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CITY GF EVERETT <br />City Nall <br />Everett� �+ashin�ton <br />�NSFECTIa`J DEFARiNEMT <br />/ LOT AFPRGVAL SHEET <br />N�n�.t� �"l � J � J <br />ADDRESS OF PRR'U D BUILDIPIa %�u '� <br />FHONE: ALpine 9-'l101 <br />ADDRESS�%.i /S ln - �i `� ��.�� ' <br />LEGAL 'JESCRIPTION: LOT'�BLOt;K -- /ADDITION ����.ti� ��-tG�-J Cc�i�� • <br />TYPE OF USE�NO. OF BEDROC�vS �� SIZE � LOT g7 X�.��_ <br />-�-v <br />SOIIRCE CF DRIP!KItJG „ATER: PUGLIC SUFFIY �l FRIVATt u�cLL <br />A. SURFACE DRAIPIAGE <br />I. Is disposal field site well drained? �J <br />2. Any water course (siream� drainage ditch� tc.) through site? �,�'�1./) _ <br />B. TOPOGRAFHY <br />,. P,ny heavy slopes in field area: �lri� <br />�. ,il] present topsofl�in field area be removed or �rade.d before field tiles are <br />insia;led? //l <br />.i. ..il] eny fill material be used in the disposal field site?�If yes� how rtucF� <br />�- <br />C. SOIL CONDITIIXJS <br />!. F=,s a hole at least 4 feet deep been dug in the disposal field area to determin� <br />the t�pe of soil present? �'`fJ.dJ <br />[. P`l�r hole is dug record the ;oil onditions at the following depths. <br />(Record as sand� ravel `" fi� packed sand� loam� etc ) <br />12 inches .C� �.tJ� 30 inches v <br />]E inches 36 inches ' <br />24 inches 4F� i�ches � <br />.. Any ground water encountered before reachinQ a depth of 4 feet? � <br />If so� at what depth? •�" <br />D. 'HATER TEST <br />A simple water test v,ill show how well this soi] will drain or percolate �vater. <br />To perPorm this test: <br />]. Dig a hole at least 3G inches deep. Use e shovel or post hole digger size <br />of hole makes no diPference - only depth. <br />'t. Fill hole wiih water, fJow let all water run out of hole. This soaks the <br />�round and will give a rtare accurate readin�. <br />3. Again pour water in hole to a height of 12 inches from the boitom. Let <br />water run out until ihere is just 6 inches from bottom left in hole. � <br />4. Note how rr�ny minutes it takes ior this lasi 6 inches to esp away. �7�s- <br />�. Divide this iime by 6 to obtain the rate per inch. � <br />6. Date v;ater test was perfornred. �- /,�, ^ G��� <br />I hereLy certify the above inforRation to be correct 3nd the above t sts were per- <br />forn�ed by me as prescribed. �� <br />SiPned eLL <br />Address '� `L'�' '� <br />— ,ZS� =.1.�.— <br />I`iGiE; P septic tank permit is issued on the basis of ihe �bove information. If <br />'here are any changes or alterations in the �buve stated suil conditions� it may <br />res�li in the installation beinp rejecfec� at the iime of inspection. <br />