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15824 75TH PL W (2).PDF111111111111 6055 15824 75TH PL W rM m i i -- � ,`sy,,i5����\��^'i'.. t�..�^�Jrs`'.S•M.st +' .:.4...x iv.. .�a'?�: ,a-�.�.. ...._..-.-_•—,._..��. �_ _--_-___ ? 'r '1jtj++ c_ 3 APPLI�AT.I 1V & WORK PERMIT �. Application No. =CITY''�`OF'EDMONDS • Building Department Pew !t Limit; One Year^ lan9 ' ;APPLICATION ereby.ma for .a permit to construct the following work, in accordance with the accompanying p a 1 '3? andspecificatloms /.. rt. fit• No. Stories..... gWC'ItA^.:.................................................................... Ground Area.. n 1 r g Y <L 4' "f✓ . .ate. - , '. ,` :.' , / Coast. T�'P.......:.�.....•................... Height ............... �.�' *}J•'� v � + st 'aPhvss Submitted ......................:......................._........ i /-..:L .k� ...1.............C^/S�J Fireg one.....-...._ xLOCAizON = Addresa 1 ..d.:.d.:.7 { Us. Zone..: G� 1 y� / n 4 '•Recopied Lot.. _......:.Bixk:...: Add'n........................._.. .a 5r Min. Bldg. Setbacks,,Front and Rena . ,Lu-. .... Ides Lot Area_ ............... Width.. �� ........ dg. a.. /....� _ Phone �2 Add, ........................� Y .................. Address✓:.ill¢..:1`l.."L................................:Phone...7... f :s / ........................................................ Phone ........................ . �.. ,.-._.. _ Bldg by .............. ........... .......... Address t _ , .� c Address....................................................................... n ......................._....... Phone i 1 3 P Heatingby ..... .....:...........:................................:.................. ..... Address...................................................... hone.............................. ................................. Phone................................ Address ......................................... ... ...... ....... Remark3...........lf.'W�.....k.�.':.°-`................ .... ... ...- ... .......... { .. -...; •1 _ .y ell, avr�l— LLc,�t%f �1�iFG/L``�rtv`F-`r l�l` ••.........; 1 1 � •A • .- _. ...... ......... -............................................................................................................................................................ . licable Codes and State Laws re atin the work. The above is a correct statement and 1 agree to comply With all applicable g r ` / on> •� !•r•rr� /Q �.......�lf�.:.�........... Date ............... ...... ..... Address ............. ....... •: .. . . • Signed: '6'waer/Ag i r i •,' _ PEMIT for the above work is hereby approved, subject to the above conditions, and to ,compliance with;,the'approved plans +`,s' 4 ._, and specifications and Building Department notations thereon. y ^ VALUATION FERbUT FEES' t $../......................... t7 Ci Bldg. .. .. $.....:......:.... j ^Plbg. .. . . $...../........��........ - - - Gam-:•' - Heat.... $................... :.. ............. s•- APPROVED: . Date.................... ............................. Elect. . . .... �- Others...$........................................ S YRTM ENT BUILDINGDEIIIIII Y�A TOTAL FEE $... ..,..o..... B.. � ` l NOTES: No work requiring Building Department or City Engineer's inspection shall be covered before inspection and approval. + Twenty-four (24) hour notice requested. Contact the City Engineer prior to construction of all site utilities, such as curbs, paving, driveways, sewer, water and street connections. i 890 - 19°i CITY OF EDMONDS 250 - 5TH AVE. N. • EDMONDS, WA 98020 • (206) 771-0220 • FAX (206) 771-0221 COMMUNITY SERVICES DEPARTMENT Public Works • Planning . Parks and Recreation • Engineering June 1, 1993 G. Messer 15824 - 75th P1. W. Edmonds, WA 98026 LAURA M. HALL MAYOR This letter is to inform you that you are served by a city maintained grinder pump system. This system pumps your sanitary waste to city gravity sewer lines as your house was too low to obtain gravity flow when city sewer mains were installed. I hope to inform you of the basics of how these pumps function, who to call should you experience alarms, and what precautions should be taken to prevent damage to your home. 1. The grinder pump was originally installed by the homeowner, but the hardware was purchased by the city of Edmonds' Lid Bond that paid for -the sewer project in your area in 1985. These pumps are float activated.to cycle the one pump to take your sewage up to where gravity flow can be obtained. 