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1562 MAIN ST.PDFIIIIIIIIIIIIII 14208 1562 MAIN ST Din OF ED___ MOIVb .. . STEEET. FLE LOT APPROVAL STREET " NAME Y ADDRESS ADDRESS 0 PROPOSED BUILDING_ /,S" j216 �V,,� jA S 7. LEGAL DESCRIPTION: LOTLOCK_�S ADDITION_ 9 ✓v wee �,� ..,i � T TYPE OF USE N0. OF BEDROOMS SIZE OF LOT -2 a ` 226=21r SOURCE OF DRINKING WATER: Public Supply Private Well a. SURFACE DRAINAGE 1. Is disposal field site well drained? Q 2. Any water course (stream,, drainage ditch through site? �p b. TOPOGRAPHY Is Any heavy slopes in field area? 14/10 2. Will present topsoil in field area be removed or graded before field tiles are installed? 3. Will any fill material be used in the disposal field sit es?,�If yes, how much? C. SOIL CONDITIONS 1. Has a hole at least 4 feet deep been dug in the disposal field area.to deter- mine the type of soil present? 2. After hole is dug record the soil conditions at the following depths. Record as sand, gravel, clay, packed sand, loam, etc.) 12 inches 30 inches >:S inches �— 6 inches 24 inches .48 inches 3. Any ground water encountered before reaching a depth of 4 feet? If so at what depth? i d. WATER TEST " 1 A simple water test will show how well this soil will drain or percolate water. -` To perform this test: 1. Dig hole at least 36 inches deep. Use a shovel or post hole digger — size of hole makes no difference --only depth. 2. Fill hole with water. Now let all water run out of hole. This soaks, the ground and will give a more accurate reading. 3. Again pour water in hole to a height of 12 inches from the bottom. Let water run out until there is just 6 inches from bottom left in hole. 4. Note how marry minutes it takes for this last 6 inches to seep away. Record this time below. Number of minutes for last 6 inches to seep away 5. Divide this time by 6 to obtain the rate per -inch 6. Date water test was performed IVA7 -? I hereby certify the above information to be correct d the a ove tests were performed by me as prescribed. Signe, Address . NOTE: A septic tank �- P permit is issued on the bxs s of he above information. If there/are any changes or alterations in the above stated soil conditions it may result in the installatioh',being rejected at the time of inspection. Percolation Rate and Required Absorption Area.. For single Family Dwellings, Percolation Rate ( Time in Lineal feet of 4 inch the minutes for water to fall using trench with width of one inch) taco Beet 3 4 150 minim m 5. 175. �t 190 7 10 225 n 250 It12 .. 265 It 15 . 285 It 30 375 Over 30 S it Uns ' tabl