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<br />Everett� 4Jashineton PHOFE: l,Lpine 9-7101
<br />Il'�I�CTI01'. DE3'A3Tl�D'T
<br />I.OT APPROV4L SH�BT �
<br />I'.AI-� ��7'TA A1 � `� C �-I I 2 /`�j�, -l; ADDRIiSS ( � ; � 13 � �% L-._; C �Y L/ „��� t,
<br />HDDR�SS OF YROPOSSll DUILDIEG � 1 1 '� l . ' ' ! ,; ,'„ (\"�, i � . ', t , '
<br />llLf�:' ��� __
<br />ILGAL D�SCRIFTI014: T_OTZ; D1ACK -- ADDITI01: t-l)!'_I;' ."F't_E_%I C�L��1
<br />Si:..i. � . .. � . +n,. !
<br />TYPE OP USG :.I,-.!✓��_ h'G. CP' DrDR00ii5 .� 3IZ� Gr LOT 'P1-1. :.r,.' ,;,'�
<br />SOIJRC� OI�' DRIf•BII'G l•IkTEH: 1'UBLIC SliYPLY �'"` PRIV.ITE `!CLL
<br />A. SURPACE UHAIIChGI;
<br />1, Is dicposal Field ,ite tirell drained? y���
<br />2, An,y taaiter course (,treom, drainnge ditch� etc, through site?_ i,.l
<br />N. TOi'OGRl:I iiY
<br />1. Any hea�.y slopes in fiel.d ar�a7 �iC1
<br />2, 4)ill preseut tops�il in field are3 be removed or �raded Uzfore field tiles are
<br />installed? i�li\
<br />3. !dil7. 4n,y fill raaterial Ue used ir t'ac dis;:osa]. :ie:.d ,ii:e'�If ,ye�� how much
<br />C. SOIL CCI�DSTI01:5
<br />1, Has a hole at least !� feet deep been du� in tl:e di3� oa::1 ."ield aren to determine
<br />the t,ype of �oil present" Y�__>
<br />7., After hole is dug ra^ord the �oi1 conditionc at the lollowing deptiis.
<br />(Recor3 as snt�d� gravel� clay� packed sand� loa�� etc,)
<br />12 inchea L(^,P�i.'. 30 inches LonM
<br />18 iriches " 3o inches�Fl� i�-T �nN�
<br />2Q inr,hes 4f2 ir.chea {`,nv;�,''nIJ
<br />3, Any ground �rater encountered beFore i•eachirg a de�;th of Q feot7 f� C� _
<br />If so� at a�liat depthi
<br />J, !Ii:TEi� T�t',T'
<br />r. simn' e vater test will show liow �-e11 thi� soi7. tiil] drain or pei•colutc �aater,
<br />io �.eriorm thic i:est:
<br />1. Dig a hole at leaet 3h inr�es deep. Use a,hovel or pcst hole dip,ger�
<br />siae of hole �::alcus no difference - otil;� depth.
<br />2. Fill hole vitii ia¢ter, i'ov let all i�ater run ou+, o?' hole. Ti.i� �oak3 t}�e
<br />�i�o•,�nd and iri11 ri•�e a more accurate read;ng.
<br />3. :+p,a.in pour aiater in i,ole to n he5glit o;: 12 irclivs fro;a t��c Lottoi:�, Let
<br />water run out until there i� ,lust h inche;; £rom bottora left in hole.
<br />;,, i4ote hoti vany minutes it tnkes for thia lcst 6 ir.che3 to ceep avay. � O
<br />5. Divide CLis time t,y 6 to ohtain tho r�.ic ci• inch. "��
<br />C. D�te iaater teat waa rerforr..ed, �-;_9-G �
<br />I iiereby certify the aLovo ir£�r.�ntion +o ':e r.o,•rer.t end, ti�c a'rovc icsi^ ^cre per-
<br />forred in� ae as �,re:criUed, , �
<br />SiFned ' -In „ � ,
<br />i;�ldrecs ( 91 � LiJ. � �. f. �- ���
<br />t��'[1;: ti ce;�tic tar.k pr;mit i� is^.:�.i or. tnc u;;sir of t}:e above int'prmation. I!'
<br />there are any chanpca or alteratirni� ir. the above otutn� so.•;l coi.c?�i;�na� �t �ca;;�
<br />rnsnl{. ir. t:ir it:stnl7^ti�r. 'oi:�r �•� ;^ri^.i •:t �Lc �.".i- n' �i_r �ec+�.o��.
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