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CITY OF EVERETT <br /> Y; <br /> X; City Hall PHONE; ALp:n( •)-il 11 <br /> Everett, ''tashington <br /> _INSPECTION DEPARTMENT LOT APFROVAL SHEET <br /> NME_ Welter L. Regie ADDRESS_ 6325 HigrraY 99 So. Eve <br /> ratt• Wn. <br /> ADDRESS OF PFOFOSED BUILDING. jok.j7th Place S. W. Upper Iddge_Road _ljeratti 1h. <br /> LEGAL DESCRIPTION: LOT_ BLOCK ADDITION _BeZIlL'lat- r3_Upper i�Oe ,. <br /> TYPE OF USE AkalAmee NO. OF BEDRDUMS 3SIZE OF LUT 7nzJ3" <br /> SOURCE OF DRINKING MATER: FUBLIC SUPFLY _ QJJM PRIVATE DELL_ _ <br /> A. SURFACE DRAINAGE <br /> 1. Is disposal field site well drained? Tom <br /> 2. Any water course (stream, drainage ditch, etc.) through site? No <br /> B. TOPOGRAPHY <br /> 1. Any heavy slopes in field area? e+ �.++ a ILa <br /> 2. 'dill present topsoil in field area be removed or graded before field tiles are <br /> installed? No <br /> 3. .fill any fill material be used in the oisEosal field site?-Hp.— If yes, haw <br /> much <br /> C. SOIL OUNDITIONS <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? 2se Smni ant nramt <br /> 2. After hole is dug record the soil conditions at the following depths: <br /> (Record as sand, gravel, clay, packed sand, loam, etc.) <br /> 12 inc;ies 30 inches <br /> 18 inchos 36 inches <br /> 24 inches 48 inches 3en� ani 6raw1 <br /> f. Any ground water encountered before reaching a depth of 4 feet•? _ <br /> If so, at what depth? <br /> D. HATER TEST <br /> A simple water test will show how well 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 digger; size <br /> of hole makes no difference - only depth. <br /> h 2. Fill hole with water. Now let all water run out of hole. This soaks the <br /> 3t round and will give a more accurate reading. <br /> f: 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 /> 5. Divide this time by 6 to obtain the rate per inch.3 minaten per inch <br /> 6. Date water test was performed. <br /> I hereby certify the above information to be correct and the above tests were per- <br /> formed by me as prescribed. <br /> r <br /> « Address <br /> NOTE: A septic tank permit is issued on the basis of the above information. If <br /> there are any changes or alterations in the above stated soil conditions, it may <br /> 1bL result in the installation being rejected at the time of inspection. <br /> 3 <br /> '�`(� <br /> 3'o AJ <br />