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CITY OF EVERETT <br />City Hall PWNE: A -pin, i-il.!1 <br />Everett, 'Washington <br />INSPECTION D7�PART'AFNT LOT APFR)VAL SHEET <br />NAB ' ��r vJ <br />Lv. /Y.�rf i r '//QrPJ �ADDRESS��ODI A1¢%Y �if% �iNOsrA< U/rlS� <br />ADDIUS OF PROPOSED BUILDING ./�A� d3// 'qM 5- <br />LEGAL DESCRIPTION: LOT BLOCK ADDITION _11h1 VGYP SS f <br />TYPE OF USE 5 F� ND. OF BEDROOMS �_ SI2E OF LUT �t/J, f S. <br />/12 ? f <br />SUUHCE OF DRINKING dATER: FUBLIC .AIPFLY ` PRIVATE BELL <br />A SURFACE D,, iINAG[ <br />1. Is disposal field site well drained? - Ye <br />2. Any water course (stream, drainage ditch, etc.) through site? 2'� D <br />8. TOPOGRAPHY <br />1. Any heavy slopes in field area?�1 <br />2_, ,Till present to soil in field area be removed or graded before field tiles are <br />installed? <br />�/jD <br />3. dill any fill material be used in the disposal field site?,�,D-- If yes, how <br />much <br />C. SOIL OONDITIONS <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? )LIe e�, <br />2. After hole is dug record the 4oil conditions at the following depths: <br />(Record as sand ravel cla , packed sand, loam, et .) <br />12 inches 30 inches(yG%rrir���S <br />18 inches 36 inches 1/ /1- <br />24 inches JI-ale C�d�l 48 inches <br />Any ground water encountered before reaching a depth of 4 feet? )%'O <br />If so, at what nipth? <br />D. WATER TEST <br />A simple water test wil! 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 />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 6 inches to seep away. �.�.Oj1J/y/, fj� <br />5. Divide this time by 6 to obtain h rat per inch. .L(_O <br />6. Date water test was performed. � , 7 <br />1 hereby certify the above information to be correct and -the above tests were per- <br />formed by me as prescribed. <br />Signed�� ''II <br />Address / / rna5 L11/SJI <br />MUTE: 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 />result in the installation being rejected at the time of inspection. <br />m <br />