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czTx or .vr;�i7� <br />City Hall <br />�verett� 4lashington <br />II::SIECTIOI'. DEPI�RTi�nT <br />LOT APPROVAL SiIs�T <br />ADDRL'SS �Yrl :, c,' '. •� � � � <br />_ —� S� <br />.�2 / 3 . .S6 '� ,f �- <br />P;'O1cE: ALpine 9-7101 <br />HDD??�SS OF Y�OPOSEll <br />LtiG�L D�SCRI?'TIOIJ: LOT�BLOCK�__�DDITIOIi V �5��.,�t�nv/C�. <br />TYPE OP USL�' � � � I�G. �^.F L�';DROOiiS : 3I�L C'L' 70� , J/�.1� /'!C� <br />SOURCS OF' DRIIiKIT'G I�IkTER: YUDLIC SUYPLY � PRIV!1TE 'GLL <br />A, SURP�ACE DHAII;hGE <br />1. Is disposal Field site uiell draine3?__(L �` S - <br />2, Any �aater course (stream� drainage ditch,/etc.) through site?_ <br />1, <br />2, <br />3. <br />1, <br />?_, <br />3, <br />3�. TOPOGi?!':: "t3Y <br />Any neavy slopes in field area4 �%/r <br />!�1i11 present topsoil in field area be removed or @raded before £ield tilcs are <br />installed? ✓l�� <br />ldi].1 an,y fill materia �e �i:ed ir, t;le disposal field site?�If yes, ho�� mucli <br />C. SOIL CCb:DTTIOi:S <br />Has a hole at least 4 feet deep been du� in the dis,osal field area to 3et.ermine <br />the type oi soil present" <br />ilfter ho7.e is dug record the :soil conditions at the £ollo�ring deF�tiis. <br />(Record as sand� gravel� cla;�� p4cked sand, loaa,i� eic„ <br />12 inches 30 inches_. <br />18 inches 3u inches / <br />2Q inches 4� inches <br />An�� ground �rater er.countered beiare reaching a depth o: 4 feet?___ <br />If so� at t:l,ct 3epthS <br />J. 'L11�R T�ST <br />:. ,;mo'e vater teat iaill show how ttell ':.his soil �ai1]. drain or percolate �•rater. <br />io �.eriorm tiii� test: <br />Di� a hole at least 3h inches deel.. Use a_ siiovel or pcst hole dip,ger; <br />size of hole �::alces no uifierence - cnl« depth, <br />Fill hole vitii �aater. T'o�r let all eater rem ou` o? hole, TP.is soaks the <br />;;row�d an1 irill give a r,.ore accurate readinp, <br />:�ga;'� pour taater in hole to a height c;: 12 ir,che: iro:a L;�e bottom„ �et <br />water rtin out un'il there is iust 6 incres £rom bottora left in hole, <br />19ote hoi; ���any minutes i'.: tar�s for this 'a�'t 6 ir.ches to ceep ataay. /�_ <br />D;'.vide tLis time by 6 te ohtain t?�e rai.e ; e_' itich. ,� <br />Date taater te�t. �ras rerforr.ed. _ � <br />1. <br />2. <br />3. <br />5. <br />. <br />c. <br />i nereUy certif;� the above ir,ioi:a^tioi: +o ':e co,•reci anc].�Ch- a; ovc ic i: �iere per- <br />/ � <br />forr�ed U}� 'ae as i,,rescriLed. � <br />Si�ned c�-' � y � � <br />i;ddress � �— <br />Ii��TL: k se;tic tarlc ��ernit ia is^^.�6 on +.nc- oc:sir of the above inCurnation. If <br />t��ere are ant� changea or 21ter1tions i;' i.he auove �tCiLr;± ;;p1I. rp1:C?_�.l::ons� 9t may <br />reault ir, tli� ir_stn11^t:n�. ' eine _.� jcci.rri r_i 'Lc tsnc. u' �.�.:'_,ec'-on. <br />