16510 72ND AVE W.PDF1111111111115609
16510 72ND AVE W
CITY OF EDMONDS __
PUBLIC WORKS DEPARTMENT FOR INSPECTIONCRLL Permit N? 6.2 5
SIDE SEWER PERMIT Issue Date 191231,5
7 -3 ?-
�* PERMIT MUST BE POSTED ON JOB SITE
1. Address of Construction Z6 S /U '70 ``- &z, 42
2. Property Legal Description ( include all easements) y/j/ 11'514',67 G 777-/ ,
3. Single Family Residence > Multi -Family No. of Units
Commercial
4. Owner and/or Builder�vi�
5. Contractor & License No. /��� ��'p ✓ter/ 5� fi .
6. Invasion into City Right -of -Way: No ;'' Yes (If Yes Right-of-
way Construction -Permit Required - Call.Dial Dig (/j�j Agf;) before
excavation) . 1-800-454-5555
7. Cross other private property: Yes No Easement required -
attach legal description and county easement number.
READ THE FOLLOWING AND SIGN:
'a' a. Property owners must obtain a permit to install side sewers.on
>4 their property. A licensed side sewer contractor must be employed to
construct side sewers in the public right-of-way.
W b. The side sewer contractor assumes full reponsibility for each
h installation for one year.
C. Commercial establishment requires a minimum of a six inch (6")
side sewer line.
u d. Side sewers may not be installed'closer than thirty inches (30")
to any structure.
e. Side sewer lines must be laid at a minimum grade of 2% (1.150)
O and maximum grade of 100% (450). o
H f. No turn in side sewer greater than 45 (1/8;bend) is allowed
between cleanout. All 90 turns must be constructed of a 45° (1/•8
bend) and wye with removable cap.
g. No down spouts, footing drains or floor drains can be connected
to side sewer system. ,
h. Pea gravel is required for bedding.. -when installing sewer lines
through other than granular soil. f,
i. Cleanouts are required"at 30"-60 from each plumbing exit line
and at minimum intervals of 100' along sewer line run.
j. Trenches within City right-of-way must be restored to original
conditions. Contractors shall be responsible for right-of-way failure
due to poor compaction of fill.
k.. Side sewer must be left uncovered until inspected and approved
by the City.
1. Inspection during normal working hours only. Two (2) working
days notice required.
DATE: 2Z--
I certify that I have rea
7p [� J 111( and shall comply with the above
ol)PERMIT FEE: 36.00 DISAPPROVED By: Date:
By: Date:
p CONNECTION FEE: 2,s-GV APPROVED By: Date:
C' 42- /Z * PERMIT MUST BE POSTED ON JOB SITE
?CITY OF EDMONDS
PUBLIC WORKS -DEPARTMENT
SIDE SEWER PERMIT
Lu 1.
Zj 2.
3.
4.
5.
6.
FOR INSPECTION CALL
7 7°5�- 2-52'5-Ex t. 2 Z
57 p j — � �e37 1"M
Permit R /f _ ° oqv�
Issue Date/
* PERMIT MUST BE POSTED ON JOB SITE *
Address of Construction /6 S /U 73ls LYNNWpOD LINE
Property Legal Description (include. all easements)
Single Family Residence A Multi -Family No. of Units
Commercial
Owner and/or Builder`s.; ;., ` `,o,e'. r'r:',• ' ��✓
Contractor & License No.
Invasion into City Right -of -Way: No X Yes r (If Yes Right-of-
way Construction Permit Required - Call Dial Dig (/314'2,1;5f3'44) before
excavation).
-800-454-5555
H 7. Cross other private property: Yes No Easement required -
Uattach legal description and county easement number.
H
a READ THE FOLLOWING AND SIGN:
a
4 a. Property owners must obtain a permit to install side sewers on
�H their property. A licensed side sewer contractor must be employed to
construct side sewers in the public right-of-way.
w b. The side sewer contractor assumes full reponsibility for each
Ei installation for one year.
aC. Commercial establishment requires a minimum of a six inch (6")
z side sewer line.
o d. Side sewers may not be installed closer than thirty inches (30")
to any structure.
e. Side sewer lines must be laid at a minimum grade. of 2% (1.150)
o and maximum grade of 100% (450). o
H f. No turn in side sewer greater than 45 (1/8,bend) is allowed
between cleanout. All 90 turns must be constructed of a 450 (1/8
bend) and Wye with removable cap.
g. No down spouts, footing drains or floor drains can be connected
to side sewer system.
h. Pea gravel is required for bedding -when installing sewer lines
through other than granular soil.
i. Cleanouts are required at 30"-60" from each plumbing exit line
and at minimum intervals of 100' along sewer line run.
j. Trenches within City right-of-way must be restored to original
conditions. Contractors shall be responsible for right-of-way failure
due to poor compaction of fill.
k.; Side sewer must be left uncovered until inspected and approved
by the City.
