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CITY OF EVERETT <br />City Hall <br />Everettq uashington <br />FHONE: ALpine 9-7101 <br />INSPECTION D_PARTNENT <br />LOT APPROVAL SHEET <br />NAN.E�_sCY,. � ADDRESS (I �,T or. C Cam.✓. �. a7,3:i �7. % ri r pe• /�, . <br />ADDRESS OF PROPOSED BUILDING_ <br />LEGAL DESCRIPTION: LOT Jti BLOCK ADDITION 2 7/et,<,o.Q , <br />TYPE OF USE�NO. OF BEDROOhS .3 SIZE OF LOT --J 3 z/ :i o <br />SOURCE OF DRINKING JTER: PUBLIC SUPFLY �Z,� n _PRIVATE WELL <br />A. SURFACE DRAINAGE <br />Is disposal field site well drained? <br />Any water course (stream, drainage ditc t etc.) through site? <br />"MM, �3:L�:►� <br />1. Any heavy slopes in field area': %le <br />kill present topsoil in field area be removed or graded before field tiles are <br />installed? 690 <br />J. ..ill any fill material be used in the disposal field site?,2U!If yes$ how much <br />C. SOIL CONDITIONS <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? 4v <br />2. After hole is dug record the'soil at the following depths. <br />(Record as sand, gravels qae packed sand) loam, etc.) <br />12 inches 3J inches- <br />18 inches 36 inches <br />24 inches 48 inches <br />Any ground water encountered before reaching a depth of 4 feet? o,%e <br />If soy at what depth? <br />D. WATER TEST <br />A simple water test will show how well this soil will drain or percol.e•p water. <br />To perform this test: <br />1. Dig a hole pt least 36 inches deep. Use p shovel or post hol, digger:sizc <br />of hole nukes 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 there is just 6 inches from bottom left in hole. <br />4. Note how many minutes it takes for this last b inches to seep away. <br />5. Divide this time by 6 to obtain the rate per inch. 3 3 <br />6. Date water test was perfornied.�++/O. Jg« _ <br />I hereby certify the above information to be correct and the above tests were per- <br />formed by me as prescribed. , <br />Signed <br />Address 1 .3 ii ,/p —may <br />MOTE: A septic tank permit is issued on the basis of the ibovp information. If <br />there are any changes or alteraiions in the above stated soil conditions, it may <br />result in the installation being rejected at the time or inspection. <br />