2. The following precautions must be adhered to prevent damage to your home: A. Do not.dump any nonbiodegradable products down into the pump tank. VIA your drains in your house. B. Minimize the amount of grease disposed down your drain. This may cause problems with the float operations. C. Do not empty pools into the tanks without a restrictor Approved by the city of Edmonds. D. Do not attempt to access tank or electrical cabinets. Should you have a pump failure from any of the above mentioned items, the homeowner will be held responsible for damage. •.lncorpo'rated August 11,•1890 •. P Sister Cities International = Hekinan, Japan 3 3. The city of Edmonds Sewer Section will maintain the pumps every three (3) months to ensure the proper operations. We will also clean, operate and check all components to ensure proper workin.g status. A separate log is kept to your pump that will reflect any maintenance done. We can track reliability and the need for upgrade or repairs when a chain of failures start to occur. Crews will require the use of your water so the tank can be washed down and we will always try to notify you of their presence when they arrive on the site. 4. Should you experience any problems with the pump, there are two alarms that will indicate failure. One alarm is located within your home and has a black push button to reset to silence. There i,s also a visual alarm located on the electrical box outside your home. When this occurs, please call us at 771-0235 immediately to investigate any problems. Our office hours are 8:00 AM - 5:00 PM Monday Through Friday. Should an alarm occur after hours, weekends, or holiday, contact 911. There is a 24-hour call person on duty to be dispatched. We do carry parts for all of these systems and should be able to correct most problems within a reasonable amount of time. If you have any questions or concerns, please contact Everett Akau or myself at 771-0235, extension 349. Sincerely, Ron Holland Water/Sewer Supervisor cc: Everett Akau RH/lk GRIND/LT/TXTSEWER ... .� .p-. �r'...w a•n1^ccY::JY�S"J�i' c �'- '-:�s.va� c.,J;•i::f....^Jl 11"Yt ., Jrm' ,Syr ^• t•.'v.`t.°I j,.. y,y,.; `.r-. ,,,� „^ - _ y 5.-:Jr. -•y. :i"'Yf1 .r''�.Y .N., a.. r6' ,�.;., _f... •,'- �.• tia". w • �• I --wanow— O 890-19() City of Edmonds RIGHT-OF-WAY CONSTRUCTION ^.►, T ■,1 Permit Number. 3 Issue Date 1 / __ 0____ Z A. Address or Vicinity of Construction: 15824 75 P1 W (9, B. Type of Work (be specific): Install New Service C. Contractor: Washington Natural Gas eompany Mailing Address: 815 Mercer St Seattle WA State License #: 111 D. Building Permit # (if applicable): Contact: Frank Swan Phone: 224-2278 Liability Insurance: Bond: $ Side Sewer Permit # (if applicable): } w 1. E. ❑ Commercial ❑ Subdivision ❑ City Project ❑x Utility (PUD, GTE, WNG, CABLE,.WATER) ❑ Multi -Family ❑ Single Family ❑ Other 11 INSPECTOR: INSPECTOR: F. Pavement or Concrete Cut : ❑ Yes ®No G. Size of Cut: x H. Charge APPLICANT TO READ AN S. GN INDEMNITY. Applicant understands and by his signature to this application, agrees to a City of Edmonds harmle�y fr�snr{Cj rIga, damages, or claims of any kind or description whatsoever, foreseen or unforeseen, that maybe m e inst the City of F.dmondb',/orj+of/�i6g,d�p¢rtmenta or employees, including or not limited to the defense of any legal proceedings including defense coats, and attorney fees by reason ofgranting this permit. THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE YEAR FOLLOWING'THE FINAL INSPECTION AND ACCEPTANCE OF THE WORK. ESTIMATED RESTORATION FEES WILL BE HELD UNTIL THE FINAL STREET PATCH IS COMPLETED BY CITY FORCES, AT WHICH TIME A DEBIT OR CREDIT WILL BE PROCFISSED FOR ISSUANCE P&THE•APaICANT. Construction drawing of proposed work required; with permit application. A 24 hour notice is required for inspection; Please call the Engineering Division, 771-0220. Work and material is to be inspected during progress and at completion. Restoration is to be in accordance with City Codes. Street shall be kept clean at all times. Traffic Control and Public Safety shall be in accordance with City regulations