1. Inspection during normal working hours only. Two (2) working
days notice required. _ n
DATE:
I certify that I have read
and shall comply with the above
PERMIT FEE:
ow
'4 CONNECTION FEE: o
w
DISAPPROVED By: Date:
B t Date:
APPROVED By.AZDate: / - /3- 9S
T BE POSTED ON JOB SITE
Side Sewer Drawing
The City of Edmonds EASEMENT NO- --------------------------------------------
NEW CONSTRUCTION El REPAIRS E] LID NO. -ASMT. NO. -----------
OWNER -------------- ---- CONTRACTOR ... RUSS ----- 3-OA"-SOt-A ------------------------ PERMIT NO. -6-5- Z's
JOB ADDRESS A-G-5.10.- ... 7 Z ----- LEGAL DESCRIPTION: LOT NO- -------------------------------------- BLOCK NO.
LYNNWOOD LINE
------------------------------------------------------------------------------------------------------------------------------------------------------------------
NAMEOF ADDITION -----------------------------------------------------------------------------------------------------------------------
lie
Ina
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C.O.CAP
16510 79-mr) Av.
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INLET
As
TRWATf- A-SPHAu L.:-% DRIVE-
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PWW-0001 -11/75 (REV. 11/78)
Approved:
13 DATE,7x,-ej --- A -----------------
A 7 W,
STREET FILE
10 -12,�J-Rpl
d
74?
APR 2 41984
ENVIRONMENTAL CHECKLIST
A. BACKGROUND
1. Name of Proponent ,Fe vs�' 1 1,e46it/,g'�qecyo
2. Address and Phone Number of Proponent 16 5/0 - 7Z 7q'�Iv� k/
404-10 A/VG A1A 74.5 - /6 ceo
3. Date Checklist Submitted 1Z_ Z4--''¢
4. Agency .Requi ring Checklist C/Tyy�Pp-
5. Name of Proposal, if applicable 41e,-
6. Nature and Brief Description of Proposal (including but not limited to
its size, general design elements, and other factors that will give an
accurate understanding of its scope and nature:
ll!:'/ZZ 70
A4
7. Location of Proposal (describe the physical setting of the proposal, as
well as the extent of the land area affected by any environmental im-
pacts, including any other information needed to give an accurate under-
standing of the environmental setting of the proposal):
50 `00
8. Estimated Date for Completion of the Proposal
9. List of all Permits,'Licenses, or Government Approvals Required for all
Proposal (federal, state, and local — including rezones):
10. Do you have any plans for future additions, expansions, or further
activity related to or connected with this proposal? If yes, explain.
No
11. Do you know of any plans by others which may affect the property covered
by your proposal? If yes, explain. .
No
12. Attach any other application form that has been completed regarding the
proposal; if none has been completed, but is expected.to be filed at
some future date, describe the nature of such application form:
-1-
B.
ENVIRONMENTAL IMPACTS (Explanations of all "yes" and "maybe" answers are required).
YES MAYBE
1. Earth. Will the proposal result in:
a. Unstable earth conditions or in changes
in geologic substructures?
b. Disruptions, displacements, compaction
or overcovering of the soil?
c. Change in topography or ground surface
relief features?
d. The destruction, covering or modifica-
tion of any unique geologic or physical
features?
e. Any increase in wind or water erosion
of soils, either on or off the site?
f. Changes in deposition or erosion of
beach sands, or changes in siltation,
deposition or erosion which may modify
the channel or a river or stream or the
bed of the ocean or any bay, inlet or
lake?
Explanation:
NO
X.
X
Fm
Y
2. Air. Will the proposal result.in:
a. Air emissions or deterioration of
ambient air quality?
b. The creation of objectionable odors? k
c. Alteration of air movement, moisture
or temperature, or any change in climate,
either locally or regionally?
Explanation:
3. Water. Will the proposal result in:
a. Changes in currents, or the course
or direction of water movements, in either
marine or fresh waters? �C
b. Changes in absorption rates, drainage
patterns, or the rate and amount of sur-
face water runoff? k
-2-
c. Alterations to the course or flow
of flood waters?
d. Change in the amount of surface water
in any water body?
e. Discharge into surface waters, or in
any alteration of surface water quality,
including but not limited to temperature,
dissolved oxygen or turbidity?
f. Alteration of the direction or rate
of flow of ground waters?
g. Change in the quantity of ground
waters, either through direct additions
or withdrawals, or through interception
of an aquifer by cuts or excavations?
h. Deterioration in ground water quality,
either through direct injection, or through
the seepage of leachate, phosphates, deter-
gents, waterborne virus or bacteria, or
other substances into the ground waters?
i. Reduction in the amount of water
otherwise available for public water
supplies?
