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CITY OF E��RETT <br />Ci ty Flal l <br />Evu�ett� aashington <br />FHONE: ALpine 9-"i101 <br />INSFECTIOP! DEFARTNEMT <br />��" 7 ' LOT APpRGVAL SHEET �; I �)��-�— C i;. ,,�._` <br />: �. /.��� --�'��.�:__ ,� . 9 <br />PJAA�.cr�._�e�-�.-c�--- �'z-.•�--<_`_ ADDRESS ✓<�...� S� �'�-�.��� <br />ADDRESS OF PRCPUSED L�UILDIDIG ��'G� �- �-c�-e-�-N <br />�1 � <br />LEGAL DESCRIPTION: LOT,�BLOCk 1DDITION .�CJ�-_.c.-�� ��w�� <br />TYPE OF USEfl-o� ,_ N0. OF BEDROCfvS_-=� _SIZE OF' LOT _ <br />SWRCE G DHIP!KI�lG „ATER: PUELIC SUFFLY '� FRIVATE ��ELI <br />A. SURFACE DRAINAGE <br />I. Is disposal field site well drained? �ti"� <br />[. Any water course (e° ^am� drainage ditcK� etc.) through site? ��' <br />B. T�p�RAPHY <br />1. Any heavy slopes in field area': !z-� <br />�_• •ill preseni topsoil in field area be rertaved or praded before field tiles are <br />insialled" lv_ <br />�. �.il] any fi!1 material be used in the disposal field siie?^-� If yes� how much <br />C. SOIL CONDITIOIJS <br />1. Has a hole at leasi 4 Peet deep been dug in the disposal field area to determin� <br />the type of soil present': `1�' <br />t. Pfter hole is dug record t� soil conditions at the following depths. <br />iRecord as sand� pravel� c�~�� packed sand� loam� etc.) <br />12 inches 30 incF�es <br />1F inches 36 inches <br />24 inches �' 4H �nches <br />. Any ground water encountered before reachi�p a depih of 4 feet? ' <br />If so� at what depth? �' <br />D. �1vATER TEST <br />? simple water test v,i11 sho�- how well this soi] will drain or percc�atr- v�ate�, <br />To t;erform ihis test: � <br />1. Dig a hole at least 36 inches deer,. Use � shovel or post hole dig�er size <br />of ho7e makes no difference - only depth. <br />�. Fill hole with water, f�!ow let all wai�r run out of hole. This soaks the <br />ground and wi11 �ive a rtare accur�te readinp. <br />3. Apain pour water in hole io a height of 12 inches from the bottom. Le{ <br />waier run out until there is just 6 inches from boitom left in hole. <br />4. Note how many minutes it iake= for this l:�st 6 inches tQ se=p away. ,�! v <br />7. Divide this time by 6 to obtain the rate per inch. 1`" <br />6. Date v:ater tesi was perforn�ed. �-- �- �''_ __ <br />I hereby certify the above inforrraiion to be correct and the above tests were per- <br />formed by me as prescribed. r <br />S i �ne.' st,� � c*-�i�_ <br />Addres� � -Z.f. �..c��-�_._i�c'�� <br />��GTE: A septic tank permit is issued on ihe basis of ihc ��bove informaiion. IF <br />'here are any chanpes or alierations in ihe ahove stated soil conditions� it rtv�y <br />res�lt in the installoiion bein� rejectcr: �t the time of inspection. <br />