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� <br />�I IY UF LVEIi'tll <br />City Hall Pl�ifcL: �,�; i�- -;1 �1 <br />eti, ��ashin_a,ion <br />I�V_.�; :; I( �� :.I �;I,l .�F'.�i � LOi APF�X)VAL SHEET <br />LEGAL DESCRIPTION: LOT� B�OCK_ ADDITION C��Pd4�/1�1f v/�w �� %-,. <br />�YFE UF USE n� �R'M%�'0. GF BEDFCUfAS �_ SIZE OF L0T %��. �� X I�:.;'�� <br />.SUURCE 'JF URI fJIU iVG �1ATER: FUBLI C SUPFLY � _ t'RI VATE .:ELL __ <br />N. SURFP.:� D'nAli�lAGt <br />i. Is disposal field site well drained? / P 5 <br />�, Any water course �stream� drainage ditch� etc.) through site� ;i1�(� <br />8. TOr'OG�A"rH'r <br />1. Any heavy slopes in field area?_[ � y' <br />2. :�ill present topsoil in fieid area be re���ved or �raded before field tiles are <br />installed? Q�� <br />�a, ,+ill any fill ma{erial be used in the disposal field site'?�_`i�_ �f yes� how <br />much _ <br />c. �oi� coNoirioras <br />l, Has a hole at leasi a feet deep been dur� in the disposal ficld area to detcrm�n�: <br />the type of soil present? �.o-� <br />��fter hole is dug rr_cord the �0'.1 condiiions at the Pollowing depths: <br />(Record as sand ravel� clay� packed sand� loam� etc.) �-, <br />12 inches � rt 30 inches �+''�'� �' i.�;. �� <br />18 inches i'.,dr,� 36 inches ' a• '�� '" <br />24 inches r P 4£i inches ��' -i % �. <br />, any ground water encouniered before reaching a depth of 4 feet: .�' � _ <br />IP so� at what depth? <br />D. iIATEF TEST <br />d simple water iest will show how well this soil will drain or percolate water. <br />To perform this test: <br />1. Di� a hole at leasi 36 inches deep. Use a shovel or post hole dig�erg size <br />o£ hole makes no difference - only depth. <br />2, Fill hole with water. Now let all �vater run out of hole. This soaks the <br />�round and will �ive a more accurate reading. <br />3. A�ain pour water �n hole to a hei�ht of 12 inches from the botiom. Let <br />water run oui �niil there is just 6 inches from bottom lePt in hole. � <br />4, Note how many minutes it takes Por this last 6 inches to seep aaay. "�»'��� �, <br />5, Divide ihis time by 6 to obtain the rate per inch. �� � <br />G, Date water test was performr_d. .�J/h'.'�% '�('. /�'%^� <br />I h�reby certiPy ihe above inPormation to b� correct-and {he above tests yvere per- <br />fcrmed by me as prescribed. %,�� , �' f;,,'�,.i � <br />S i �ne� - <br />Address r ! . f� ? ' " (� <br />!JTE: a septic tank permii is issued on the basis o the above information, lef <br />there are any channes or altera{ions in the above stated soil conditions� it may <br />result in 1hr instaila{ion beinn rojecif�d .�1 {hc time of insnection. <br />