Explanation:
YES MAYBE NO
k
k
X
k
k
4. Flora. Will the proposal result in:
a. Change in the diversity of species,
or numbers of any species of flora (in-
cluding trees, shrubs, grass, crops,
microflora and aquatic plants)?
X'
b. Reduction of the numbers of any
unique, rare or endangered species
of flora?
c. Introduction of new species of
flora into an area, or in a barrier
to the normal replenishment of exist-
- ing species?
<'
d. Recution in acreage of any agri-
cultural crop?
-
Explanation:
-3-
YES
MAYBE NO
5. Fauna. WIll the proposal result in:
a. Changes in the diversity of species,
or numbers of any species of fauna (birds,
land animals including reptiles, fish and
shellfish, benthic organisms, insects or
microfauna)?
)C
b. Reduction of the numbers of any
unique, rare or endangered species
of fauna?
c. Introduction of new species of
fauna into an area, or result in a
barrier to the migration or movement
of fauna?
d. Deterioration to existing fish or
wildlife habitat?
Explanation:
6. Noise. Will the proposal increase
existing noise levels? k'
Explanation:
7. Light and Glare. Will the proposal
produce new �T ght or glare? X
Explanation:
8. Land Use. Will the proposal result
in the alteration of the present or
planned land use of an area? �C
Explanation:
9. Natural Resources. Will the proposal
result in:
a. Increase in the rate of use of any
natural resource? k
b. Depletion of any nonrenewable
natural resource?
Explanation:
-4-
r
YES MAYBE NO
10. Risk of Upset. Does the proposal involve
a risk of an explosion or release of hazard-
ous substances (including, but not limited
to, oil, pesticides, chemicals or radiation)
in the event of an accident or upset condi-
tions?
Explanation:
11. Population. Will the proposal alter the
location, distribution, density, or growth
rate of the human population of an area?
Explanation:
12. Housing. Will the proposal affect existing
housing, or create a demand for additional
housing?
Explanation:
13. Transportation/Circulation. Will the pro-
posal result in:
a. Generation of additional vehicular
movement? K
b. Effects on existing parking facili-
ties, or demand for new parking?
c. Impact upon existing transportation
systems? SIC'
d. Alterations to present patterns of
circulation or movement of people and/or
goods? iC
e. Alterations to waterborne, rail or
air traffic?
f. Increase in traffic hazards to motor
vehicles, bicyclists or pedestrians?
Explanation:
5.11
YES MAYBE NO
L 14. Public Services. Will the proposal have
an effect upon, or result in a need for
new or altered governmental services in
any of the following areas:
a. Fire protection? �C
b. Police protection?
c. Schools?
d. Parks or other recreational
facilities? X'
e. Maintenance of public facilities,
including roads? X
f. Other governmental services?
Explanation:
15. Energy. Will the proposal result in:
a. Use of substantial amounts of fuel
or energy?
b. Demand upon existing sources of
energy, or require the development
of new sources of energy?
Explanation-
16. Utilities. Will the proposal result in
as nee -Tor new systems or alterations to
the following utilities:
a. Power or natural gas? k
b. Communications systems?
c. Water?
d. Sewer or septic tanks?
e. Storm water drainage? iC
f. Solid waste and disposal?
Explanation: __
41
YES MAYBE NO
17. Human Health. Will the proposal result
in the creation of any health hazard or
potential health hazard (excluding
mental health)?
Explanation:
no
Aesthetics. Will the proposal result
in the obstruction of any scenic vista
or view open to the public, or will the
proposal result in the creation of an
aesthetically offensive site open to
public view?
Explanation:
19. Recreation. Will the proposal result
in an impact upon the quality or quan-
tity of existing recreational oppor-
tunities?
Explanation:
20. Archeological/Historical. Will the
proposal result in an alteration of
a significant archeological or his-
torical site, structure, object or k
building?
Explanation:
C. SIGNATURE
I, the undersigned, state that to the best of my knowledge the above information is
true and complete. It is understood that the lead agency may withdraw any declaration
or non -significance that it might issue in reliance upon this checklist should there
be any willful misrepresentation or willful lack of full disclosure on my part.
PROPONENT:
-7-
To File
FORM 44 - LITTLE'S
.I
INTER -OFFICE COMMUNICATIONS
��� DATE September 12, �s 74
FROM Bill
FRO, 0 ff ff i 6
1, MIJ
SUBJECT: Birlenback Septic Tank Permit 363 - 72d Avenue W. - Fill over Absorption Trenches
Per Leif, I called Mr. Birlenback regarding the excess fill; he said he will
locate the lines and uncover them for our inspection. I agreed with this
procedure and called Reid's, the septic system designers, to inspect also.
0
SEWAGE DISPOSAL PERMIT
Septic Tank ... CITY OF EDMONDS No.
ee V- --------- gab. ,
Disp. Field.... .......... sq. ft. Department of Public Works
Other-------------------------------------------
---------- ---------_---- ------------------------------------------ ----- is hereby authorized to install/
Name..— repair sewage disposal system at
---_----- ---------- --------- .....................................................................................
