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<br /> C:'i'Y Cfi �1'�^;;1T
<br /> �j' o c ��Q-�- City Hnll
<br /> � ,� � � Ev�rett� ldas'�ington PFiCnE: ALpire ?-71�1
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<br /> IA'Sl'�CTIOP'. DEP!1RTbiENT
<br /> LOT APPROVAL SH3�T
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<br /> 1,.�,,� �'l.�F:.�..` '(�' , , � �r- •f • •
<br /> �Y � < �:n�x�ss �.���,.� - .�;Fl��.t -a oue..::f
<br /> ADDki;SS OF YROPOSED BUILDING_ '7�S �=l� �CL.� C,(G'. !-G
<br /> I�GAL D�SCRIFTI01�: IAT .3I BIACK 9DDITI01;��,/-l--�' 2�tG�'il L �,,E E t � �
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<br /> TYf'� OF USE�.I�v. ^P Di.DR00iS_ ,3 SIZi: OL' LOT �b�_�� �,.''_�
<br /> SOURCG OF DRIIiKIFG YIATER: YUBLIC SUrTLY � PRIVATL �!GiL
<br /> A. SURr^AG� DRAI1:kG�
<br /> 1, Is dispqsal field ^,ite well d^ained? �� .C' �
<br /> 2. Any i•!cter course (ci.rearm, draina�e ditch� otc, hreugh site":. -�w
<br /> B. TOi'OGi2AFF.Y
<br /> 1. Any heaV�� slopes ir. field area? ��
<br /> 2, 41i1i present +,opsoil in f/�eld r��a"�e�a be r/@moved or Pzuded�Sp�e field tile� are
<br /> ].115't811C:[1? •-�/;':r-�.��A ;I.G{u.ff f.l�K., �Q tJ_;v �'.•�r./e� .,e.... . .
<br /> 3. YIi].1 an,y fi1L�r�:aterial be usediir. the dis;Sosal field s te?i��I£ yes� how mu�.i
<br /> C. SOIL COI�DITIOfiS
<br /> 1, Has a hole at least w feet deep been dug in the dis;osal !'ield area to determine
<br /> the t,ype oF soil present"
<br /> ; 2. Afte. hole is dug record the soil conditions at the Yo]].owing 9epths.
<br /> (Hecord as sand� gravel� clay� packed sand� loar, etc,��
<br /> 12 inche� �_.':": .,L� 30 inches
<br /> 18 inches_ _ ('�. r, . : _ 9G inches_� �-
<br /> 2!. inches � r. ,, ., .. ' (4 inches_ C,�,, �/ .�.✓,..L
<br /> 3, An3• gro�nd �aater encountered be£ore reaching a depth o� /,i �et? na.t
<br /> If so, at iahat depth?
<br /> D, F1r:TER T3S7
<br /> .. ,imn'e vater te�t itill shotr tiow irell this soi.l �ail7. drain or percolate +.aater.
<br /> lo pertorm this te�t:
<br /> 1. Dig �. hole at least 3b inchos deep, Uee a shovel or nost hole dip,ger;
<br /> size oF hole ;aalce� no difference - only nepth.
<br /> 2. E`ill hole intL �aater, Z�011 let all ert:ter rim ou+ oF hole, T;.i s soaks tlle
<br /> �round and irill give a nore accurate r.eadir.g,
<br /> 3. �+gain pour i•rater in hole to a height oi 12 incl�es fro:a ti�c uotto��. Iet '
<br /> iaater run out un•cil there is just 6 inahes from bottor�i left in hole, �
<br /> l,. 19ote hoir ��any minutes it tril:es fm• thi, lest 6 ir.che� to seep aira,y. .',�,�,
<br /> 5. Divide tL•is tirra by 6 to obtain t!ie rate •er inch -;�0 „�..,,;,,
<br /> 6. Dute taater teat was rerforr.:ed, �j(.� .^�'L �C.�. (y;3
<br /> �
<br /> I i�ereUy certif'�� the akove infor:iation to ':e correct and tl�e •a' ove ie�t; �rere per-
<br /> forr,�ec1 ln� '�e as �;resr.ribed.
<br /> Signed �/%.zL.�-�-,� C'_ .�i�
<br /> iiddre�s �i 3/� �;-- 3•��L/'c�=�_nz�-��f=
<br /> ItOTL: A ,eptic tar.k permit is issned on tue Uasio of tl:e aUove in"�rmction, I£
<br /> there are any chan�e: or alterations i�i i,he above stated soil coi.ditions, it ma��
<br /> re�ult ir: the irstalleti�i: ' ein� re.l�ct�a at +l�e tine o: i�,anectior,
<br /> —c .. -
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