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i;ITY CF CVtF,tl i <br /> Ci{y liall PI-di�E: l�,_�,tn 1-il !1 <br /> �v�rett. '��as!�insicn <br /> INSP�CTICiV DEP�aRTia1ENT LJi AFf�L1VAL SHFET <br /> iJAm:E �%UYAryCons�J v�c/ion Cdn��,:sn y AllDfiES3 /O /o /�c+!/{ ,'�Yk"�/��'r�`�� �'n <br /> �JD13�SS GF FF�Ji�OSEii BUI�_LIIJG 34c��j S['qNURST .4Vc, <br /> Fyod�rn ef ��ir7/.po%�/) <br /> LEGAL DESCRIPTION: LOT{�/ BLOCK — AGDITIUN f�'erc11-bn/:�s <br /> TYFE �F USE ��'S�J���« f�. GF BEDP(;Of�iS 3 SI ZE OF LOT 9a � a'/°8 � <br /> .SUURCE OF llRINK1iJG �1ATEft: t=UBLIC SUPrLY X _ 'rRIVNTE .+ELL, _ <br /> A. �UFr"PC� DriAIN�.Gt <br /> 1. Is dispcsal field site w�eil draired: �Fs — <br /> 2. ��ny water course �stream� drain��e oitch� etc.) throu�h siie`•'_�Vo <br /> 8. TOFOCRA�H'� <br /> 1, Any heav� slopec in field area? No _—— <br /> ?_. ';�ill present topsoi ! in field area be removed or �raded before tield {iles are <br /> insta11ed7 " <br /> 3. �Jill any Fiil m,itc :al be used in the disposal Piold site'• Nn_ If yes� how <br /> much <br /> C. 701L CU��DITIONS <br /> 1. Has a hole ai least 4 feet deep bee�g dug in the disposal fiald area to determinc <br /> the type of soil present? YF•s <br /> l. �ifter hole is dug record the soil cnnditions at .he following depihs: <br /> (fiecord as sand� gravel� clay� packed sand� loam� etc. ) <br /> 12 inches �n�n 30 inches -3o�s''���""� <br /> lE inches so�dvc �.,r�/ 36 inches -��•'�/� �����'�� <br /> 24 inches Sa.,d:G;,:v,/ 48 inches H�+�-.� /''4„ <br /> s, Any ground waier encouniered berore reaching a depth of 4 feet'? �✓�' _ <br /> If so� at vrhat dep{h'? — <br /> D. P;A7ER TEST <br /> A simple waier test will show how eiell this soil will drain ur percolate ��a1er. <br /> To perform this test: <br /> 1. Dip a hole ai leasi 3G inches deep. Use a shovel or posi hole dip�e � size <br /> of hole makes no difference - only depth. <br /> 2, Fill hcle with v+atar. (Jow let all waier run out of hole. This soaks the <br /> �round and will pive a more accurate readinr�. <br /> 3. Again pour water in hol� to a heighi of 12 irches from tF�e bottom. Let <br /> water run oui until there is jusi 6 inches from bottom left in hole. <br /> 4. Note how m�ny minutes it takes Por this las: 6 inches to seep away. �1 n <br /> 7. Divide ihis tirn� by 6 to obtain the rate pe: inch. � en'��� <br /> 6. Uate watcr te�t was performed. ���_�7-�y�'-5 <br /> I hereby certify thz rabove information to be correci and the abe�e tests rrere per- <br /> formed by me as prescribed. ��iz._,��1 t J;���«s,�Gl- <br /> Ji�ned_ <br /> Address •!`1i.''j�/ °i"`n/D'"_£ri=-r!/']�? <br /> ��OTE: A septic tank permit is issued on the basis of ihe above in£orma{apn.,. 1F .,�� <br /> there are any chanpes or alterations in the above state? soil ccndi,io ��%�� �1�a \O� <br /> result in the installation baing rejecied at the time of inspection. � �� ; <br /> � <br /> ; <br /> ,�M1ti, , . , _�,' <br /> ',. .4#�•�--.'S+,_'�. <br />