as required by the City Engineer. All street cut ditches shall be patched with asphalt or City approved material prior to the end At& working day; NO EXCEPTIONS. Ihave read the abovestatements and understand.the permit requirements and thepink copyof thepermit lvill be available on site at es for inspection purposes. Signature: �'�` Date: November 1, 1993 (Contractor or Agent) CALL DIAL -A -DIG PRIOR TO BEGINNING WORK FOR CITY USE ONLY APPROVED BY: TIME AUTHORIZED: VOID AFTER "` DAYS SPECIAL CONDITIONS: p �- COMMENTS: DATE: RIGHT OF WAY DEPOSIT NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE F.ng�K. Div. 1991 FIELD INSPECTION NOTES Comments• 0 Diagram V J w (Fund 111 - Route copy to Street Dept.) r CONTRACTOR CALLED FOR INSPECTION ❑ YES ❑ NO Partial Work Inspection by P.W.: " Work Disapproved By: Date: FINAL APPROVAL BY: Date: 11/01/93 12:53 N.O.B. WASH. NAT. GAS. 002 - .1,-• .�.' ,N.1 ••, •• -`fi .. ..:.• ���Y :V�LL%��•�••y� ,��yiY;'$'SoF'�4'�'rr .� ' • Na#t�ai Gas dendum to City of Edmonds Right of Way Permit Application Submitted by: Guyla Connors ... Engineering Aide Washington Natural Gas 521-5248 I 2— 76 Pc- .1i, 0 "A WNG to window N/� Water wain depth ( unknown 2" gas main ..gft. gns -so- sewer -e- water hydrant q water valve $15 Mac St. (RO. Box 1869), Scauk, WA 93111 (M) 6=-6767 a STREET FILE CITY OF EDMONDS - LARRY S. NAUGHTEN 250 • 5TH AVE. N. • EDMONDS, WA 98020 • (206) 771.3202 MAYOR COMMUNITY SERVICES: PETER E. HAHN Public Works • Planning • Parks and Recreation • Engineering DIRECTOR I890 19C!I0 January 12, 1990 Mr, Gary Messer 15824 - 75th Place West Edmonds, WA 98020 Subject: SEWER'CONNECTION Dear Mr. Messer: This is a follow-up to the letter sent to you of August 18, 1989.- To date no permits have been issued. Therefore, I see no progress to install your sewer service. Would you please contact me and make arrangements. Otherwise, I have no choice except to discontinue your water service per Council action. Your cooperation would be appreciated. Sincerely, Bobby R. Mills Public Works Superintendent BM/lk IV SOPIREEw FILE.--, CITY OF EDMONDS d SIDE SEWER P E RXI'T s �g9p 19�0 PERMIT 262 - .. Address of Construction: �sg Q` / 7, Pl— c.c.s 4cQ�'L10�yCy s Property Legal Description (Include all easements): I 1 © 2 9 " "' 0 (OnH OCT PUBLIC WORKS s o -ver Owner and/or Contractor: oti S �C3 C� �C yl() C. 5 5' x, a; SSe tl'-- State License No. C/ _r'gnss C) 8) Building Permit No. ©l,(7:)5v $-Single Family ❑ Multi -Family (No. of Units ) ❑ Commercial ❑ Public m Invasion into City Right -of -Way: [�—No ❑ Yes RW Construction Permit No. Cross other Private Property: 8- No ❑ Yes Attach legal description and,copy of recorded easement I certify that I have read and shall ply with all city requirements as indicated on the back of the Permit Card. /0 — //— 90 Date * CALL DIAL -A -DIG (1-800-424-5555)- BEFORE ANY EXCAVATION'* OFFICE USE ONLY * FOR INSPECTION CALL 771-3202, PUBLIC WORKS DEPT. Permit Fee: © Issued By 1 p ( $0 Trunk Charge: Date Issued: Assessment Fee: Receipt No.: Lid No.: — Partial I.nspection: Date —Initial — Comments Reason Rejected:, Final Inspection Approved Date L1 9 b Initial I/ Date Initial ** PERMIT -MUST BE POSTED ON JOB SITE ** White Copy: File Green Copy: Inspector Buff Copy: Applicant Revised 3!90 i: NOW.' m-, Vic, r C,l by the Cj�y 0-i City 01 �dlilonds dog; - no: i. Mir o, enDy rom, J,a,. t. a. p; p+iajitor. to Rk, I cf co z may S, loanlddmEyorr'- j shzli bo f, a,s nci its c.-, cjjli this ncr fc;, all' J t& 0 Till - CP rn 0 ',Z- T r 50 0) CA LO tv 0%-* �70 :gj TJ n 0 0 0 z 0 IN ro El X 0 0 0 m IL 3 0 CL &I 'CITY OF E D M O N D S LARRY S. NAUGHTEN 250 - 5TH AVE. N. • EDMONDS. WA 98020 • p. MAYOR (206) 771-3202 Mal COMMUNITY SERVICES: PETER E. HAHN j Public Works • Planning • Parks and Recreation • Engineering DIRECTOR 890 19°' v`�EET FILE September 10, 1990 u Gary Messer 15824 - 75th Place W. Edmonds, WA 98020 Dear Mr. Messer: As you know, I have worked with you to install your sewer service. As of to date, no action has been taken which shows you are trying to complete this connection. Unless you provide me with a schedule and date you plan to install you sewer connection, I have no choice but to disconnect your water service as approved by City Council. You have until October 