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HomeMy WebLinkAboutSEP2014-00038 Jefferson County Department of Community Development 621 Sheridan St., Port Townsend WA 98,-368,(363)379-4450 CC SEPTIC PERMIT APPLICATION ©20/i PROPERTY OWNER ROBERT&JANICE BAKER !uNG ADDRESS P.O. BOX 22 BRINNON, WASHINGTON 98320-0022 PHONE ( 360 ) 774-0424 SYSTEM DESIGNER NATHAN N. CLEAVER Designer Phone# 360-598-6546 LEGAL DESCRIPTION- Section 01 Township 29N Range 1W PARCEL# 997-900-101 Subdivision Name VILLAS BY THE SEA Division Block Lot(s) Site address/Directions to site 21 GRANDVIEW DRIVE, PORT HADLOCK '-'DY)RCE OF SEy11AGE/USE TYPE OF WORK WATER SOURCE `tent'al V New Tank/s only Private -esidef al AIX) _ Modification Public i `:,r_;,,:sna cial Expansion Community Upgrade_!__ SYSTEM TYPE RepairSITE SIZE 16,422 +/- Partial Repair-(tank) _(drain`ield) __ , Previous Evaluation Conventional Designate Reserve Area Yes#SEP1 -00038 Alternative Redesign I No - SYSTEM DETAILS Number of Gallons/day 360 Soil type 4 (attach soil eval.) Application Rate 0.6 gaLlsq.ftlday Drainfield Length 200 ft. Trench Width 3 ft. Trench/Bed Depth 12 in. Septic Tank size 1,000 _gal. Pump Chamber size NA gal. 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 iefferson,County as a result of or in consequence of the granting of this permit. farther 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 `')T assure you of any other County approvals. For example, it DOES NOT GUARANTEE that will later obtain permission to build a permanent residence or other structure on this parcel. Any _ure applicaf ill be separately judged by the rules and laws in effect at that time. Property Owner Signature Date ! AlFOR OFFICE USE ONLY KV 10/ 1 PARTIAL"l� ,��. �D ASBUILT`� /g�� FINA lir AP OVED INSP/PUMP TEST prd6 ,k'/')U\1�\ ALL HOLD REQ.MET Date i Z� I I I` 1 Fee `� _ Rec# 15 5 1.0 Check# � JCL.'�l Case#SEP ) \ ' Li 0� :\WEB\PDFs\Septic\septc_permitapp 2008.DOC JEFFERSON COUNTY PUBLIC HEALTH 615 Sheridan Street•Port Townsend•Washington •98368 www.jeffersoncountypublichealth.org Phone 36U-3135-9444 fax 3b0-3/9-4413/ ON-SITE SEWAGE DISPOSAL PERMIT PERMIT #: SEP14-00038 Date Received: 04/08/14 Date Issued: 03/27/15 SITE ADDRESS: 21 GRANDVIEW DR Date Expires: 03/27/18 PORT HADLOCK, WA 98339 APPLICANT: ROBERTABAKER PHONE: JANICE M BAKER PO BOX 22 BRINNON WA 983200022 LEGAL DESCRIPTION: VILLAS BY THE SEA PHASE II PARCEL#: 997900101 Section: 1 Township: 29N 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: 360 Type of work: NEW Drainfield Trench Septic Tank Length: 200 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 E vironmental 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.: SEP14-00038 1.) This property has part of a state approved septic system (LOSS) installed along the norther property line. No ground disturbance is permitted within 10' of this system, as per plan. See the survey that was recorded for the Plat alteration under AFN 590038 pg5 2.) MAXIMUM TRENCH DEPTH 12 INCHES 3.) Contact designer prior to installation for staking of drainfield area. 4.) 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. 5.) 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. 6.) 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 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.) 10' separation required between a Water line and all portions of the onsite sewage system; effluent transport line, tanks, treatment and disposal components. 12.) 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. 13.) All components of the septic system are to be completely protected from vehicular traffic or mechanical disturbance. 14.) Divert all sources of drainage, including roof drains away from septic tank and drainfield area. 15.) 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. 16.) 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. 17.) This approval is valid only with a connection to an approved public water supply. SEP14-00038 Page 2 of 4 \\tidemark\data\forms\F_SEP_Permitmod.rpt 3/27/2015 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. 19.) This parcel is within a no shooting area per JCC 8.50. 