- / 0/0. Z
Date issued. on.....___..// - ------- -----
Permit expires one year fro ate o /
J sli
Y6 e sue
DO NOT COVER BEFORE APPROVED BY DESIGNER OR SANITARIAN
I hereby certify this system was installed under my supervision and control and complies with all provisions of the City
EN GIN HERiNGs DfiRAHMENT
City of Edmonds ...... Date ----------------------------------
505 Bell Street Signature of Installer-----------------------------------------------------
....... I ........
Edmonds, WA. 98020
ApprovedE] Disapproved F-1 Date -------------------------------------------------- --_-------- By ..................................................................................
Remarks: ............ ...... ---------------------------------------------- .......................... .... ----------------------------------------------------------------------------------------------------
SANITARIANOR DESIGNER ---------------------------------------------------------- ------------------------------------- Date ---------- ------------------------------------------------
This permit shall be posted in a reasonably conspicuous place on the job until inspection has been completed.
PLE
RECEIVED
CITY OF EDMONDS
DEPARTMENT OF PUBLIC WORKS
250 Fifth Avenue North, Edmonds, Washington
SEPTIC TANK INSTALLATION PLAN
(Subnat in Triplicate)
JUN 5 1974
Edmonds Engf. Dept.
ADDRESS OF PROPERTY.................-------.................-----72n.d...Ave......WeS.t....... Lot No.........-----------... Permit No.36.3....... .......
Owner ---- E rn.es.t--- i.-r.l-e.nb.ach..............._......... Address ...1, 822.8.Tremont ... ve_...N.....Sea.tt 1 Ehone.1_1.27:5.793--.
Builder------ - ................... _--------------.. ............... Address----------------------- . .................... Phone...------------------.
Designer...... ReJ d.,-..M.i.dd.l.e-ton... S..As.so.c...... Address.-.324-- Main .-.St ........ Edmonds. ---_----_- Phone .... 77.5-3434.
Installer _-.J.Qhn.:.s.... Con.c.r..ete-T.ro.du.cts....... Address.-.R.t-.....5.-Box..4.3-A.... Ar-.l-i-n:gton..... Phone...653-5.70-
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 ................
..5_ 1.3/-74............................have been complied with.
r
........---ele . .. ........ - `� l 1 7�
Signature o D e
TO BE FILLED IN BY CITY ENGINEER ONLY
Accepted..w..�� r ..... llat N y.lv
Not Accepted ................. Date
Signature of Sanitarian.. f ........ ....V71R)"w'jo..................
Remarks(�o-.... ..1.0 ... ........................
------------------- -----------I....--------- .........................-------••-----------------------.....................................
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.
/009
Lo/ Csr
r
owner:
Ernest Birlenback,
18228 Fremont Ave N
Seattle, Wn.98133.
Ph: L12-5793 Home
763-9)20 nffice
Legal Description:
See attached al
/ Design Data:
/ Design Rate: 3 min/in
Provide 1000 gallon septic
tank
/ Provide,z// if. by Z.5"wlde
' .laterals; 'total drain -.-
field area-S27s,q.ft.
/ Qh A min. of '12" of gravel
/ (U shall be placed where
/ trees are encountered.
h The system shall -be in-
/ tV stalled in accordance 1
/ w/ City of'Edmonds
/ Health Dept. Rules 8 Req
/ Perc. Rates: '
%P,,
- 8 min/in
? P#2 - 2.38 min/in
PN3 - 1.93 min/in -I
/ ! Soil'Lo s:
/ S 1 - 0" - 30" Sand
S#2 - 0" - 32" Sand w/small amt
of grv).
S#3 =•0" - 35" Sand w/small amt
of gr.vl.
SO - 011 - 48,, Sand
No Water Table encountered
e
fps- Goa•/�^ -l��on S 2/-if '7�l.�
Dr+os,�:r/o/ . Lora Sys
-
2'2.c.
,44c w ��G✓
REID. MIDDLETON & ASSOCIATES. iNc.
ccksmIrINO [NOINE[M • L."D 9UNv9vO" 3 7
... MI... A.. M.Ow., w"M I... ►YVIC _....V[M.•IT MUM.
RECEIViv
CITY OF EDMONDS
DEPARTMENT OF PUBLIC WORKS
250 Fifth Avenue North, Edmonds, Washington
SEPTIC TANK INSTALLATION PLAN
(Submit in Triplicate)
jUN 5 1974
Ed►�wilds Ea;r. G"A�-
ADDRESS OF PROPERTY. _...... %--.... Lot No........ Permit No. --------------
Owner .... '...................... Address.. b?-6...i•-I'G:i;2;41P_-.ik. ."C...?j.....S.eatei�hone.
Builder........................................... .............. Address......-..----------- ------------- • --- ------ Phone......................