15, 1990. Your response is of the utmost importance for your water will be turned off October 16, 1990 at 9:00 AM. Sincerely, Bobby R. Mills Public Works Superintendent BM/lk cc: Water/Sewer Supervisor Peter Hahn Mayor City Attorney Ordinance Enclosed MESSER/TXTSEWER/3 0 Incorporated August 11, 1890 • Sister Cities International — Hekinan, Japan STREET FILE CITY OF EDMONDS 250 - 5TH AVE. N. • EDMONDS, WA 98020 • (206) 771-3202 COMMUNITY SERVICES: 1 Public Works • Planning • Parks and Recreation • Engineering 8g0-1g August 18, 1989 Gary Messer 15824 - 75th P1. W. Edmonds, WA 98020 Dear Mr. Messer: LARRY S. NAUGHTEN MAYOR PETER E. HAHN DIRECTOR Upon receipt of your letter, you stated you were planning to install your own sewer the same time as your neighbor. To date, we have not issued a permit for that connection. Would you please contact me for arrangements for you sewer connection or we will be forced to comply with the city ordinance (see attached) per Council action. Please contact me at 771-3202, extension 314. Sincerely, ir� e �7-e� Bobby R. Mills Public Works Superintendent BM/lk Attachments MESSER/TXTSEWER • Incorporated August 11, 1890 • Sister Cities International — Hekinan, Japan 8 9 0- 1 9 y_ CITY OF EDMONDS 250 - 51h AVE N. • EDMONDS. WA 98020 • (206) 771-3202 COMMUNITY SERVICES: Public Works • Planning • Parks and Recreation • Engineering July 20, 1988 Dear Resident of the Meadowdale Area: LARRY S. NAUGHTEN 1\ - MAYOR PETER E. HAHN DIRECTOR Our records show that you have not connected to the sanitary sewers in your area. If our records are in error, please notify us. Otherwise, we'd appreciate it if you read the rest of this letter. On July 19, 1988, the Edmonds City Council.passed an ordinance which al.laws the City to turn off water service to residents who choose to continue not connecting to the sanitary sewers. Althoughall of you were notified of this hearing, only one affected person spoke to the Council. The Council and I were hoping to hear directly of the reasons why you have not connected. For those of you who may be on wells, the Council's direction is to ensure compliance by other means, so this letter applies to you also. The Council's and City's intent is to achieve 100% connection, and my direction is very clear in this regard. I recognize, however, the need to work individually with you and to provide you with some flexibility in helping to achieve the goal of the ordinance. I would ask each one of you to propose to the City a reasonable plan and timetable for complying with the Council's intent. We are prepared to be flexible, but we are prepared to eventually resort to the measures which the Council included in the Ordinance in the event of non-compliance. If that point were to be reached, and I certainly hope we would not even get close, there would be extensive notification and contacts with you. Please send me your plan and proposed timetable by August 12. If there is any reason for delay of this date, state so in a letter. Once we get these plans, we will review your proposals and get back to you. Meanwhile, please do not hesitate to contact Jerry Hauth in the Engineering Division for any technical questions. Attached is a copy of the ordinance. Sincerely, Peter E. Hahn CC., Mayor Naughten City Attorney Jerry Hauth MEADOW5/TXTPEH61 0 Incorporated August 11, 1890 • Sister Cities International — Hekinan, Japan 0 9L SYREET FILE CITY OF EDMONDS 250-5th AVE N. • EDMONDS, WA 98020 • (206) 771-3202 COMMUNITY SERVICES: Public Works • Planning • Parks and Recreation • Engineering March 29, 1989 Gary Musser 15824 - 75th P1. W. Edmonds, WA 98020 Dear Mr. Musser: LARRY S.NAUGHTEN MAYOR PETER E. HAHN DIRECTOR Upon receipt of your letter, I have reviewed this matter with the Community Services and we will approve your request to install your sewer service by June 15, 1989. Should there be any problems with you meeting this deadline, please contact this office for a possible extension. Your cooperation in meeting this deadline is much appreciated. Sincerely, ,�/e 4� Bobby R. Mills Public Works Superintendent BM/lk cc: Archie Brena MUSSER/TXTSEWER • Incorporated August 11, 1890 • Sister Cities International — Hekinan, Japan Ct i t gFozo WORKS—- J _� � �.