Fillable ON-SITE SEPTIC PERMIT APPLICATION POLICIES (Swinomish Indian Tribal Community)

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ON-SITE SEPTIC PERMIT APPLICATION POLICIES (Swinomish Indian Tribal Community)

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ON-SITE SEPTIC PERMIT APPLICATION POLICIES
1. All designs for on-site sewage systems shall be prepared and submitted by a civil or sanitary engineer, certified
designer, or registered sanitarian. A resident owner of an existing or proposed single-family residence may
design or repair a conventional gravity system for that residence, if such a system meets or exceeds all the
requirements in “Design Standards for On-Site Sewage Systems,” as published and amended from time to time
by the Washington State Department of Health or in “Criteria for Sewage Works Design”, as published and
amended from time to time by the Washington State Department of Ecology.
2. All designs for on-site sewage systems MUST clearly identify the following elements on the submitted site plan:
a. Property boundary lines
b. Location of all surface water
c. Location of active and decommissioned wells
d. Location of any existing sewage disposal systems
e. Location of water supply line(s)
f. Location of all structures
g. Location of shoreline(s)
h. Location of all soil test holes
3. Soil tests MUST be performed by a civil or sanitary engineer, certified designer, soil scientist, or registered
sanitarian.
4. Soil logs shall have a minimum depth of 60 inches or reach ground water, whichever distance is less, and shall
note the texture, appearance, and type of soil according to the most recent “Soil Survey of Skagit County Area,
Washington” as published by the United States Department of Agriculture.
5. The person evaluating the soil and site shall record the following:
a) A minimum of two soil logs at each proposed disposal and reserve site(s)
b) The ground water conditions, date of the observation, and the anticipated maximum height of the
ground water table
c) The general topography of the site by drawing arrows on the site plan indicating the direction of
slope;
d) The drainage characteristic of the site
FOR STAFF USE ONLY
Attached Supporting Documents
_____Site Plan (2 copies
_____Soil Log (2 copies)
_____System Design Drawings (2 copies)
INCOMPLETE APPLICATIONS WILL NOT BE ACCEPTED
ON-SITE SEPTIC PERMIT APPLICATION
– PERMIT #________
LAND OWNER INFORMATION PERMIT INFORMATION
Property Owner:
PERMIT TYPE
New Construction
Design Only
Repair:
Entire Systems
Tank Only
Drainfield
DESIGN TYPE
Conventional
Pressurized
Mound
Sand filter
Innovative
Other (Describe):
SITE EVALUATION
Existing Lot
Proposed Lot
Address:
City:
State:
DESIGN STATUS
New Design
Redesign
No Design
Submitted
Zip Code:
Day Phone:
Cell Phone:
Fax:
PARCEL / LOT INFORMATION
RESIDENTIAL NON-RESIDENTIAL
Parcel No.
No. of Bedrooms: No. of Occupants:
Assessor’s Account No.
Total Daily Flow:
Gal/Day/Occu
pant:
Allotment No. 122-
Total Daily Flow:
Existing Plat Name or No.
SITE EVALUATOR (If different from Installer/Designer)
Parcel and/or lot size:
Name / Company:
Lot No. Work # : ( )
Section: Fax # : ( )
Township Range: Registration No.
INSTALLER INFORMATION SYSTEM DESIGNER (If different from Installer/Evaluator)
Name / Company:
Name / Company:
Registration No. Work # : ( ) Fax # : ( )
Registration Expiration Date / /
Registration No.
Address:
SIGNATURE BLOCK
Application is hereby made for a permit to authorize the activities described
herein. I certify that I am familiar with the information contained in this
application, and that to the best of my knowledge and belief, such
information is true, complete, and accurate. I further certify that I possess
the authority to undertake the proposed activities. I hereby grant to the
officials of the Swinomish Indian Tribal Community the right to enter the
above-described location to inspect the proposed or completed work.
_______________________________________ Date: _____________
Signature of Applicant (REQUIRED)
City:
State:
Zip Code:
Work # : ( )
Fax # : ( )
E-Mail:
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ON-SITE SEPTIC PERMIT APPLICATION POLICIES (Swinomish Indian Tribal Community)

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Completed 27 January 2021

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