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CITY OF ;VERETT <br />City Hall <br />Everett, Washington <br />IKSIECTION. DEP.ARTIENT <br />LOT APPROVAL SHEET <br />PHOKEt Alpine 9-71.01 <br />ADDRESS OF PROPOSED BUILDING <br />LEOAL DESCRIPTION: LOT_? _BLCCK ADDITIOV-Z! � e vra� e <br />TYPE OF USE P • NO. OF BLDRO 1i5--d _SIZE OF LOT_/nn X Zjjq <br />SOURCE OF DRIKKIYG IIATERt PUBLIC SUPPLY PRIVATE 'fELI <br />A SURFACE DRAIi'AGE <br />01 <br />1. Is disposal field site well drained! eft <br />2. Any water course (stream) drainage ditch, tc. through site?. n, in <br />B. TOPOGRAPHY <br />1, Any heavy slope$ in field area? 17 A <br />2, Will present topsoil in field area be removed or graded beforo field tiles are <br />installed? % d <br />3. Will any fill material be used in the disposal field site?a0—If yea, how much <br />C. SOIL CONDITIONS <br />1. Has a hole at least 4 feet deep een dug `in the da�o`al field area to determine <br />the type of soil present? <br />2. After hole is dug record the soil conditions t the following depths. <br />(Record as sand, gravel, clay, packed sand, iloaam, etc.) <br />12 inches 30 <br />16 inches 36 inches <br />24 inches 45 inches <br />3. Any ground water encountered before reaching a depth of 4 feet? <br />If so, at what depth? D. i1ATER TEST <br />r: aimn?e stater test will show how yell this soil will drain or percolate water. <br />To perform this tests <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. r`ott let all Crater run out 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. Hote hots many minutes it takes for this last 6 inches 'tttoyeep away._ <br />5, Divide this time by 6 to obtain the rate -or inch. <br />6. Date water teat was performed. le - <br />I hereby certify the above information to 'ie correct and ppthe move tests vero per- <br />formed by me as prescribed. Signed <br />4 <br />Addroea If <br />VOTE: A septic tank permit is issued on the basis of the above information. <br />there are any changes or alterations in the above stated soil conditions, it may <br />result in the installation 'eing re.iectnd at +he tite U, it,spection, <br />