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. .u��..: ��.. .. _ <br /> CITY OF EVERETT <br /> Ci ty Flal l <br /> . Everett� �+ashington <br /> _ ' FHONE: A.Lpine 9-'l101 <br /> INSFECTIOPJ DEFARTNEPJT <br /> ��s�u N ,(rl�l��icff <br /> LOT APPRGVRL SHEET <br /> , tL -�����;aE,rf <br /> NAhtE ;I//C IC M�✓� /� t�{ �'� G � ADDRESS �� �f �I j �' <br /> ADDRESS OF PRCPOSED BUILDIPIG ,SFr7 1iiFk, I-��iCllFf <br /> LEGAL DESCRIPTICN: �OT�BLOCk GI ADDITION I�=«- U���-�� <br /> i YPE OF USE I�O.n'1� N0. OF BEDROClvS ,3 S I ZE OF LOT I U � X c�0 n � <br /> SOURCE OF llRi�!KIP1G �.ATER: PJELIC SUFFLY � PRIUATE v�ELL <br /> A_SURFACE DRAIMAGE <br /> 1 . Is disposal field site well drained?_ :.' �� <br /> 2. Any water course (stream� drainage ditch� etc.) through site? ,}/iJ <br /> B. TOPOGRAFHY <br /> 1 . Any heavy s:opes in field area'r lA F S <br /> �. 'sill pr=sent topsoil �n field area be ertaved or graded before field tiles are <br /> insialled? <br /> .i. ',:il] any fill ma erial be used in the disposal field site?�/�If yes� how much <br /> C. SOIL CONDITIOtJS <br /> 1 . Has a hole at least 4 feet deep been dug in the disposal field area to determin� <br /> the type of soi ] present? �S <br /> 2. After hale is dug record he soi conditions at the following depths. <br /> (Record as sand� gravel � t"e�y� packed sand� loam� etc.) <br /> ]2 inches ''�P s�/ � 30 inches C ��1`�1 <br /> 18 inches roYSci � 36 inches c%h�9�-�, <br /> 24 i oches ('1_r�� q8 i nches N��i y <br /> . Any �round water encountered before rear.hing a depth of 4 feet? ��' <br /> IP so� at what depth? _ <br /> D. 4'aATER TEST <br /> A. simple water test rill show how well this soi] will drain or percolate water. <br /> To perform tiiis test: <br /> ] . Dig a hole at least 36 inches deep. Use e shov�] or post hole dig�er: size <br /> of hole makes no difference - only depth. <br /> 2. Fill hole with w�ter, tJow let all water run out of hole. This soaks the <br /> �round and will give a more accurate reading. <br /> 3. A�ain pcur water in hole to a height of 12 inches from the bottom. Lei <br /> water run o�it until ther4; is just 6 inches from bottom left in hole. � <br /> 4. Note hovi many minutes it iakes for this last 6 inches to seep away. � 1'��`S 5 'y''ti'' <br /> 5. Divide this time by 6 to obtain the rate Fer inch. . <br /> 6. Date v:ater test was perforn�ed. _ <br /> I hereby certify the above inforrration to be correct and the a�ove teets were per- <br /> Pc�rrned by me as prescribed. � <br /> Signed (�� ����-�=-��' <br /> �ddress tf >__.!'ct_ 17S=r9 n21-�wFF�w, u�J��� <br /> PiGTE: A septic tank permit is issued on the basis of the aLiove inform�.�tion. If <br /> there :�re any chanpes or alterations in ihe above stated so� l conditions� it may <br /> ras�lt in the installa4ion beinp rejected at the time oi inspection. <br /> � cc c 1 <br /> -��� �� l.0 . �1: te;i�.� �1w ��_ . � L'L .)_� ��i- it`iA.i._.. J�.a_: �l'. —. �� T �1-�.:��_�4_ . <br /> 4 '� <br /> i <br /> I <br /> i <br /> rr _ '... -__ . . . <br />