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17122 TALBOT RD
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The City of Edmonds
APPLICATION
for
SEDE SEWER PERBUT
NEW CONSTRUCTION E] REPAIRS
Ll-(uj,o - L / t� g , , � -
EASEMENT No.
A-1
.............. if ..... r . ........
OV*rNER ........ . ............. CONTRACTOR .................................................................. .. . ......... ......... PERMIT No.
ADDRESS .... ....... ..................... BL4DCK No . ....................
2 .. .........
................................ LEGAL DESCRIPTION: LOT No . .........................
NAME OF ADDITION J,,
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APPROVED
APR 1 7 1910
Approved:
..... ........... ......... . ......
..0..
DATE .... ---- .................
Property Description - R.F. Aline - 171.22. Talbot C) a d.
B e I 'i A t"I C; C, r
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"N 1 4 o h e Tru(-.! Po-.nt of Bep-InnIng;
h e n c e coril-1-nuo 3 4 4:1 16' 50 "' IN 85 feet; tbence N 45043"I'o IN
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165 f e, o
:_CITY'. OVEOMONDS
.6an_p1jospect 6-�107 wheno' work
CIVIC -'OE WATER -"SEWER DEPARTMENT:.',... iris
NTER ready1for pspecti�n- (N .
".. ' ".y,� or bolid�ec;- N2 316-6 3
tions Satui
SIDE SEWER PERMIT
-122 ............ ..............................................
ADDRESS ....... %X%2:ZX%XM'%'a ..... 17. ... Talb.ot..R6 . . ...............................................
OWNEP ........... RMXay= ..... Robert ... Aline .................... I �CONTRACTOR . ..... liya�.�t ... -no . . ......................
Peril-iission is granted AprjtL..L7 ............ ....... O.M., for ..... ................... dayi;"th7 AEPAIR or. CONNECT a side sewer
witil city Sewers in accordante witil ap�llcabon on file and4oveftiluk ordlhances-..
ATTENTION IS CALLED TO THE FOLI�OWING:
NOTE No. 1—The owners of the property may obtain a, permit to 'construct sewer iris Ide property line. A licensed Side Sewer Contractor must
be employed to construct side sewer in street area. Do not. cover. any portion pf sewer before It has been inspected.
�p'—E No. 2—Obtain full information regaxding Ordin . anew 11A . 6.030 and . Regulations governing side sewers.when You get permit.
f side se-wer must have at leas . t 30 Inches co, . verage at property . line and 12 Inches inside property line; minimum grade of 2%.
3 No. 3—Top o
No bends in grade sharper than % will be permitted."
NOTE No. 4—Trenches in street m I ust be water settled. . and I surface of street restor . ed to original condition. Contractors shall be responsible for
faJIure due to improper Work which ma;y develop within one�'�ear 6f completion.
NOTE No. S—It is unlawful to alter or do any other . work than is'provided for In the permit, or to do any work on the main sewer or its appur-
tenances except to Insert the pipe Into the wye.
PW A. 1�
'No.
Septic Tank ............. g a I s.
M)w ............
F tDMON 0-
C11 T Y:,� 0
-o- PAHC W
ft. Department �t�s,
Diip. Yield....
Other..........................................
Name ........... . ...... is here�by 44�orized to �install/
;.� .................................
repair sewage
disposal system, at
................. ...................................................................................... Z
...............
..........
...........
0— V ........
4/
Date issued on ... ...... / . ........
Permit expires one year from *date*' of issue,
T
-DO NOT -COVER- BEVORE,�'AP:'P"ROVED�'�BY'�,DESIGNER,�OR SAM ARL�N
control- and complies with all provisions of the City�,
I hereby certify this system was ifistalled' under. my.supervisi,ir fid
of Edynonds Resolutions.
"Sigiid;tur� of Installer.. ...............
.......................................................................... Date ....... .............
ApprovedDisapproved F� Date ...................... .............................. ........... By ......... t .................. ...........................................................
Remarks: ................. ........ : .................. .................. ...............................................................
......................... ................................................
SANITARIANOR DESIGNER ............. I .......................................................... ............ i ............. Date ......... ....................... o .........................
This permit shall be post I ed in a reasonably conspicuous place on the' job' until inspection has'bein completed.
0 0 job # 670 0 0
SNOHOMISH HEALTH DISTRICT
DIVISION OF SANITATION
3011 Rockefeller Avenue, Everett, Washington
APPLICATION FOR A SEWAGE DISPOSAL SYSTEM PERMIT
(Submit 3 Copies)
Permit to be issued to: .......... Robert Aline
------------------- / ----------------------------------------------------------------------------------------------------- --------------
1W.19 Talbot Road
For installation at: (street address) .......................................................................
- ------ ------------------------------------------------------------
Addition or Subdivision ------------------------------- Se.e..Attached -------------------------------------------------- Lot ---------------- Block --------------_
.... .. ....................
Type of Building: New ------- X.X-,-- Existing ------------ Single family residence ----- 78_q---- Number of bedrooms .... 23 --- _------------
Other: (specify type or use)
Robert Aline 51362 161st Place SW, Edmonds
Builder------------------------------------------------------------------------------ Address ----_------ ----- I ------ -------- ------------------ ------------------
Designer .... Ron Whaley & Associates 7301 179th S.W. Edmands
- ---------------------------------------------------------------------------- Address. --- _1 --------------- ----------------- _ --------------- --------------------------
Soil Log Hole No. I ---------- 0 -- — --- 17 " ..... Bra --- Sa --- Si --- 1,o_.w/_coars.e_.Gr ........................... I ............................ I -------
....... ------- .... .... - ----- ----------- .....
17 — 48" R Bm Sa Lo w/coarse Gr
........................................................................................................................................................................... ..............................
0 — 20" L Bm Sa Lo w/coarse Gr
SoilLog Hole No. 2 --------- --- --------------------------------------------------------------------------------------------------------------------------------------------
20 — 48" R Brn $a Lo w/coarse Gr_
....................................................................................................................................... % -------------------------------------------------------------------
Elevation of Water Table, if encountered. (Distance from ground surface) ----- ...... --_--------------- -----------------_-----
Corrections to control surface water if needed ------------------------------------------------------------------------------------------------------------------ ......
............................................................................................................................... __ -----------------------------------------------------------------------
None
Specify if any removing or grading of topsoil in field area ..................................... -------_------------------ --------------------------------
.................................................... I ..................................... : ...............................................................................................................
Percolation:
3.2*0Test Hole No. I —Average Rate --------------- .................... ----- (Fall in minutes/inch-bottorn 6" test hole)
1010
Test Hole No. 2 —Average Rate --------------- -------------------- ------------ (Fall in minutes/inch-bottorn 6" test hole)
8,6 Test Hole No. 3 — Average Rate ----------------- ------------------------------------- (Fall in minutes/inch-bottom 6" test hole)
Average percolation rate on which to base drain field desigm.... .... _10* 2 min/inch
.......... -------- _1 ------ ---------------
Septic tank requirements based on present rules and regulations:
Septic Tank Size --------------- �00 ----- gallons.
Amount of Square Feet of Disposal Field ................. 5.04 ----------------- -
Signature — Designer ------ .................. 7/17/63
-------- ---------------------- Date-. ----------- ------------ ---------------------
DO NOT WRITE BELOW THIS LINE (To be completed by Issuing Agency)
Permit issued (date) ------- ......................... Permit Number ----------- //_� -------------------------
Remarks: .... ............................................ -----------------
.................................................................................................... ----------------------------------------------------------------------------------------------------
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