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,.�l; � J1« <br />:S'� <br />-Q�6 fee for permit <br />NAME l�.G�� ��'r��� <br />S"IOHCHCSH NFALTH DISTRICT <br />301i t:ockeE�?ies .�venne <br />Everett, Wesh:ngtoc <br />Phone ALpine 9-2061 <br />IAT APPROVAI. SHEET �J �j <br />ADDRESS � �� " �� � � �^�� � <br />L <br />ADDRESS OF PROPOSED B)UILD{�ING �l <br />•l "-C�E�^' ��i .Y � �Q �� <br />LEGAL DESCRIYTION: IAT_3,% BIACK ADDITIOti �-N��-�-47 .�'-���' <br />/ i <br />TYPE OF USE ✓/M"� N0. OF BEDROOMS -� SIZE OF IAT ��d�u <br />SOURCE OF DRINKING WATER: PUSLIC SUPPLY � PRIVATE WELL <br />A, SURFACE DRAZhAGE <br />1. Is disposal field site well drained? �'' <br />2. 'Qny water course (�,Gceu�, drainage ditch', etc.) Ci�rough site? �v' <br />B, TOPOGRAPHY <br />1. Any heavy slopes in field areaY ��'�� <br />2. Will present topsoil in field area b� ramoved or �raded befr,re field tiles <br />are installed? /1�! ��Z <br />3. Will any fill material be used in the disposal i'ield site?_If yes�hownuch_ <br />C, SOIL CANDITIO"]S <br />.l. Aas a hole at least 4 feet deep bee:i dug idnthe disposal field area to deter- <br />mine the type oi soil present? )./�- <br />"L. After hole is dug recctd the soil conditions at the following depl•hs. <br />(Record as sand, gravel, caly, packed ;an�l, loem� etc.} <br />12 inches 30 inches <br />18 inches 36 inches_�4t —�. ,���1��,��""� <br />r.G. , �•=� .� <br />24 inches 48 inches <br />4. Any ground water encour•<_ered before rea�.hing a depCh of 4 EeetZ;�v ' <br />If so� at what depth? <br />D. WATER T_EST ���,�.. �=r .!�tP<a -`y;i1C G-<t,�. y <br />�' / <br />A simple water test will show how well this soil will drain or percolate water. <br />To perform this test; <br />1, Dig a hole at least 36 inct�es deep. Use a shovel or post hole digger - <br />size of hole makes no difference - only depth. <br />2. Fill hole with wa;ter. Now le.t all water run ovr of hole. This soaks the <br />ground and will give a more accurate reading. <br />3. Again pour water in hole to a height of 12 inches Erum the bottom, Let <br />water run out until there is just 6 inches from bottem lett in hole. � , <br />4. Note how mar�y minutes it takes for this last 6 inches to seep away. ��'���" <br />5. Divide this time by 6 to obtain t e rate per inch, �i <br />6. Date water test was performed, ���•l� <br />I hereby certify the above inforc�ation to be correct and the above tests were per- <br />formed by me as prescribed, �,/ L <br />Signed G�±tu`/�'ti�/��' <br />Address LS/ i/l:�'c5>�.cz'L ' <br />NOTE: A septic tank permit is issued on the basis oi the above informution, If <br />there are any changes o: .�lteration in the above stated soil conditions it may <br />r.esult in the installai:i�n b��ing re_jected at the time of inepection. <br />