Designer.. Address--- 1"14--11ai-r..'ot.a......€ dzi;arnus .............. Phone .... 775".315. 1-
r---
Installer..--.1Q,lil ° a.. Loath r.c. 3._l?.ro:iit3cts ...... Address...�.g,.. �.. � ,�..GQ'm � � � { �t�_ s f
3 ^ ' -3- -...--Ar-i 1ir,,2tpn..... Phone.--. �� ....��`�-f-
�tne.
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 ................
a i --------- ------- --------have been complied with.
.......... ------del"IC....... l 1
Signature of Designer It
TO BE FILLED IN BY CITY ENGINEER ONLY
Accepted...... ....................... ............................... Date.......... .......................
NotAccepted .................. ................................... Date ...................................
Signature of Sanitarian ...........................
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.
/
/
/
/
/
/
.
/
a
D
/
d
P
P
A
t
/
T
I
Owner:
Ernest Birlenback
18228 Fremont Ave N
Seattle, Wn 98133
Ph: L 12-5793 Horne
763-9.120 office
Legal Description:
See' attachhe� al
h
est n Data:
sign Rate: 3 min/In
rovide 1000 gallon septic
tank2 rovIde'// if by Z.s'wide
laterals; total drain-
fleld area - Szz S,q.ft.
min. of 12" of gravel
ha_I1 be placed where
roes, are encountered.
e system shall be in- i
stalled in accordance
w/ City of Edmonds.
Health Dept. Rules S Re
Perc. Rates:
/ P#I-_T.0T-min/in
? P#2 - 2.38 min/in
/ PN3 - 1.93 min/in -�
So I Lo sf
/ 5 ` - 0" 30" Sand'
S/2 - 0" - 32" Sand w/smell amt
of grvl: _
/ Spa - 0" - 3S" Sand w/small amt
of grvl.
s#4 - v - 48" Sand
.1
No Water Table encountered.'
t
5 =/ 3--7 9' '.00w,
1-
fo,e
Tiocr 87��/. :� •�/<��.w..G✓ Ate`
REID. MIDDLETON do ASSOCIATES. INc.
CONSULTING ENGINIMPS • LAND SURV[YO" ,r3 %
u• r•w �., warao. wur �.i•'.anc •va...vswrrr w•wr �, / •,
,- -. RE
87 �
CITY OF EDMONDS JUN 5 1974
DEPARTMENT OF PUBLIC WORKS Edmonds Engr. Dept+
250 Fifth Avenue North, Edmonds, Washington
SEPTIC TANK INSTALLATION PLAN
(Submit in Triplicate)
ADDRESS OF PROPERTY.. ......................... .................... 72nd..Avp . ..... U-_ S t ...... Lot No.------------.......... Permit No.363,1.........1-1..
Owner.---C�ri*Sat...S.1.t'.let'1bach......................... Address ...l$228..Frerm$.Ava--A..-_Seattlfhone.U2.-57 -3---
Builder-- -- ....... -----._...... ............... Address.-- ---.........._..... ----------- :.....-........................ Phone...------------------...
Designer. -..Re.s.d.,...f41dd.l.e_.t0l--- &..As.soc...-. Address...32A.14aln--St CdmOndr.-------------- Phone..:.775-3434.
Installer --- J-4?l"n...&.X011creta P.rod4Jcta...--- Address...Ptt --5-.80:4- 4-3-nA....AK-1-laq,$$� 9rl----- Phone .... 65.9-570k
1.14n
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. ........... .
$1� .' ..........................have been complied with.
----61!;-------------
Si --nature of Designer. Date l
t
TO BE FILLED IN BY CITY ENGINEER ONLY
Accepted...._ ...................... ................................ _. Date.. --- --- ............. --
Not Accepted .. ......... Date .............................. ... .....
Signatureof Sanitarian.........................................................................•----- ------
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 ivay 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.
i
4. Limit toilet fixture disposal to sanitary wastes and toilet tissue.
5. Detergents and bleaclies used in normal household quantities will not harm the action of the septic tank and
disposal field.
r..
/IOQ
Lot Csi
N � '
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0
h '•. " O sz'
h
0 5af't�� S
0. . � i Tn� • iq o
13
N
ISodrp
r:
it Birlenback
18228 Fremont Ave N
Seattle, Wn 98133
Ph: L12-5793 Home
763-9120 office
Legal Description:
See -attache3 legal
De s_i_gnD_a_t_a_:
Design n Rate: 3 min/in
Provide 1000 gallon septic
tank
P rov i de • Z// 1 f by Z:S" l de
laterals; total. drain -
field area-S27S,q.ft.
A min. of 12" of gravel
shall be placed where
trees are encountered.
The system shall be in- `
stalled in accordance
w/ City -of Edmonds
Health Dept. Rules 6 Re�
Perc. Rates:
P # I - .0 min/in
? PN2 - 2.38 min/in
/ PN3 —1.93 min/in .
