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HomeMy WebLinkAboutSEP2013-00020 Jefferson County Department of Community Development 621 Sheridan St., Port Townsend WA 98368, (360)379-4450 !y*�j� V/SEPTIC PERMIT APPLICATION �' PROPERTY OWNER —�T r �1 7' w a MAILING ADDRESS 2-330 S/-t 4/V S' T P0737" r014144C , W/ 98'3 6-g. PHONE ( 3(Q ) 7 7 5 ° 7 -0113 SYSTEM DESIGNER 14 .=736 4 a 0 Designer Phone# 30 -Cg 3" (3 y co LEGAL DESCRIPTION: Section 7-'7 Township 30N Range I W PARCEL# 00 I - 2.35 - O III Subdivision Name W OOD&4/149 -._ / Division Block Lot(s) 2- '"" Site address/Directions to site 55 3 14101N2 617/142 0/ SOURCE OF SEWAGE/USE TYPE OltVORK WATER SOURCE Residential ® New Tank/s only Private Residential ADU Modification Public PV D Commercial Expansion Community Upgrade Repair SITE SIZE /9g /9 k SCE F/ SYSTEM TYPE Partial Repair- (tank) (drainfield) Previous Evaluation Conventional (L ' Designate Reserve Area Yes#.r ?° 90—0 BSc Alternative Redesign No SYSTEM DETAILS Number of Gallons/day 3 6® Soil type T (attach soil eval.) Application Rate ©. 6 gal./sq.ft./day Drainfield Length 2 CC) ft. Trench Width 3 ft. Trench/Bed Depth/2—/0 r� in. Septic Tank size /000 qal. Pump Chamber size gal. TYPE of system C°/I/VC-21/ / '- 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 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 futur pplica n will be s:•crate■ judged by the rules and laws in effect at that time. A Property Owner Signature Date "7 oFOR OFFICE USE ONLY Zz f / ti I 1J PARTIA ASBUILT / FINAL gd)24/4)V APPROVED * rw INSP/PUMP TEST PUD g I I 4 ,,,,�� ALL HOLD FZEQ. MET //y� /� l '` / ' (3 F e� '6" C� Rec# / M Check# 5? Case#SEP / r✓, "' H:\wEB\pbFs\septIc\septic_permitapp_zoos_boc JEFFERSON COUNTY PUBLIC HE A 615 Sheridan Street .Port Townsend*Washington *93368 .................................. .. -Phone_Phone"'360=385=9244- 'Tax 60:379:4487_,......_......... .. ON-SITE SEWAGE DISPOSAL PERMIT PERMIT #: SEP13-00020 Date Received: 02/14/13 SITE ADDRESS: 553 WOODLAND DR Date Issued: 04/12/13 PORT TOWNSEND, WA 98368 Date Expires: 04/12/16 APPLICANT: GARRY L WOOD PHONE: CRISTINA C WOOD 1630 LANDES ST PORT TOWNSEND WA 983688327 LEGAL DESCRIPTION: WOODLAND HILLS NO 1 LOT 22 PARCEL#: 001275014 Section: 27 Township: 30N Range: 01 W DESIGNER: ERIC HIBBARD PHONE: 360-683-6300 SOILS APPLICATION INC. P. O. BOX 1120 CARLSBORG WA 98324 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. ,//1 " 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.: SEP13-00020 1.) 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 246-272A AND 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 2.) If a gravelless product is used in the drainfield, measures should be taken to prevent dammage to the laterals by moles or other burrowing animals. 3.) 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.) 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. 6.) Notification of the start of construction shall be faxed or emailed to Jefferson County Public Health ONE WORKING DAY prior to start. 7.) H -An asbuilt drawing and certification of completion by the Designer is required prior to final approval. 8.) 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. 9.) Divert all sources of drainage, including roof drains away from septic tank and drainfield area. 10.) 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. 11.) 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. 12.) 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. 13.) This parcel is within a no shooting area per JCC 8.50. 14.) 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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ERIC HIBBARD LEGAL DESCRIPTION: Section-27 Township- 30N Range- 1W Parcel# 001-275-014 Subdivision Woodland Hills #1 Division Block Lot(s)- 22 Date Logged: 2-7-2013 Logged by: Eric Hibbard Include soil textural characteristics and depths at which significant changes occur. Be sure to include depth where mottling or impermeable layers occur.SOIL LOG #1 Health De t. Comments: fill p 0" to 4": Dark brown loamy fine sand 4" to 10": Red brown loamy fine sand 3( ..ctY 10" to 48": Faintly mottled fine sand 48" to 52": Moist grey medium sand Observed water table @ n/a Roots to 48" SOIL LOG #2 Health Dept. Comments: o4, 0" to 4": Dark brown loamy fine sand o, 4" to 13": Red brown loamy fine sand _� 4/1„9/Alj �r' !1�. 13" to 46": Faintly mottled fine sand 4 �\ �f l OV- "� 46" to 56": Moist grey gravelly sandy lo. ••• ' f � I/0�4} Observed water . • - 7r a Roots to 50" -2y d7 `�@ L z L old:-2 -31/33 f.@ - SOIL LOG • 33.--y�� - Health Dept. Comments: 0" to 3": Dark .rown loamy fine sand 3" to 13": Red brown loamy fine sand 13" to 58": Faintly mottled fine sand 58" to 62": Moist grey medium sand Observed water table @ n/a , / Roots to 52" v Jefferson County Environmental Health Dept. 615 Sheridan St., Port Townsend, WA 98368 SOIL LOG #4 Health Dept. Comments: 0" to 4": Dark brown loamy fine sand 4" to 20": Red brown loamy fine sand 20" to 60": Faintly mottled fine sand 60" to 64": Moist grey medium sand Observed water table @ 62" Roots to 60" 4