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HomeMy WebLinkAboutSEP2014-00103 /v0 k 'L Jefferson County Department of Community Developmen�ii F1`�e r 1�Z 621 Sheridan St., Port Townsend WA 98368,(360)379-4450 'tor so �/1 SEPTIC PERMIT APPLICATION �e co4o PROPERTY OWNER TIMOTHY GREEN /Y0 MAILING ADDRESS 1805 APPLEWOOD DRIVE LAKEWOOD, CO 80215-2521 PHONE ( 720 ) 301-9864 SYSTEM DESIGNER NATHAN N. CLEAVER Designer Phone# 360-598-6546 LEGAL DESCRIPTION: Section 05 Township 28N Range 1W PARCEL# 801-054-002 Subdivision Name Division Block Lot(s) A Site address/Directions to site 3744 EAGLEMOUNT ROAD, PORT TOWNSEND SOURCE OF SE)tVAGE/USE TYPE OF WORK WATER SOURCE Residential �/ New Tank/s only Private d Residential ADU Modification Public Commercial Expansion Community Upgrade Repair SITE SIZE 871,199+/- SYSTEM TYPE Partial Repair-(tank) (drainfield) Previous Ev luation Conventional V Designate Reserve Area Yes#SEP14-00103 Alternative Redesign V No SYSTEM DETAILS Number of Gallons/day 480 Soil type 4 (attach soil eval.) Application Rate 0'6 gal./sq.ft./day Drainfield Length 270 ft. Trench Width 3 ft. Trench/Bed Depth 12 in. Septic Tank size 1,500+1000gal. Pump Chamber size NA qal. TYPE of system SIMPLE GRAVITY 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. Staff's 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 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 inI effect at that time. )4 _ e /,C{. `-- /� fD �ii Property Owner Signture / Date I FOR OFFICE USE ONLY 43/fiK PPARTIAL—r 7 3- I� ASBUILT �Ld /19�5 FINAL , l ' 16- APPROVE INSP/PUMP TEST ptf y"CPI* ALL HOLD REQ.MET Date I/( 1 D // �Fee j21-1 Rec 4157)7G0 9 Check# C c- Case#SEP I — , 0 H:\WEB\PDFs\Septic\septic_permitapp 2008.DOC ,'� JEFFERSON COUNTY PUBLIC HEALTH ,SHN� 615 Sheridan Street•Port Townsend•Washington •98368 www.jefferson countyp ub lichea lth.o rg Phone MU-Job-9444 Fax 3bU-319-44tf/ ON-SITE SEWAGE DISPOSAL PERMIT PERMIT #: SEP14-00103 Date Received: 08/01/14 SITE ADDRESS: 3744 EAGLEMOUNT RD Date Issued: 11/13/14 PORT TOWNSEND, WA 98368 Date Expires: 11/13/17 APPLICANT: TIMOTHY GREEN PHONE: 1805 APPLEWOOD DR LAKEWOOD CO 80215-2521 LEGAL DESCRIPTION: S5 T28 R1W TAX 14 (INC PTN IN S4)BND TGTH THRU BLA#107248 PARCEL#: 801054002 Section: 5 Township: 28N Range: 1W DESIGNER: NATHAN CLEAVER PHONE: 360-598-6546 NATHAN CLEAVER SEPTIC DESIGN 262 NW THOMPSON RD POULSBO WA 98370 SYSTEM DESCRIPTION: CONVENTIONAL TRENCH No. of Gallons per Day: 480 Type of work: NEW Drainfield Trench Septic Tank Length: 270 feet Width: 3 feet Depth: 12 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 Envir mental 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.: SEP14-00103 1.) Approval/issuance of a sewage disposal permit or installation of a septic system does not guarantee the approval of other development or a building permit on this site. Future buildings that require connection to an on-site sewage system (OSS) shall only be approved if the OSS meets the current standards and codes in effect at the time of the building application. 2.) 3 "D" boxes minimum required, 2 must be 6 hole or greater. Each lateral line must be fed from an individual line out of a "D" box. Levelors required on each line out of"D" box 3.) ALL 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. 4.) MAXIMUM TRENCH DEPTH 12 INCHES 5.) Contact designer prior to installation for staking of drainfield area. 6.) The long transport line route must be marked w/ steel "t" posts for future location. 7.) H - AS PER WAC 246-272A AND 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 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.) 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. 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.) 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. 14.) When/if designated reserve area is utilized an alternative system providing an additional level of treatment may be required and must comply with code at the time of application for use. 15.) Divert all sources of drainage, including roof drains away from septic tank and drainfield area. 16.) Portions of transport line under the driven way are to be sleeved/cased or equivalent. 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. 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. SEP14-00103 Page 2 of 3 \\tidemark\data\forms\F_SEP_Permitmod.rpt 11/13/2014 19.) The site plan as submitted with the septic system application on August 1, 2014 has been reviewed for consistency under the UDC, and has been approved by Jefferson County Department of Community Development. Any modifications, changes, and/or additions to the stamped, approved site plan dated August 19, 2014 shall be resubmitted for review and approval by Jefferson County Department of Community Development. 