HomeMy WebLinkAboutSite Plan-APPROVED DESIGN-13307 151 st-RentonSite Design Application Form for Individual On-Site Sewage System (OSS)
ON Record ID:
Payment Date:
Approximate Site Address:
Name & Mailing Address:
Phone Number:
Designer Phone Number:
DOL Certification:
If replacement, Non-conforming
Distance from property line to a public sewer is > 200 ft. ?
Type of Area:
Acreage:
Block:
Water Supply:
Water System Name:
Septic Tank Material:
Pump Tank Material:
If Disinfection, Disinfection Model:
Total Gallons/Day (450 minimum) (Gal):
Application Rate (Gal/sq. ft./day):
Date Soils Logged:
Trench Width (inches):
Trench Depth Maximum (inches):
Max. Slope in drainfield/Reserve Area (%):
Basement Plumbing:
Dwelling Type:
Water System ID:
If Drainfied Type is OSCAR Coils, OSCAR Coil size:
System Information
Septic Tank Size (in Gal):
Pump Tank size (in Gal.):
Name:
Address:
Email:
THIS IS NOT A PERMIT
Property Information
Parcel # (APN):
Subdivision Name:
Property Size (sq. ft.):
Design Type:
Other Tank 2 Type:
Other Tank 2 Size:
Lot:
Other Tank 1 Type:
Other Tank 1 Size:
Calculations
Number of bedrooms:
Soil Texture Type (1-5):
Total Absorption Area (sq. ft.):
Drainfield Length(ft.):
Trench Depth Minimum (inches):
Garbage Disposal:
If encountered, provide depth to the restrictive layer in Inches:
Email
Additional Tanks?
Drainfield Type:
Drainfield Material:
Nibbler:
Treatment Type:
Disinfection:
Applicant Information
Preferred method of communication:
Email:
Mail
Designer Information
Proprietary Treatment Product:
Distribution Product Manufacturer and Model (If applicable):
Proprietary Treatment Product Model:
Individual On-Site Sewage System Site Site Design Application Form (Online) Page 1/2 Updated on 6/04/2019
ON0167814
06/10/2024
13307 SE 151ST ST Renton WA 98058
WRIGHT, COLEEN 13307 SE 151ST ST RENTON WA 980585
2534359999 tyson@aadvancedservices.com
Westside Septic Design
PO Box 731069 2533138195
connor@westsideseptic.com 22010799
2223059116
Urban 8
12781.0 0.2934108608
Replacement of a failed system
Yes
Public Water System - Group A Single Family
Maplewood Addition Water Coop
1500.0 Concrete
1500.0 Concrete
Sand Lined Trench/Bed
Gravel
No advanced treatment (only septic tank)
8
3.0 450.0
1 1.0
450.0 05/28/2024
45.0 120.0
36.0 40.0
0.0
78.0
46"66"
Note: SYSTEM MUST BE INSTALLED BY A KING COUNTY CERTIFIED INSTALLER UNLESS OTHERWISE PROVIDED BY CODE
APPROVAL OF THIS DESIGN APPLICATION IS BASED SOLELY ON INFORMATION PROVIDED IN THIS APPLICATION AND DOES NOT
CONSTITUTE PERMISSION TO BEGIN CONSTRUCTION OF THE PROPOSED SEWAGE DISPOSAL SYSTEM OR ANY OTHER
IMPROVEMENTS ON THE SITE. THIS APPROVAL SHALL NOT BE CONSIDERED AN ASSURANCE, EITHER EXPRESSED OR IMPLIED, THAT
DEVELOPMENT PERMITS FOR THE SITE WILL BE ISSUED.
Any person aggrieved by any decision or final order of the Health Officer may file a written application for appeal to the Health Officer within 60
calendar days of the date of the above decision. (Title 13, K.C.B.O.H. Chapter 13.12 –Sewage Review Committee). CS 13.15.97 Rev. 7/21/00
Site Design Application Form for Individual On-Site Sewage System (OSS)
Record ID:
FOR HEALTH DEPARTMENT USE ONLY:
THIS IS NOT A PERMIT
Designer's Comments:
I understand that failure to comply with the Code of King County Board of Health Title 13 may result in the disapproval of the sewage
system being proposed in this application. Non-compliance may also lead to revocation of my Designer's Certificate of Competency and/
or appropriate legal action by the Health Department. Furthermore, I understand that failure to submit a proper and complete set of
supporting documents may result in delay or rejection of my site application.
Designer's e-signature: Date:
Individual On-Site Sewage System Site Site Design Application Form (Online) Page 2/2 Updated on 6/04/2019
ON0167814
06/10/2024Westside Septic Design
SITE CONSULTATION WITH MAGGIE TO REVIEW TEST HOLES. TEST HOLE WAS BACKFILLED
AFTER.
8
NON-CONFORMING REPAIR: THIS SYSTEM
REPAIR/REPLACEMENT DOES NOT MEET
REQUIREMENTS OF A NEW SYSTEM. THE
REPAIR DOES NOT REPRESENT A SYSTEM
UPGRADE TO ACCOMMODATE STRUCTURUAL
EXPANSION, REMODELING, ADDITIONS, OR
ENLARGEMENTS ON THE PROPERTY
Non-conforming Items:
1. No reserve area
Critical Lot - Limited Space: The designer must stake off drainfield and
reserve area and monitor lot during preparation and construction. Cuts,
structure relocations, or improper clearing may invalidate this plan.Non-conforming Repair -
A non-conforming notice
on title is due prior to
stub-out release.
Certificate of abandonment for
the existing system is required
at record drawing submittal.
Pre-construction Meeting
Required between designer and
installer prior to permit issuance.
Rhododendrons to be removed by
septic installer only. Do not pull roots.
This project is within the 100-year
flood plain and requires a Shoreline
Exemption prior to stub-out release.
Contact City of Renton Planning
Department.
Approved
By:
Printed Name: Maggie Ankoudinova
07/03/2024
This application expires 2 years from
date of approval.
Traverse PC
confirmed MA 5/28/2024
Received
Eastgate Environmental
Health
By Maggie Ankoudinova
07/02/2024
Approved
By:
Printed Name: Maggie Ankoudinova
07/03/2024
This application expires 2 years from
date of approval.
Traverse PC
Received
Eastgate Environmental
Health
By Maggie Ankoudinova
07/02/2024
Approved
By:
Printed Name: Maggie Ankoudinova
07/03/2024
This application expires 2 years from
date of approval.