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� <br />CITY OF EVER[TT <br />City Hall <br />Everett� �iashin�ton <br />INSFECTIOPJ DEFARTNEPJT <br />LOT APPRGVAL SHEET <br />NAA�t �• �-'-�' ,!� <br />ADDRESS OF PRCPUSED BUILDIMG__/.__=_ <br />FHONE: ALpine 9-'l101 <br />ADDRESS -� %�' C��yr�,G' � �� '.' �� <br />,—� <br />_ �'._.. .. <br />LEGAL DESCRIPTION: LOT�BLCCk ADDITION �%� /%'. �� �.�- •.�` _ <br />TYPE OF USE%�i�'�:-„:-'�-���NO. OF BEDROCtvS .� SIZE OF LOT --^ �� ': ,; ;- <br />SWRCE OF DRIP!KIPlG �.ATER: PUBLIC SUFFLY � PRIVATE ��ELL <br />A. SURFACE DRAIMAGE <br />I. Is disposal field site well drainedi =��--'•-- <br />G. Any �vater course (stream� drainage ditch� etc.) throu�h site? — <br />B. Tt�OGRAPHY <br />1. Any heavy slopes in field area: � i�'- rt�- •/ ^<^ :'�• !�� __ <br />�. ;.ill present topsoil in field area be remo�aded before field tiles are <br />installed? �`� <br />.3. '�.ill any fill m�.teriel be used in the disposal field site?�_.�If yes� how much <br />i.z-i,v�<..„ .':h ,�/.!•-r/ <br />C. SOIL CONDITIOiJS 'y `'�'-' i--•' �-- <br />1. Nas a hole at least 4 feet deep been dup in the disposa] field area to determine <br />the type of soil present? <br />2. After hole is du� r=cord the soil conditions ai the following depths. <br />(Recerd as sand� pravel� `�� packed sand� loam� etc.) <br />12 inches .=*�-+:�w 30 i�ches --* :-=� <br />]E inches_�;-. � ,�r 36 inches � <br />24 i nches , �+•.. , 4E i nches • r' <br />.. Any ground water encountered before reachinQ a depih of 4 feet?�_ �`-' <br />If so, at whai depth? <br />D. S4ATER TEST <br />A simple viater test Kill show how well this soil will drain or percolat� wate�. <br />To perform this test: <br />1. Dig a hole a.t least 36 inches deep. Use e shov=l or post hole digger:size <br />of hole rt4�kes no difierence - only depth. <br />Z. Fi:l hole with water, fJow let all watar run out of hole. This soaks the <br />�round and will give a rtare accurate readin�. <br />3, A�ain pour water in hcle to a height of 12 inches from the bottom. L,t <br />vlater run out until there is just 6 inches from bottom left in hole. <br />4, f�ote hovi many minutes it takes Por this last 6 inches to seep away. !"� <br />�. Divide this time by 6 to obtain the rate per inch. z_ <br />6. Jate w.ater tesi was perforned. ii/: '/ ..' --� <br />I hereL•y certiiy the above inforrraticn to be correci and the above tests were per- <br />iormed by me as prescribed. � / <br />Signed " "' � <br />Address_ <,� : "/ __ _ <br />DiCTE: P septic tank permit is issued on the basis of ihe above information. If <br />'I-,��re are any changes or alterations in the ahove stated soil conJitions� it may <br />�'es�lt in the insiallatiun beinp rejected zt the tirre of inspection. <br />