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CITY OF EVERETT <br />City Hall <br />Everett, 4shington <br />PHONE: ALpine 9-7101 <br />INSPECTION DEPARTMENT <br />n/ LOT APPROVAL SHEET <br />NAk.E ,tav L.,, ,liA.gj7t_ ADDRESS <br />ADDRESS OF PROPOSED BUILDING �a� �� �OS 73./Sr"-•E <br />LEGAL DESCRIPTION: LOT BLOCM ADDITION <br />TYPE OF USF,�NO. OF BEDROOkS .-J. SIZE OF LOT <br />SOURCE OF DRINKING ..ATERs PUBLIC SUPFLY �� PRIVATE hELL <br />A. SURFACE DRAINAGE <br />1. Is disposal field site well drained? L �1 ) <br />2. Any water course (stream, drainage ditch, etc.,pT through site? <br />S. TOPCGRAPHY <br />1. Any hnavy slopes in field arealc. '% c <br />-'.ill presen' topsoil in field ores be removed or graded before field tiles are <br />installed:_, ::Z'c c— 1 <br />J. ..ill any fill material be used in the disposal field siteI%tglf yes, how much <br />C. SOIL CONDIT]-= <br />1. Has a hole at least 4 feet deep been dug in the disposal field area to determine <br />the type of soil present? <br />2. After hole is dug record il�« soil conditions at the following depths. <br />(Record as sand, pravel� Y packed sand$ loam, etch),' <br />12 inches L t5 -A N) 30 inches <br />1R incher i 36 inches <br />24 inches i i 48 inches <br />Any ground water encountered before reaching a depth of 4 feet? <br />If soy at what depth? <br />D. WATER TEST <br />A single water test Kill show how well, this soil will drain or percolate wate, <br />To perform this test: <br />1. Dig a hole nt least 36 inches deep. Use P shovel or post hole digt size <br />of hole makes no difference ;only depth. <br />2. Fill hole with water. Now let all water 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 threre is just 6 inches from bottom left in hole.,,, <br />4. Note how many minutes it lakes for this lnst 6 inches to seep away. <br />5. Divide this time by 6 to obtain the rate der inch. �' <br />6. Date water test was performer'. %- 2, _ <br />I hereby certify the above information to be correct and the above tests were per- <br />formed by me as prescribed. 2 <br />Signed /I a - <br />Address� <br />NOTE: P septic tank permit is issued on the basis of the above information. If <br />there are any changes or alterations in the e.bove stated soil conditions) it may <br />result in the installation beinp rejected at the time of inspection. <br />