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J'1 ���� � �'/ 07 � / � � �3 �� <br />0 CITY UF EVERETT ��%�o %� <br />, O" � City Hall PI-iO�E: ALpina 9-7101 <br />.-� Everett� '�lashin�ton <br />IPJSPECTION DEPARTf1�ENT LOT APFrfJVAL SHEET <br />.�e� ,� y �� ADDRESS .j'� /G/cT- �L 5 "� <br />i�1:1:J�E c r V � <br />�— L'"a�onds �'`�a�J <br />AJDRtSSUF FfiOFOSED BUILUING�d33 - cS 0.3-i Cr�-cfLvn� <br />IOrTie��1 rF IJ{<j�,$tv%y .�cS�Y�SccT�•',�3I�%-19Nk'.�K'M <br />LEGAL DESCRIPTION: LOT BLOCK ADDITIUN ��p'.�ti7'( � i� /_°„--.T 1.•••c. <br />iv�5 �o F v, e,v i2, dy e�S <br />TYFE Uf USE �_ K� . �0. GF BEDFC)OMS �_ SI ZE UF LOT �-� non <br />S�JURCE OF DRINKIiVG �JATtR: FUBLIC SUPFLY dC rRIVATE ilE�L <br />H. SURFACc DRAINAGE <br />1, Is disposal field site v:ell drair.ed° <br />2, Any water course �stream� drainage ditch� c.) through site? ,Q[I� <br />8. TOFOGRAPHY <br />1. Any heavy slopes in fi�ld area? <br />?. :lill present topsoil in field area e removed or Fraded before field iiles are <br />installed?_�[(� <br />�. 'rJill any fill material be used in the disposal field site? Ni7 If yes� how <br />much <br />C. SOIL OUf�DITIONS <br />1. I-las a hole at least 4 feet deep been dug in the disposal field area to determine <br />the type of soil present? U p 5 <br />2. i\fter hole is dug record the so 1 conditions at the following depths: <br />(Record as sand� gravel� clay� packed sand� loam� etc.) <br />12 i ncl�es � 30 i nches S n.. A � <br />lE inches n-� 36 inches _�„.�.� <br />24 inches �� 48 inches S.•x�� <br />?. Any ground water encountered before reaching a depth of d feet'• /v0 _ <br />If so� at what depth? <br />D. PlATFR TEST <br />A simple water test tvill show how well this soil will drain or percolate �vater. <br />To perform this test: <br />1. Gig a hole at least 36 inches deep. Use a shovel or posi hole dip�ar� size <br />of hole makes no difference - only depth. <br />2. Fill hele with e�atar. I�ow let all �vater run out of hole. This soaks the <br />�round and will give a more accur�te readin�. <br />3. Again pour �vater in hole to a hei�ht of 12 inches from the bottom. �et <br />water run out until there is ju=t 6 incnes from bottom left in hole. <br />4. Note how many minutes it takes for this las: 6 inches to seeP away. ,.�� Mi�i <br />5. Divide this time oy 6 to obtain the rate per inch. �-_ h± r..� n���„� y <br />6. Date water test was performed._ /0//� '1 ' <br />I hereby certify {ha above informatien to be correct and the above t sts were per- <br />formed by me as prescribed. ' <br />Si�ned � <br />Address o / [��L�� Sw E'.�ncr�,,.��G�� <br />�:O1E: A septic tank permii is iasued on the basis of the above information. If Ju^'�• <br />t'�era a'e .iny chan�as or alterations in thc- above stated soil ccnditions� it may <br />r,:sult ir the installation being rejected at ihe time of inspection. <br />