� j Li■ uUmme Y m ■S ;a z Q m m v N U c z z m 0 w o n .r3 10 7 z M H M zO0 H M U! \ z 4� k � a CD P o b 'M` 5' .Q CAD 00 I(n mommc ERIC ■ A A � m m m (n � 0 0 m h w O' G rt O S 3 c h y N C z 9- z m N O ^, asMe 00 :,� • to o r`D N a c� H O z O H Ll J °N:mI MINNIE- al Cl MINE m p ) m m m m m NI m v o w 1 a a m [� m v co < zz H O lt-I z x o O � > v [zn r (D yx M H z 01 M I � 0o r hi 0 a co o�+ s [ [ I [ [ i o m 12 ti a � IH Ci H uta, •.- i z w ILA d 0 9 I� y I0 q to i5 I t7 Ic r7I -9 FILE CITY OF E ® ice ® Y V ® B HARVE H. HARRISON 200 DAYTON ST. • EDMONDS, WASHINGTON 98020 • (206) 775-2525 MAYOR DEPARTMENT OF PUBLIC WORKS September 25, 1980 _Patrick Crawford 15824 75th Place West Edmonds, Wa-. *..98020 Dear Mr. Crawford: �2Reference your request regarding the installation of a�san terry sewer to your property. We are currently designing a sewerage system to serve your property. The City Council will consider this project for construction during the early part of 1981 and if approved, my best estimate is that a sewer will be available to your property by the summer of 1982.. Sincerely, JAPIE S E . ADAMS , P.E. City Engineer JEA:gdl • City of Edmon*16 STREET FILE City Engineer's Office COMPLAINT REPORT Report No. Referred to for Action Ron. Whaley, Asst. Pub. Works Dir. Time Date 9/26/69 Received By Jim ConwU, Engineering Department Time Date 9/18/69 Made By Pat Crawford Address —15824 75th Tel. How Received: Letter x Telephone In Person Nature of Complaint: Run-off water coming down street and running across yard. The catchbasin needs cleaning out. A ditch is needed along east side of street and eeveral ditches are needed through shoulder on west side of street. Swale across pavement at catchbasin needs to be blocked. Describe Action Completed: 1'14ells X-Ij A,','ZdU a�� aU, Time Date Completed By V Location Sketch: r e tv 04 ih, CZ Ak' 'Ye IV A 4Z- F,' 0 rt A I- STREET FILE CITY OF EDMONDS DEPARTMENT OF PUBLIC WORKS 250 Fifth Avenue North, Edmonds, Washington SEPTIC TANK INSTALLATION PLAN (Submit in Triplicate) ADDRESS OF PROPERTY----. ........ ............... Lot No........6 ......... Permit No...l.Ya...:... Owner..... ...... .......................-------.---- .................. Address ................. ...........................---------------- Phone--------................ Builder......... ...... ..... .._............................ ....... -----. Address................... .... ..--...... %.... Phone...........------------. Designer.. i.. --.. ... Address../.J'_/7;Z�....... 7.6_.'.. 4a .... Phone------------------------ Installer. r'11.. G . '. ........ Address.-/ /-?-.------ /ffl . -T7-Vic'............... Phone"-.-F-'F7%, I hereby certify the accompanying drawing is an accurate representation of the system installed at the listed address. I also certify all recommendations and restrictions (concerning plumbing stub elevations, maintenance of grades, fills, surface drains, etc.) listed by me on my sewage disposal system permit application dated ................ ........... ..... .......................... have been complied with. ----------- ---- -------------------------------------- /;�... Signature o Date TO BE FILLED IN BY CITY ENGINEErrR ONLY Accepted ..----.... ........... ........... Date. `..-1.n..�..�P.. Not Accepted Date .. ................... Signature of Sa ian...... -................. Remarks---------------------- --................................... ..................... .......................................................................... INSTRUCTIONS: Use the reverse side of this form for the drawing. Use a scale which will permit the greatest detail and still contain the entire site on one page. ATTENTION HOME OWNER: Your septic tank has limitations! It was designed and installed to care for an average -size family: Over- loading the septic tank or disturbance of the drain -field may seriously impair satisfactory operation. Points to remember: 1. Have your tank checked periodically to see if pumping is necessary (2%-3 years). 2. Do not channel ground water, surface water,' footing drains or downspouts into the tank or drainfield. 3. Do not excavate, fill, place a structure, driveway or. patio in, on, or over the drainfield. 4. Limit toilet fixture disposal to sanitary wastes and toilet tissue. 