Soil Logs:
S - 0" - 30" Sand
/ SA2 - 0" 32" Sand. w/small amt
-of grvl .
l Srr3 0" - 35" Sand w/small amt
of grvl.
SR4 - 0" - 48" Sand
No Water Table encountered
Ica
v�sedt�zs• 1n 5'-/3-7�4.QrP.tl,
` REID. MIDDLETON & ASSOCIATES• i►+c. kdie
I
coNsuvnma trwlrteoes A LAND SUNvtvowi Y..3 7
l�• Y.W f1.. ■DYOYOY. .IYY 1-1► ►-C ..9_ T - -�• �,
ILE RECEIVED
CITY OF EDMONDS APR 151974
ENGINEERING DEPARTMENT Etlnlands Engr. Dept.
250 Fifth Avenue North, Edmonds, Washington
APPLICATION FOR A SEWAGE DISPOSAL SYSTEM PERMIT
(Submit 3 Copies)
Ernest Birlenback - 18228 Fremont Ave. N., Seattle, Wash. 98133
Permit to be issued to: .......... I ......................................................... -------------
For installation at: (street address) ..........See attached legal 40 C S''... 72 ;ow
Addition or Subdivision... .... P 1 a t.. of---Meadowda 1.a ... 6e.ach...................... Lot................ Block ................
Type of Building: New... x...... Existing ............ Single family residence ..... x......... Number of bedrooms........ 4................
Other: (specify type or use)-------------------------------------------------------------------------------------------------------------------------- --------------------------
Builder----------------------------------------------------------------------------------- Address.................. .---......--- .--...--.......------------------------------------
Designer....... Re-i d , _ __M.i.dd.l.e.tan...g.-.As.s-o.c....................... Address._ 3.2----- Ma i_R.. S.t r ee t.,.. _Edmond s.,-.-Wa s h ... _..9 $020
0" - 48" Sand with forest litter cover
Soil Log Hole No. 1.................... -------------------------------
----------------------------------------------------------------------------------------------------- - -- ----- ------------------- --- ---- ------------------- ---------------------------------------
0" — 35" Sand with forest litter cover
SoilLog Hole No. 2...................... -.................. ----------------------------------------------------------------------------------------------------------------
Elevation of Water Table, if encountered. (Distance from ground surface) .......... None.............................
Corrections to control surface water if needed.......... NQrie.....................................................................................................
Specify if any removing or grading of topsoil in field area....... None
..........................................................................................................................................................................................................
Percolation:
Test Hole No. 1 —Average Rate ... 2...08 min./..i...............n (Fall in ►nnutes/inch-bottom 6" test hole)
.... .
Test Hole No. 2—Average Rate ..2 .8 min/ i. n . . _ ..._. . (Fall in minutes/inch-bottom 6" test hole)
Test Hole No. 3—Average Rate ...1...9 3...m i n/ i n ....... ....... (Fall in minutes/inch-bottom 6" test hole)
Average percolation rate on which to base drain field design ...3 min/in Date Taken4/11/74.
Septic ank requirements based on present rules and regulations:
'Septic Tank Size.........1,000 gallons.
,/ Amount of Square Feet is)osal Field..-460 s q . f t .
s� � Z
Signature — Designer---------- ----4":vl........ ..-------- - - .. ..............--... Date....... ----.----- ......./...../.. -------
DO NOT WRITE BELOW THIS LINE (To be completed by Issuing Agency)
(G Permit issued (date) ............. !1
f n s�...^s . .7...=/.:...................Permit Number ---------- '.43.......------------..
Remarks:........................................................................................................................................... .. .. ..........—...--.................
P� ----------------------------------------------------------------------------------------------------------------:-----------------------------.....------------------.....-----.................... .......................
E � SSE �t/Ew✓ DWG. �P/'�'o✓� S/3•%�
Not
LEGAL DESCRIPTION FOR ERNEST BIRLENBACK
All that portion of Tract 87, Plat of Meadowdale Beach according to plat
thereof recorded in Volume 5 of Plats, page 38, Records of Snohomish County,
Washington, described as follows:
Beginning at a point on the easterly line of said Tract 87, south 0013'15" East,
151.75 feet from the northeast corner thereof; thence S64043'45"West, a distance
of 23.38 feet to a point of curve; thence westerly along the arc of a curve
to the ri.ght having a radius of 112.10 feet and central angle of 410081, a
distance of 80.22 feet to point of tangent; thence N74016115"West, a distance of
42.18 feet; thence N0013'15"West, parallel to the east line of said Tract 87, a
distance of 156.91 feet to a point on the north line; thence N89059'11"West
along said north line a distance of 330.0 feet; thence S44030'E, a distance of
172.25 feet; thence S74016'15"E , a distance of 252.14 feet to a point of curve;
thence easterly along the arc of a curve to the left having a radius of 137.10
feet and a central angle of 410001, a distance of 98.11 feet to point of tan-
gent; thence N64043'45"E, a distance of 11.69 feet to a point on the east line
of said Tract 87; thence NO°13'15"W, along said east line 27.60 feet more or
less to the point of beginning; EXCEPT any portion lying within the east 10 feet
of said Tract 87.
