Paradise Bay Division Block 4 Lot(s) 8;
Date Logged: 6 January 2014 Logged By: Suzanne Martin
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 6 in. Dark brown sandy loam 0 to 8 •n,Dark brown gravelly sandy loam
6 to 33 in.Dark yellow brown gravelly sandy loam 8 to 33 in.reddish brown gravelly sandy loam
33 to 50 in,light yellow brown very gravelly sandy loam 33 to 42 in.yellow brown sandy loam
50 to 55 in.yellow brown gravelly medium sand
to 61 in. restrictive
Anticipated water table n/a in. Anticipated water table 42 in.
Roots to 48 inches Roots to 61 inches
Health Dept. Comments Health Dept. Comments
SOIL LOG #3 Hand Dug soil log SOIL LOG #4
0 to 12 in. Dark brown loam • �) e 0 to in.
•12 to 27 in. Brown sandy loam 1 CO i to in.
27 to 36+ in. Yellow brown fine sand /' to in.
to in, some bum remnants (/a! IIMC
_____to in.
`
Anticipated water table n/a in. I > 0 Anticipated water table in.
Roots to 19 inches Roots to inches
Health Dept. Comments Health Dept. Comments
SOIL LOG #5 SOIL LOG #6
to in. to in.
to in. to in.
to in. to in.
to in. to in.
Anticipated water table in. Anticipated water table in.
Roots to inches Roots to inches
Health Dept. Comments Health Dept. Comments
H:IINFOHLTHISOIL.FRM 1/00
• Page 2 of 2;Manahan;
Tank Cross Section-Not To Scale parcel#983 400 407
(For illustrative purposes only, actual tank configuration may vary, tanks must be on list of approved products.)
SECURED LID WITH GAS TIGHT SEAL
1 ACCESS RISER
FINISH ISH GRADE
to drainfield
FROM SEWAGE
SOURCE FLOATING MAT
APPROVED
EFFLUENT
FILTER
SEDIMENTS maximum 3/16"filter
SEPTIC TANK
(TYPICAL)
•
SEWAGE DISPOSAL DESIGN
Approve r struction
Date
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