20.) This approval is for a septic system only. Any future permits on this site are subject to review for consistency with applicable codes and ordinances and does not preclude review and conditions which may be placed on future permits. 21.) This septic system permit appears as if it will help correct the COM14-00037 case (of septic discharge in brambles) on this parcel. It does not correct the COM14-00039 case (of building living space without permits). SEP14-00103 Page 3 of 3 \\tidemark\data\forms\F_SEP_Perm itmod.rpt 11/13/2014 ' CONVENTIONAL SYSTEM ASBUILT INSPECTION REPORT INSTALLER 14 ►4 $v. fit • PARCEL# 'JO - 3; - 2 Permit Owner 111A4vT14V 6I7- j Permit # - as ABSORPTION AREA: DRAINFIELD TRENCH , TRENCH 1, TANK #OF #GAL! LENGTH 2-740A WIDTH DEPTH �', .. SIZE ‘, BEDRMS 1 DAY LA 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 //' ; ; '�, ` 1 �, * flATF INSTALLER SIGNATURE DATE INSTALLED te”%-'1. (}rQ cA1h‘,5. �(�1 NATHAN N CLEAVEk "?9}� MAINTENANCE BASICSxfsa?? 6 P *There is a "filter sock" in the outlet baffle of the septic tank. e f ter sock should be pulled out and hosed off every 6 months to avoid clogging and backing up into the house. Rubber gloves and other precautions must be taken to avoid contact with sewage. •The tank should be pumped every 3-5 years. The drain field area needs to be seeded to prevent erosion. 'The D-box should be opened once a year to make sure that the outlet pipes are all level. Rubber gloves and other precautions must be taken to avoid contact with sewage. There is a "Speed Leveler" dial on each outlet pipe that can be turned to level the outlets *The large green lids on the septic tank and the green cover over the D-Box must be secured at all times with screws or bolts to prevent hazard and tampering. *Keep all traffic and heavy equipment off the drain field area. *Septic systems are only capable of treating and disposing of normal human waste, toilet paper and water. Some mild soaps and cleaners are also expected to go to the system as part of household cleaning. *Do not dispose of chemicals, harsh cleaning agents, medications, garbage disposal waste, etc. to the septic system. Please feel free to call with any questions. 360-598-6546 Nathan N. Cleaver Licensed Onsite Wastewater Treatment System Designer I -7 tr- `. In . 1 I . 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Cleaver Log#1 0 - 2" Duff P 2 - 50" Brown Gravelly Sandy Loam ,e 50" Roots To 50" Mottling/Compaction *There are small pockets of mottling at less than 50 inches(// but there is good round color all the way to 50 inches. �/ tALr 4 ( t 43 o/ 50 Soil Log#2 0 - 2" Duff 2 - 52" Brown Gravelly Sandy Loam 52" Roots To 52" Mottling/Compaction S Soil Log#3 0 - 2" Duff 2 -42" Brown Sandy Loam 42-48" Mottled Brown Sandy Loam 42" Roots To 48" Compaction 5 L use - Please feel free to call with any questions. Thank you, •fiti .` ca: 51,251 1. NATHAN N.CLEAVED 4.; LI ...N ; EXPIRES Nathan N. Cleaver Licensed Onsite Wastewater Treatme t stem Designer. Address: Telephone: 360-598-6546 1990 Kimball Rd. NW Fax: 360-598-6548 Poulsbo, WA 98370 Email: nathan @nathancleaver.com Please call ahead to make an appointment if you would like to meet with me. Nathan Cleaver Septic Design Inc. Contractor Registration#: NATHACS94002 Soil Logs 4,0 Re: TIMOTHY GREEN d Parcel#: 801-054-002 a�OJQ Section: 05,Township: 28N, Range: 1W Soil Logging done on 6th JUNE 2013 by Nathan N. Cleaver Soil Log#1 0 - 2" Duff 2 - 50" Brown Gravelly Sandy Loam 50" Roots To 50" Mottling/Compaction *There are small pockets of mottling at less than 50 inches, but there is good ground color all the way to 50 inches. Soil Log#2 0 - 2" Duff PP 4A - 52"' Brown Gravelly Sandy Loam Z ,b 52" Roots To Z( 1 �l 52" Mottling/Compaction ( \© Ie � Soil Log#3 / 0 - 2" Duff 2-42" Brown Sandy Loam - rte:•• ' ` • 42-48" Mottled Brown Sandy Loam o?y. NATHAN, Fa (f 42" Roots To 48" Compaction EXPIRES C. j Soil Log#4 Added Soil Log on the 20 OCT 2014 0 - 2" Duff 2 - 18" Brown Sandy Loam 18-42" Mottled Silty Dense Silt Loam 1)9°A 05vtilrAl\ 42" Compaction Please feel free to call with any questions. (15)-4 Thank you, Nathan N. Cleaver Licensed Onsite Wastewater Treatment System Designer. Address: Telephone: 360-598-6546 1990 Kimball Rd. NW Fax: 360-598-6548 Poulsbo, WA 98370 Email: nathan @nathancleaver.com Please call ahead to make an appointment if you would like to meet with me.