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^ip . <br /> CITY OF EVERETT _ . . . <br /> City Hall <br /> ' Everett� �+ashington ' <br /> • ' FHONE: ALpine 9-7101 <br /> INSf-ECT106J DEPARiNENT <br /> LOT APPRGVAL SHEET I <br /> � � <br /> NAA�.E T� � �r � �.� �r�' ADDRESS S :�� '� i�t l-r/,�. 1 I��C.' � <br /> l ��, P > .�� /S + <br /> ADDRESS OF PROPUSED RUILDING G e Y " % . � � <br /> LEGAL DESCRIPTION: LOT �= BLOCK ADDITION � croc' it/�7c✓ . f� :«'�� � � � <br /> TYPE OF USE R�s ��Ir � w N0. OF BEDROCW S 3 S I ZE OF LOT I Z 2 -'C 7 �d <br /> SOURCE OF DRIMKING „ATER: PUELIC SUFFLY `IE S FRIVATE �+ELI <br /> A. SURFACE DRAINAGE <br /> 1 . Is disposal field site well drained? y � s <br /> 2. Any water course (stream� drainage ditch� etc.) through site? `� t:� _ <br /> B. T(�OGRAPHY <br /> I . Any heavy slopes in field area': t�i� <br /> �. :+ill present topsoil in field area be rertaved or graded before Pield tiles are <br /> installed? N O <br /> .i. ',.ill any fill material be used in the disposal field site?U D If yes� how much <br /> C. SOIL CONDITIONS <br /> 1 . Has a hole at least 4 f'eet deep been dug in the disposal field area to determine <br /> the type of soil present? �r� S <br /> 2. After hole is dug record t�ie_soil conditions at the following depths. <br /> (Record as sand� gravel �TjTy packed sand� loam� etc.) � � ' <br /> 12 inches Suti� c� � 30 inches S��*, c� C ,� <br /> 1 S i nches 5 a v� �l I n a 1» 36 i nches �' � » �-� C P v <br /> 24 inches Sr��+ d �� lal 4R inches Sc�� � L <.T/� <br /> .,, Any ground water encountered before reaching a depth of 4 feet?_�(,�_ <br /> If so� at what depth? <br /> D. s'iATER TEST <br /> A simple water test v:ill show how well this soi] will drain or percolate wate�. <br /> To perform this test: <br /> ] . Dig a hole at leasi 36 inches deep. Use a shovel or post hole digger size <br /> of hole makes no difference - only depth. <br /> 2. Fill hole with water. Glow let all waier run out of hole. This soaks the <br /> �round and v. 11 give a rtare accurate reading. <br /> 3. Apain pour �vater in hole to a hei�ht of 12 inches from the bottom. L>t <br /> water run out until there i�s just 6 inches from boitom lefi in hole. <br /> 4. Note how many minutes it takes for this last 6 inches to seep away. %h'/�11I�S, <br /> 5. Divide this time by 6 to obtain the rate per inch. `�� G 6 /�1�+�. 1 �N. <br /> 6. Date water test was perfornred. `7 ��`7 � �t � <br /> i <br /> I hereby certify the above inforRation to be correct and the above tests were per- <br /> formed by me as prescribed. ,/ �'�� � <br /> Signed ��� �r�� °� , /� -<? �"�— <br /> Address �-tiL-i!>_ �,c � -i ;_ �L��. <br /> �!CTE: P sepiic tank permit is issued on the basis of the above information. IP <br /> there are any changPs or alterations in the 16ovo stated soil conditions� it may <br /> res�lt in the insta; lation beinp rejected at the time of inspection. <br /> -�c:c <br />