20.) This approval is for a Septic Permit 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.) The site plan as submitted with the building permit and septic application on 4-8-2014 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 3-18-2015 shall be resubmitted for review and approval by Jefferson County Department of Community Development. SEP14-00038 Page 3 of 4 \\tidemark\data\forms\F_SEP_Permitmod.rpt 3/27/2015 22.) NOTICE: This permit does not excuse the proponent from complying with other local, state, and federal ordinances, regulations, or statutes applicable to the proposed development, but consistent with RCW 90.58. Development pursuant to this permit shall be undertaken subject to the applicable policies and performance standards of the Jefferson County Shoreline Management Master Program and the Jefferson County Unified Development Code. If during excavation or development of the site an area of potential archaeological significance is uncovered, all activity in the immediate area shall be halted, and the Administrator shall be notified at once. The Federal Endangered Species Act rules to protect threatened Chinook and Summer-run Chum salmon became effective on January 8, 2001. Bull trout have been listed as threatened since early 2000. Under the ESA, any person may bring lawsuit against any individual or agency that "takes" listed species (defined as causing harm, harassing, or damaging habitat for the listed species). In addition, the National Marine Fisheries Service can levy penalties. Portions of Jefferson County, including marine environments are included as "critical habitat" for listed species. Development of property along any marine shoreline, freshwater shoreline, or floodplains could harm habitat if protective measures are not taken. To minimize the potential to damage habitat, all property owners developing adjacent to marine shoreline, freshwater shoreline, or floodplains are advised to do the following: - All development activities should avoid unstable slopes, wetlands, and forested areas near surface waters - Remove minimal vegetation for site development, especially large trees - Allow trees that have fallen into surface waters to remain there - Infiltrate stormwater from buildings and driveways onsite through drywells rather than discharging directly into surface waters or roadside ditches The Federal Bald and Golden Eagle Protection Act requires landowners within 660 feet (1/8th of a mile) of an eagle nest to consult with the US Fish and Wildlife Service. This Eagle Act prohibits anyone from "taking" bald eagles. This federal law defines the term "take" and describes the possible legal consequences when a "take" occurs. Among other actions, "take" includes a disturbance of bald eagles or their habitat. Under federal law a permit may still be required for activities that impact bald eagles or their habitat. Contact the US Fish and Wildlife Service (http://www.fws.gov/pacific/eagle/) to learn more about how this law affects your project. Any individual, group, or agency can bring suit for a listed species "taking", even if you are in compliance with Jefferson County development codes. The risk of a lawsuit against you can be reduced by consulting with a professional fisheries habitat biologist, and following the recommendations for site development provided by the biologist. For more information, contact the National Marine Fisheries Service in Seattle, or the U.S. Fish and Wildlife Service. SEP14-00038 Page 4 of 4 \\tidemark\data\forms\F_SEP_Permitmod.rpt 3/27/2015 A\7 CONVENTIONAL SYSTEM ASBUILT INSPECTION REPORT INSTALLER BOB 13Ake oemsOu3 J Z) PARCEL# °IT+ -q0D• l o Permit Owner ROBEitt ?JAN 1Ge s TL. Permit # &EP \4 — 00()34?) ABSORPTION AREA: DRAINFIELD , TRENCH TRENCH TANK #OF #GAU LENGTH 210 WIDTH 3 DEPTH 12 SIZE % 1500 BEDRMS 3 DAY J(DO Tank Shroadt- IF PUMP AND PUMP CHAMBER REQUIRED: Size NSA Screen Ov11 t G3AFFt,E' 0GO 1-4(.€112- Float tFloat Arrangement High water float—distance to topof tank/emergency storage 9 9 Y 9 Dose drawdown(#of inches) #Gallons/Dose ted Timer/Dose Counter info Pump Size/Manufacturerco-g05., I CERTIFY THIS ONSITE SEWAGE SYSTEM WAS INSTALLED AS DESIGNED, PER PLAN APPROVED 2 7 /-) 5 OCT ?AIS 1?i+JI T INSTALLER SIGNATURE DATE INSTALLED 1ft glk 0 NATHAN N CLEAVER �. LIC NSED DESI N EXPIRES MAINIhNANCE BASICS *There is a "filter sock" in the outlet baffle of the septic tank.The filter 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. 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Cleaver l Soil Log#1 2 ) 6' \\2 ' ly 0 - 2" Duff <j L V ✓ 2 - 10" Brown Sandy Loam 10-60" Gravelly Medium Sand -�J j L5 ozF.�/�' Soil Log#2 1--(6"4 /' 0 - 2" Duff / C j � 6 . (0 2-48" Gravelly Medium Sand o_z L5 �. 48-60" Mottled Gravelly Medium Sand VU 914(( lb gkelcve Soil Log#3 gb -i-- Firc Lis'''°‘AQ m ,\ 0 - 2" Duff c j,�Sp 2 - 10" Brown Sandy Loam '5 l �^J�"'" ac ) 10-60" Gravelly Medium Sand Oi _(/ `l r„,--ou'w1 Ls Soil Log#4 L 0 - 2" Duff D---i5\pww ''AA 2- 53" Gravelly Medium Sand pk,44 t5-55 3 wi, cam.' Please feel free to call with any questions. Thank you, 1,'� 7. ,,. . -,....t .., . ,,,,... ,., c'" ,,_ -,,.. ,. NATHAN No CLEAVER , LI N. D9 R v EXPIRES , AO" • 4,0,J 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.