Laserfiche WebLink
0 0 <br />SNOHOMISH <br />HEALTH DISTRICT <br />WWW.SNOHD.ORG Application For An On -Site Sewage System Permit <br />GENERAL APPLICATION INFORMATION <br />PROPERTY TAX ACCOUNT #: 280508-004-0,1300 <br />j LOT#: <br />Sec: 8 Twp. 28 Rg: 5 <br />ZNew El Renewal 11 Redesign ClAlteration1:1 Revision Repair Waiver Request Submitted <br />Applicant Name-, Mark G 01 i ke <br />Mailing Address: 7818 Larimer Rd <br />City: Everett <br />State: WA <br />Zip: 982 0-8- <br />Applicant Phone: 425-941-9958 I <br />Applicant Email: mark.gol i ke@g mail, com <br />Installation Address: 7818 Larimer Rd Installation city: Everett <br />Water Supply: Individual Well 1__1— <br />Public Name City of Everett <br />SEWAGE DISPOSAL SYSTEM DESIGN INFORMATION <br />-New <br />IT <br />Type of Buildingi P/1 Existing 1,V( I SFR D Duplex [:]Comrriercial ZOther Acc Apt # of Bedrooms 3 <br />Pretreatment Type: SF [:] ATU [:] PBF Z N/A E Other <br />Dispersal Type: Gravity W1 LPD 0 SSD [] Mound 0 SLE3 <br />[:]Other <br />Lot Size: 3.14 Acres Operating Capacity: 270 — fgallons/day) Design Flow: 360 (gallons/day) <br />% Slope in Drainfield Area: 32 Depth to Water Table/Restrictive Layer: 48+ (inches) Soil Texture Type (1 -6): 4 <br />Application Rate: 0.6 (gallsq ft/day) Absorption Area: 600 --- (sq ft) Installation Depth: 12-15 (inches) <br />Septic Tank Size: 1000 _ (gallons) (gallons) Pump Chamber Size: 1000 (gaiions) Date Soils Logged: 3/25/2019 <br />Required Cover Soil: Volume: 80+/- - (cubic yards) <br />—.,--DESIGNER INFORMATION <br />Designer Name (Printed): Richard 01fivier <br />Designer Sign <br />Address: 12702 48th Dr NE, Marysville, WA 98271: <br />License Number: 5100371 <br />Email: roseptic@gmail.com <br />Phone. 425-377-3660 <br />Fee Simple Owner, Contract Purchaser or Owner's Authorized Agent's <br />Name (Printed)' Richard 011ivier <br />Fee Simple 1, . ,act P77r or Owner's Authorized Agent's <br />Signature: <br />Designer Comments, <br />j"EALTH PJWICT USE ONLY <br />APPLICATION APPROVED E is 7 /26/1S APPROVAL EXPIRES ON: 7/26/21 <br />Corn ments/Conditions: 3-BR 2%Wil�Ipitiall Serye 1-BR ADU; 2-JR SFR <br />Serve Existing Sys With No Record o AsBuilt <br />El APPLICATION DISAPPROVED EHS Date_ <br />Rev 1 0022018jg <br />Environmental Health Division SR0013296 / ONO 002048 <br />3020 Rucker Avenue, Suite 104 0 Everett, WA 98201-3900 N fax: 425.339.5254 N tel: 425.339.5250 <br />