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c�t�x or ��,;vri�zT
<br />City Hall
<br />B•✓erett� Wa�hingi,on PHOA'E: ALpi.ne ')-7101
<br />II?S1�ECTIOP'. DE1ARTi�NT
<br />c LOT APPROVkL S&?,LT
<br />P.'A1dE_ �1 � C �� � ) 7� i L I liDDRGSS_� 2 / - / b 1 � �%[ol � �
<br />f /�d�,o�ds
<br />aDDA�SS OF YROPOSBD BUILDIP?G_ .�j,',1 �y / _ ,/y"� j�o�� � � '
<br />I�GltL D�SCRIFTIOIQ: LOT_�BLOCK � ADDITIOI; � � �
<br />. � ) Y/� -r � %r =.i1
<br />TYPFS OP USE_F-�.'� IdO, OI' D�DROOiiS_ ,� SIZL�' Ot� LOT�[(�!,q �( /7rj
<br />�� SOUP.C� OF DRIIiYIFG YlATER: NUBLIC SUYPLY l—�- PRIV.9TL t.�LL
<br />ti�
<br />A, SURFACE DHAI1ChG�
<br />Z. Is dispocal �ield site irell drained? i, e
<br />2. An,y iaater course (stream, drainage ditch� etc, through site?._ '}� �
<br />�3. TOI'OGi�l! I Hy
<br />1. A.ny neavy slopes ir field area?�
<br />2, l•lill present to�p soil in £ield area be removed or �raded Uefore Field tiles are
<br />installed? /'/7 p
<br />3, t�!ill ::n,y fill naterial Le used ir� t:ie dispos�.l field site. I..
<br />' �_�jQ �P yes, hOW i.'.11Cll
<br />C, SOIL CCI�DITIOI;S
<br />1, Has a hole at least 4 feet deep been dug in th� 3is;�osal field area to determine
<br />the type o£ soil present?_ _�_/_ �- 5 s_a �� �
<br />2, Alter hole is dug record ti% ooi7. oondition�he following depti�s,
<br />(Record as sand� gravel� clay, packed sand, loarn, etc,)
<br />12 ::nches 30 inches
<br />18 i;iches 3o incl�es /�� 3
<br />241'.�ches "'��"'. `
<br />48 inches
<br />3. Any grounc.irater encountered bePore reaching a depth o� /, feet?
<br />If so, at iahat. depth?_��
<br />D__ iIAT�H T�ST
<br />�: simn'e u2ter te:�� iaill shoi•r how ireL this soil iril�. drain or percolate �rater,
<br />lo F.eriorm this test:
<br />l. Diz a liole at least 96 inches deep, Use a shovel or nc;t hole di�;gr:r;
<br />size o£ hole :�akes no 3ifference - onh� depth.
<br />2. ti`ill hole xitl� taater, P'oir let all t;ater run ou+, o±' hole. Tl,i s soaks the
<br />�round and irill give a nore accurate read_ng,
<br />3. :lgain pour taater in hole to a height of 12 inchcs iro::� ti�e bottom, Let
<br />iaater run out until there is just 5 inches from bottora left in hole.
<br />�'<. 1'!ote hoi> otany ninutes it taNes for this 1^;;t 6 in.ches to ceep atra,y,_
<br />5. Divide tLis time by 6 to obtain tha rai;e ei inch, _ 3 —
<br />6, Date ianter test tira^, rerforr�ed.
<br />I i;ereby cerCifz� the above it:for;��tioi, +,o ?;e co�rect �nd� a:�ove ie� ^�rere pe�•-
<br />forr.�ed Uy� ^�e as �;rescribed. � � �
<br />Sigr.�d�. -
<br />Addre�s
<br />ifDTL: A se; tic tank pe^mit is issn�ci on t��e u:sic o�._ :e a�ove inFormatiun, If
<br />thore are any chan�e, or alteratior.s in {,he above stated so�1 coi.ditio.z�� =t ma,y
<br />result ir; t;ic ir-tall^tirn; ' ei:�r re j�ci,od n.t +.he ti-te o' i�:,-,ect�o; .
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