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CITY OF EVERETT <br />City Hall <br />Everett� �+ashington <br />I�Sf'ECTIOM DEFARTNEPJT <br />LOT APPROVAL SHEET <br />�_-., ;'-. <br />FNONE: FLpine 9=l101 <br />NAAiE � G�'S n/,f h <br />ADDRESS 7 Y 3-�--�-%�� ��/ R' -� n S.tG/• <br />ADDRESS OF PRC4'USED BUILDING '2 �/ zi '7 ; S�— ^ , �.'� r ,,,. ..�� ; <br />�EGAL DESCRIPTION: LOTL_BLOCk ADDITION �i � t r �Yr ny— <br />TVPE OF USEfj�sr,IF'hCNO. OF BEDROCNS � SIZE OF LOT %D �C /�7 ��r <br />SOURCE OF DRIMKIPlG „ATER: PUBLIC SUFFLY �-- <br />PRIVATE �� <br />A. SURFACE DRAI�IAGE <br />1. Is disposal field site well drained% V c'.3 <br />l. Any water course (stream� drainage ditch� eic.) through site? �, c� <br />B. TOPOGRAFHY <br />I. Any heavy slopes in field area: '� � — <br />�. :,ill present topsoil in field area be removed or graded before field tiles are <br />insialled?_ � ^ <br />i. '�.ill any fill ���terial be used in the disposal field site?:'c If yes� how much <br />2. <br />� <br />C. SOIL CaUDIT10(JS <br />Has a hole at least 4 feet deep been dug in the dispesal field area to determin� <br />the type of soil present% <br />After hole is dug record the soil conditions at the followinp, depths. <br />(Record as sand� aravel� ��� packed sand� loam� etc.) <br />12 inchPs 30 inches <br />18 inches 36 inches / s�� �� h,nxr <br />24 inches 4h inches <br />Any ground water encountered before reachinQ a depth of 4 feei? �� �` <br />If so� at what depth? <br />D. 9dATER TEST <br />a simple waier test �tiill _how how weli this soi] will drain or percolate waler. <br />Tc F.e�fnrm this test: <br />!. Dig a hole zt ]easi 3(. inches deep, Use e shovel or post hole digger size <br />o£ ho:e makes no difi'erence - cnly depth. <br />�. Fill hole with waier, fJow let all water run out of hole. This soaks the <br />�round and will give a more accurate reading. <br />3. A�ain pour water in holc to a hei�ht oP 12 inr_hes from the bottcm. Le1 <br />water run out un'.il there is just v inches from boitom left i� hole. <br />4. Ro{e I.ov�rnany minutes it takes for this last 6 inches to seep away.__ <br />�. Divide this time by 6 to oblain the ra:e ��er inch. % h+� ° 7 •'r <br />6. Date vrater test was perforn�ed._ �.Qc..2� --- <br />I nere!.y cartify the above inforrration to Fe correct �nd the a�ve tests �vere/ e�- <br />formed by me a� prescribed. ��C �����_ <br />SiQned � �i/>. s <br />Address'" ^ / _-S�_�' -+) � i `y'=-`l / <br />D�CTE: P septic tank permit is issued on th� basis of ihe above informt^tion. If <br />'here are any c5anpes or alteralions in the �hove stated soil conditions� it may <br />res�lt in the ine{allation hein� rejeclr.o at the tim^. of inepection. <br />