Subject to a permanent, non-exclusive easement for road and utility purposes across,
over and upon the southerly 25 feet thereof.
$ zs•
.Sa�oY's Tir.F; b
k
0
i
D�.A-0 -�
5
rA
RECEIVED
AID; � 15 1974
U:2!1"'s Ea;r' Dept.
1
/
Owne r :
Ern st Birlenback
/ 18228 Fremont Ave N
Seattle, Wn 98133
/ Ph: L12-5793 dome
/ 763-9120 Office
Le al Description:
J
/es
See attache legal
/ i n Data:
/ gn ate: 3 min/in
vide 1000 gallon septic
ank
/ Provide 230 if by 24" wide
laterals; total drain -
field area - 460 sq.ft,
A min. of 121' of gravel
shall be placed where
f Xe
es are encountered.
{� system shall be, in-
1V stalled in accordance
% w/ City of Edmonds
Health Dept. Rules & Re
8
Perc. Rates:
2 `min/,
P#2 - 2.38 m /in
/ - 2 .9 min/in
% Sol- Lo s:
-0"-30"Sand
/ S#2 - 0" - 32'! Sand w/small amt
- of grvl.
S#3 - - 35" Sand wismall amt
of grvi.
S#4 - 0" - 48" Sand
No Water Table encountered
0 M A ,
y ;
,
s,
; ^>�s. `'�.umis...s�...
�' %2nc� Al/Eii/UE `t/EST
.NJ
Is )4
L
6's'f; pr1
I
/
/
/
I (�� s
t
Soil Lo
S - 0
/ S12 - 0-1
/ SO 01-
Owner:
Ernest Birlenback
18228 Fremont Ave N
Seattle, Wn 98133
Ph: L12-5793 Home
763-9120 Office
Legai Descri tion:
See attached egal
Desi n Data:
Des gn Rate: 3 min/in
Provide 1000 gallon septic
tank
P rov i de Zo7 . l f by 3ol'.w i de
.laterals; total drain -
field area - 6i7,S1q.ft.
A min. of 12" of gravel
hall be placed where
rees are encountered.
The system shall be In-
stalled in accordance
w/ City of Edmonds
Health Dept. Rules S Reg,
Perc. Rates:
P#I - 27-07"min/in
PN2 - 2.38 min/in
P#3 - 1:93 min/in
s:
30" Sand
32" Sand w/small amt
of grvl.
3511.Sand w/small am*
of grvl.
SO 4 - 011 - 4 8" Sand .
No Water Table encountered
CITY O� EDM<<ONDS ENCINEERAG DEM.
Examined bby— **
Date
Remarks--����%
{
STR�U RLE RECEIVED
CITY OF EDMONDS AP'R 1.51974
ENGINEERING DEPARTMENT
250 Fifth Avenue North, Edmonds, Washington (�:: i's:.I
APPLICATION FOR A SEWAGE DISPOSAL SYSTEM PERMIT
(Submit 3 Copies)
Permit to be issued to:
Ernest B1r1enback - 18228 Fremont Ave. N., Seattle, Wash. 98133
-• • •.... ---- •--- .
For installation at: (street address) .... ...... See attached-.isg91
Addition or Subdivision .... T.C.act...8L.-RI.at..of...Meadoetdale...beach...................... Lot................ Block................
Type of Building: New....?...... Existing ..... ....... Single family residence. .... x......... Number of bedrooms.......A...............
Other: (specify type or use) ----- --------------------------------------------------------------------------------------------------------------------------------------------------
Builder--------------------------------------------------------------------------------------- Address......................---.....-----..........--.....----------------------------------
Designer......_Re.1-d.,...Mi.ddleton..S..As-soe...................... Address._ 32k-.Main..Ureet,-. 0mon4s-,._Vash.-_98020
Sand with forest utter cover
SoilLog. Hole No. 1.:....................•-------------._..-.-.------...................... ......._....
------------------------------------------------------------------------------------------------•--•---------.........................--------................----............---............----......
Soil Log Hole No. 2
0" - 35" Sand with forest litter cover
.. ---
Elevation of Water Table, if encountered. Distance from ground surface None
Corrections to control surface water if needed ........... t.1.0na....................................................................................................
Specify if any removing or grading of topsoil in field area....... None
---•...........................•--•------•-------•-----...................---------•---•-•-----•-•--•-----------..............-----.....------....................--.--...................................
Percolation:
Test Hole No. 1 —Average Rate .....