5. Detergents and bleaches used in normal household quantities will not liarm the action of the septic tank and disposal field. box Pion -for -t e be Used ©n 4.of S, i3A, 29 Play Scol� �Gj,� / . R 1- . L r u La -�orC1 is72./ 7.rt h p1• W. A- CITY OF EDMONDS DEPARTMENT OF PUBLIC WORKS 250 Fifth Avenue North, Edmonds, Washington SEPTIC TANK INSTALLATION PLAN (Submit in Triplicate) ADDRESS OF PROPERTY..... `�.o....... = t+' Lot No......�J.............. Permit No...�..�,�Q...-... r............ , Owner..' .............. --- ..... Address .................. I .... .................... ......... ---------- ... Phone.:...................... Builder............. Address _ ------- ----------:'........................ Phone........................ Designer. 4_A"/100111,_ Address_J4. 7X......... �� .. Phone .................. y . Installer. ! �� �--- -------- --- Address_AA/12 ,...... `n $......----....................... Phone..R ?..F 7 I hereby certify the accompanying drawing is an accurate representation of the system installed at the listed address..I also certify all recommendations and restrictions (concerning plumbing stub elevations, maintenance of grades, fills, surface drains, etc.) listed by me on my sewage disposal system permit application dated ................ . ....... .... ................... .......... ....have been complied with. r ....................... Signature of RekiVW Date TO BE FILLED IN BY CITY ENGINEER O LY Accepted...... __. ......._............... ...-.. Date....... --....----.................... NotAccepte ...................................................... Date....................................... Signature of San 1i arian........ --............................................................... Remarks:...... ...........................................................----•------••---.........----•-•.------•.................... INSTRUCTIONS: Use the reverse side of this form for the drawing. Use a scale which' will permit the greatest detail and still contain the entire site on one page. ATTENTION HOME OWNER: Your septic tank has limitations! It was designed and installed to care for an average -sire familyy Over- loading the septic tank or disturbance of the drain -field may seriously impair satisfactory operation. Points to remember: 1. Have your tank checked periodically to see if pumping is necessary (2%s-3 years). 2. Do not channel ground water, surface water, footing drains or downspouts into the tank or drainfiel¢. 3. Do not excavate, fill, place a structure, driveway or, patio in, on, or over the drainfield. 4. Limit toilet fixture disposal to sanitary wastes and toilet tissue. 5. Detergents and bleaches used in normal household quantities will not harin the action of the septic tank and disposal field. ;r CITY OF EDMONDS DEPARTMENT OF PUBLIC WORKS 250 Fifth Avenue North, Edmonds, Washington SEPTIC TANK INSTALLATION PLAN (Submit in Triplicate) ADDRESS OF PROPERTY..... z .............. Lot No ....................... Permit No ... ....... t�.4; _ ........ - f. Owner................................................... ............... Address ........... ................. ....... ....................... -.. Phone------ ................. Builder-- . ...... Address........ ._............. . .. .......__ ............. Phone...------------....-"... llesigncr_ if, :`<.......... ..�`: ct� 1 L • - -- Address. " t�._.... .. .. : .... Phone ----------- f �' . " Installer...'`-�-r��s�}fir'�..- .�tJ�_ �,�,,.-- -•- -- ------ Address. �l'�7/:�� -- .....��..�..--�-t'e''--------- ----- Phone..a_�:.6�;..�w.... 9�.!''�� I hereby certify the accompanying drawing is an accurate representation of the system installed at the listed address. I also certify all recommendations and restrictions (concerning plumbing stub elevations, maintenance of grades, fills, surface drains, etc.) listed by me on my sewage disposal system permit application dated ................ . ....... .... ................................. have been complied with. 4 Accepted.. -...... Not Accepted.I Signature of ! . v .............. d `rota ' ................. ....... ... d . ....... Signature of Designirr Date t -r- LED IN BY CITY ENGINEER ONLY .... Date.. _. .......... ........... Date. _... . Remarks------------------------------------------------------------------------------------------------------------------ -------------------- INSTRUCTIONS: Use the reverse side of this form for the drawing. Use a scale which will permit the greatest detail and still contain the entire site on one page. ATTENTION HOME OWNER. Your septic tank has limitations! It was designed and installed to care for an average -size family. Over- loading the septic tank or disturbance of the drain -field may seriously impair satisfactory operation. Points to remember: 1. Have your tank checked periodically to see if pumping is necessary (2%2-3 years). 2. Do not channel ground water, surface water, footing drains or downspouts into the tank or drainfield. 3. Do not excavate, fill, place a structure, driveway or. patio in, on, or over the drainfield. 4. Limit toilet fixture disposal to sanitary wastes and toilet tissue. 5. Detergents and bleaches used in normal household quantities will not harm the action of the septic tank and disposal field. r �C W 0- J N O 0 0 z 0 41 • N � y ti N N Q o _ o �� o 0 \ O N a 1 A o a O z c A o z O 0 a A m 3 N T pq p 7 O a H rw 0 a a A I CITY OF EDMONDS DEPARTMENT OF PUBLIC WORKS 250 Fifth Avenue North, Edmonds, Washington APPLICATION FOR A SEWAGE DISPOSAL SYSTEM PERMIT (Submit 3 Copies) Permit to be issued to :.............. For installation at: (street address) ..... .....,,..AA.. 7907 ?/ W' Addition or Subdivision...C.�a t....0- I•I e4d ow d 4 /e J3 e- a G 4 S -------------------------------- ------ ----------- - -- --------------------- -- -- Lot.---------...... B1ock..Z 9..... Type of Building: New... V... Existing............ Single family residence..-.'** ........ Number of bedrooms...... 3................ Other: (specify type or use)-..... -------------------------- -------------------- - - ---- -------------------------------------------------------------------------------- Builder.----- DD------------------------------------------------------------------------- Address. . ........ ---- -------....... ---- ......-------------- --------------------- Designer ... LE ' ��Or�7z..7J�h �/, f/ ................................ u.......... .... ..-...----... N q Soil Log Hole No. 1... 0 ...'- 3 2 S a n Q...Qf-. #,d ve 1 �� — 36 , s � n d 4- G� ct g— ---- 9 ..... 3%� ....... y. . ,a Soil Log Hole No. 2................................... 54!ry ...a .5%.t''-Q1otL.�...t.................-A?'-1 3 6. said e%4 al- vava/ ------------------------�..-------y----..�.... ----------------------------------------------------------------------------------------------------- -- ......... ...................... .....................----------.........--- ......-------- Elevation of Water Table, if encountered. (Distance from ground surface)...................................................................... Corrections to control surface water if needed...... Drnii.l►9......C..1. o.....Wi Wilt .... ...... .............................................................:...................... Specify if any removing or grading of topsoil in field area ...... &&!IC.................................................................................. .---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- Percolation: Test Hole No. 1 —Average Rate... 1 ... ... .. (Fall in minutes/inch-bottom 6" test hole) • �'^....................... Fall in minutes inch -bottom 6" test hole Test Hole No. 2 —Average Rate... Z...................%...- ( /' ) 'Pest Hole No. 3—Average Rate.... 3j!.3....n(Fall in minutes/inch-bottom 6" test hole) Average percolation rate on which to base drain field design . - m ih �/ /"I . Date Taken!�.�..1�G4 Septic tank requirements based on present rules and regulations: Septic TankSize....67.00............ gallons. Amount of Square Feet of Disposal Field.......?® ............ ..... Signature —Designer f��!� C�/�'.—Q-'?'- ............... . Date..................- ... ... ...... DO NOT WRITE BELOW THIS LINE (To be completed by Issuing Agency) Permit issued (date)........ -L. �a ...............Permit Number....../1/0..... . Remarks:........................................................ ...... . ---------------------------------------------------------------------------------------------------------- --- ----- ---------------------------------------------------------------------------------.