HomeMy WebLinkAboutSEP2014-00016 - 02 PERMIT4w ,4,50N 5`. JEFFERSON COUNTY PUBLIC HEALTH
615 Sheridan Street - Port Townsend - Washington - 98368
www .jeffersoncountypublichealth.org
one MU-38b-9444 ax MU-3/9-448
ON -SITE SEWAGE DISPOSAL PERMIT
PERMIT #: SEP14 -00016 Date Received: 02/10/14
SITE ADDRESS: 163 MOON VALLEY DR
Date Issued: 05/16/14
QUILCENE, WA 98376 Date Expires: 11/16114
APPLICANT: MICHAEL K WHITTAKER PHONE: 360- 765 -3157
DORA LEA WHITTAKER
PO BOX 220
QUILCENE WA983760220
LEGAL DESCRIPTION: RIVER VALLEY VIEW LONG PLAT LOT 1 REVISED
PARCEL #: 991700001 Section: 22 Township: 27N Ranqe: 02 W
DESIGNER: SUZANNE L MARTIN PHONE:
PO BOX 178
PORT HADLOCK WA 98339
SYSTEM DESCRIPTION: CONVENTIONAL TRENCH
No. of Gallons per Day: 240 Type of work: UPG
-------------- Drainfield-------------- -------------- - - - - -- Trench------------ - - - - -- ----- - - - - -- Septic Tank--- - - - - --
Length: 134 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 -00016
1.) This permit was issued to up -grade a old pre 1970's septic system that serves an existing
residence. The existing septic system was not found to be in a state of failure, as a result this
permit is issued with a 6 month expiration date. This permit could be renewed /extended if another
inspection of the existing septic system finds it to be operating in an acceptable manor.
2.) 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.
3.) Setbacks to EXISTING wells- 100' required from drainfield and reserve areas. 50' required from
tanks and effluent transport lines.
4.) 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.
5.) H - AS PER WAC 246 - 272AAND JEFFERSON COUNTY CODE 8.15 ALL ONSITE SEWAGE
SYSTEMS REQUIRE THAT 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
6.) 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.
7.) Notification of the start of construction shall be faxed or emailed to Jefferson County Public Health
ONE WORKING DAY prior to start.
8.) H - An asbuilt drawing and certification of completion by the Designer is required prior to final
approval.
9.) 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.
10.) 10' separation required between a Water line and all portions of the onsite sewage system; effluent
transport line, tanks, treatment and disposal components.
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 /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.
13.) Divert all sources of drainage, including roof drains away from septic tank and drainfield area.
14.) 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.
15.) 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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