... 08 m 1 n/ i n (Fall in minutes/inch-bottom 6" test hole)
................. .
Test Hole No. 2—Average Rate....Z.4.38..min/-in..........................(Fall in minutes/inch-bottom 6" test hole)
Test Hole No. 3—Average Rate....�..:93..���.ln ......(Fall in minutes/inch-bottom 6" test hole)
Average percolation rate on which to base drain field desi,�In ...3..min/fn................ . Date Taken--
Septic tank requirements based on present rules and regulations:
Septic Tank Size .........1000.......... gallons.
Amount of Square Feet Disposal field. 60 Sq. ft.
I
Signature — Desi ner.... Date ` .....�.Z�./....�
g g .................... .
DO NOT WRITE BELOW THIS LINE (To be completed by Issuing Agency)
Permit issued (date).......--� 'v�Z �---7. .......-•----------------Permit Number ......----29F41?....................
Remarks:..Ftew..-Q4.e I ..D--'?S\..L ec� t...Pm...5 s.111�4---.C%_X-R.e..�. F.� .........
.... M�'T... WI -r-0.5...�f_da.AUILTS-----------•-------_-----------•....................................................•-----------------------------
y
LEGAL DESCRIPTION FOR ERNEST BIRLENBACK.
All that portion of Tract 87, Plat of
thereof recorded in Volume'5 of Plats,
Washington, described as follows:
Meadowdale Beach according to plat
page 38, Records of Snohomish County,
Beginning at a point on the easterly line of said Tract 87, south 0013'15" East,
151.75 feet from the northeast corner thereof; thence S64043145"West, a distance
of 23.38 feet to a point of curve; thence westerly along the arc of a curve
to the right having a radius of 112.10 feet and central angle of 410081, a
distance of 80.22 feet to point of tangent; thence N74016115"West, a distance of 42.1
42.18 feet; thence NO°13'15"West, parallel to the east line of said Tract 87, a
distance of 156.91 feet to a point on. the north line; thence N89059'11"West
along said north line a distance of 330.0 feet; thence S440301E, a distance of
172.25 feet; thence S74016115"E , a distance of 252.14 feet to a point of curve;
thence easterly along the arc of a curve to the left having a radius of 137.10
feet and a central angle of 410001, a distance of 98.11 feet to point of -tan-
gent; thence .N64043'45"E, a distance of 11.69 feet to a point on the east line
of said Tract 87; thence NO013'15"W, along said east line.27.60 feet more or
less to the point of beginning; EXCEPT any portion lying within the east 10 feet
of said Tract 87.
Subject to a permanent, non-exclusive easement for road and utility purposes across,
over and upon the southerly 25 feet thereof.
a
f-• �' 72�� 'A!/Eil/UE NEST
h
ioo3
/
Owne r:
Ernest Birlen'back
! 18228 Fremont Ave N
Seattle,,Wn 98133
Ph: L12-5793 Nome
763-9120 Office
Leal Description:
See attached egal
Design Dataa:
/ Des g—i� n Rete: 3'min/ln
/ l Provide 1000 gallon septic
l tank
o �A Provide 207 � 1 f by _161" w l de
,._
�3� o /0006a/, ' laterals; total drain-
zo SaPt,z field area-617,Aq.ft.
IIDS
A min. of 12" of gravel
\
.A / (� shall•be placed where
i3 'Q �%1
�� ,trees are encountered.'
'm _ ..82 h The system shall be in-
1G��. stalled in accordance
s g Liw� w/ Ci.t (�'` ....,........- : ! 6's?: hn� rki o y of Edmonds
�� l Health Dept. Rules 6 Reg,
4- t� -- Perc. Rates:
P#1 -2 . (gymin/in
? P#2 - 2.38 min/in
/ P#3 - 1:93 min/in
Soil Lo s:
S -0'-30"Sand
/ S12 - 0" - 32" Sand w/small amt
/ of grvl.
/ S�3 - 0" - 35" Sand w/small amt
/ of grvl.
SA - 0" - 481, Sand
s
No Water Table encountered
CITY OF EMAONDS . ENGINEERING DEPT.
Examined by - -
Date
Remarks— '
�••�> {q�.y-.._.. -_irl. :..:..W-_9k .•'kt •�.i �?�.'�& eo-�.._)�CG}'S_`:a�l`4 �iM�'•ias�_`•K.�•..#y
4
r:
st Birlenback
8 Fremont Ave N
tle, Wn 98133
L12-5793 Home
763-9120 Office
-scrri tionn:
ach- ed a 1
9:
3 min/in
)0 gallon septic
If by 24" wide
total drain -
:a a 460 sq.ft.
12" of gravel
laced where
:ncountered.
shall be in-
n accordance
>f Edmonds i
:pt. Rules 6 Recu
d
d w/small amt
grvl.
d w/small amt
grvl.
d
No Water Table encountered