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$5.00.fee_far permit <br />SNOROMISH HIA=- H DISTRICT <br />3011 RockeVeller kve., <br />Everett, Washing-41n Phone ALpl.ne 9-2061 <br />7 LOT APPROVAL SHEgP <br />AL-2C-_3S OF PROVOYM BUILDING `70cr <br />IMAL DESCRiPTfnN Trm <br />`rYPHE OF U$E�'c//" 'C NO. OF BEDROOMS 3 SIiE OF LOT` — <br />SOURCE OF DRINKENG WATER: Public supply��_ private Well <br />A. SU:,:7 ACE DRAINAGE <br />1. Is disposal field site well drained? s <br />2. Any water course (stream, drainage ditch, etc.) through site? , <br />B. TOPCGRAPHY <br />1. <br />Any heavy slopes in field area? 0 <br />2.. <br />Will present topsoil in i-jeld area be removed or graded before fieldii_les <br />installed?�/cr <br />are <br />3• <br />Will any fill material be used in the disposal field site?! - If es <br />L, y '" <br />�w much <br />_ <br />C., SOIL CONDITIO14S <br />1. <br />Has a hole at least 4 feet deep been dug in the disposal field area to <br />the type <br />determine <br />of soil present? �/E <br />2. <br />After hole is dug record the soil conditions at the following depths. <br />(Record <br />as sand, gravel, clay, packed sand) loam, etc.) <br />12 inches_ I OA14 30 inches <br />18 inches �� / 9 �9v z 36 inches r• <br />4. <br />24 inches__ 48 inches <br />Any ground water encountered before reaching a depth of 4 f t? <br />If <br />what depth? p <br />so at <br />D. WATER TEST <br />A simple water test will shos• how well this soil will drain or percolate water. To <br />perform this test: <br />1. Dig a hole at least 36 inches deep. Use a shovel or post hole digger-- <br />size of hole makes no difference --only depth. <br />2. Fill hole with water. Now 1,.t all water run Dut 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 from the bottom. Let <br />water run out until there is just 6 inches from bottom left in hole. <br />4. Note how many minutes it takes for this last 6 inches to seep away. <br />Record the time. Number of minutes for last 6 inches to seep away -27� <br />5• Divide thi.s time by 6 to obtain t rate pe/ inch.%g <br />6. Date water test was performed. �,� <br />I hereby certify the above information to be correct and the pbove testE ere per- <br />formed by me as prescribed. -� <br />Signed <br />Address= i <br />NOTE: A septic_ tank permit is issued on the basis of the above info r 'tion. If there <br />are acrr changes or alterations in the above stated soil conditions it may result in' <br />the insi-,a:Jation being rejected at the time of inspection.. <br />Pr <br />