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�ITY �F cVEF;EII �� /��� <br />City Hall P!-,Of�E: A�E;irn. :i-iL!1 <br />Evereit. l'Jashin�ion �//� /L� <br />I f�"'P�C i IGN "'EP 1RT' iFN' <br />��� �� _ i LOT APFrO�,�L SHFET <br />L `� / <br />idAw�E��(L./�7..t �� _ ADDFESS�'=�1i��''.�v-'�:�G�---' <br />AilDR�SS UF FFi�FOS[D BUILUIfJG_ +�'!-� /3 �-A�r.�/ � <br />LEGAL DESCRIPTION: LOT� BLOCK `L ADDITION <br />TYFE UF USE _ fW. GF BEDFOOf.15 �_ SI ZE OF �UT l 00 Y/ 5(J__ <br />:UURi:E UF DRINKIiVG dATER: FUBLIC SUPFLY �� 'rRIVATE dELL <br />A. aURrPCc Dii.41NAGE <br />1. Is dispo,al field site vrell draicedY "�/fJ� <br />2. Any water coursa (stream� drainape ditch� etu.) through site? �%f�t� <br />B. TOFOGRA=HY <br />1. Any heavy slopes in field aren?_ �7^-L <br />2. Clill presant to soil in field area be removed or �raded before field tiles are <br />installed? �� ��,^ <br />3. �Jill any fill mater�al be used in the�dis�posal ii=1d site? ""lOit If yes� how <br />much . t.G �/.r-�.,c;.t,.�('.,G��.U=L� V <br />C. SOIL OU�!DITIORS <br />1. Has a hole at least 4 feet deep�een dup in the disposal field area to determine <br />the type of soil pre�ent? _ Fi <br />l. After hole is dug record the sotl condi{ions at the followine depths: <br />(�ecord as sanJ� rav=1� clay� packed sand� loam� etc.) � <br />12 inches � 30 inches �-�i./i..,,� Q,D-e.Q <br />18 inches �� ��� 36 inches _ �` <br />24 inches -�'� 48 inches � � <br />s. Any ground water encouni�red before reachinp a depih of 4 Peet'? �._ __ <br />If so� at what depth'? <br />D, GATFR TEST <br />A sirnple water test will show how well this soil will dre.in or percolate water. <br />To perform this iest: <br />1. Di�: a ho:e at leasi 36 inches deep. Use a shovel or pos ole dipgerg size <br />of hole makes no difference - only depth. <br />2. Fill hole with water, f�ow let all water run out of hole. This soaks thc <br />�round and will give a more accur�{e readinP. <br />3. A�,,ain pour �vaier in hole to a hei�ht ef 12 inches from the botiom. Let <br />water run out until there is just 6 inches `rom bottom left in hole'/U L <br />�1. Note how many minutes it takes for this las: 6 inches to seep away. L <br />5. Uivide ihis time by 6 to obiain the rate per inch. ,� <br />G, Daic water tesi was performed. C- — <br />I hereby certify iha above information to 6e correct and the above tests �vere per- <br />formed by me as prescribed. �[ ���� <br />Signed�v""� ��if L<< <br />Address � Lti(�i �...0 <br />ti01E: !1 septic tank permii is issued on the basis of the above information. If <br />there are any channes or altera{ions in ihc above stated soil ccnditions� it m3y <br />resuli in tho ir;tallation bainp n��ecicd �t the time of inspec:ion. <br />