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CITY OF XERETT <br />City Hall <br />+ Everett, Washington PHOM Alpine 9-7101 <br />IFSPECTIOU DEPARTMENT <br />LOT APPROVAL SHEET <br />NAME ADDRESS !,^ t - wh __5 f r4a <br />ADDRESS OF PROPOSED MILDING ..rZr 2 ] O9 % <br />LEGAL DESCRIPTION: LOT - BLOCKS ADDITION Q'te:.1 <br />TYPE OF USE NO, OF DLDROOiS 3 SIZE OF LOT <br />SOURCE OF DRILKIPG WATER: PUBLIC SUPPLY_ 211 PRIVATE '!ELL <br />A. SURFACE DRAINAGE <br />1. Is disposal field site well drained? <br />2. Any water course (stream, drainage ditc , etc.) through site?. 71e. <br />H. TOFOGRAFHY <br />1. Any heavy slopes in field area? <br />2. Will present topsoil in field area be removed or graded before field tiles are <br />installed? '7io . <br />3. Will any fill material be used in the disposal field site?)LIf yes, how much <br />C. SOIL COMITIOES <br />1. Has a hole at least 4 feet deep been dug in the dis;osal field area to determine <br />the type of soil present? <br />2. After hole is dug record the s it conditions at the following depths. <br />(Record as sand, gravel, clay, packed sand, loam, etc.) <br />12 inches.-j.r /,; 1,� }„ 30 inches_ <br />1S inches o d- 36 inches <br />24 inches It 48 inches <br />3. Any ground water encountered before reaching a depth of 4 feet? <br />If on, at Crhat depth? <br />D, WATER TEST <br />is simn'e eater test will show how yell this soil will. drain or percolate water. <br />to perform this test: <br />1. Dig a hole at least 36 inches deep. Use a shovel or post hole diggerl <br />size of hole r:+akes no difference — only depth. <br />2. Fill hole with Crater, row 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 bottai. 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. 'h•, .+ +r <br />5. Divide this time by 6 to obtain' the rate !,or inch. <br />6. Date Cater test was performed, 1 i I .: + <br />I hereby certify the abovr, i,.forr•ation to ' s correct and the a=•ove, tests iere per— <br />forred by me as proscribed. <br />Signed 4r+-1`l * k'C'J l lt' <br />Addreea 0 fy1 <br />NOTM A septic tank permit is issued on tit basis of the above information. If <br />there are any changes or alterations in the above ntated soil co::ditionn, it may <br />result in the irstallntinn 'sing rejnctnd at the tine oI i+,specton. <br />