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17316 73RD AVE W.PDF111111111111 5739 17316 73RD AVE W tA Fii- E. The City of Edmonds APPLICATION for LYN.N PLAINT SIUDE SEWER PERAHT EASEMENT No . .......................................... NEW CONSTRUCTION,M,�,— REPAIRS E] I / f) //" /-/ (-'-Ice- ) OWNER 1,jArlfj�� ...... 4 ........................... ADDRESS -.173146 ....... .......... . ............ CONTRACTOR .-V ........... ...... . . ........................ PERMIT No. LEGAL DESCRIPTION: LOT No. ........................... BLOCK No. — I ....... ------------------- I-c)7- 15�;' /W �r NAME OF ADDITION ............. r ............................................................................... 44 0 J t J 5 CITY OF EDMONDS CIVIC CENTER — WATER —SEWER DEPARTMENT Call PROSPeCt 6-1107 when work is ready for inspection. (No inspec- SIDESEWER PERMIT tions Saturday, Sunday or holidays.) N2 3604 ADDRESS ................... 17 ..316 ... M ... 7.3rd._Amenue ... WjqA.t. . ..................................... . ............................................................................. OWNER .......................... ...................... coNTRAcToR --- We - ste ' r ' n ... Sewe ' r ... * ..................... Permission is granted ....... Mar-C11_10 ................. 19.3-0., for ------------------------ days to REPAIR or CONNECT a side sewer With City Sewers in accordance with application on file and governing ordinances. ATTENTION IS CALLED TO THE FOLLOWING: NOTE No. I —The owners of the property may obtain a permit to construct sewer inside property line. A licensed Side Sewer Contractor must be employed to construct side sewer in street area. Do not cover any portion of sewer before it has been inspected. NOTE No. 2—Obtahi full information regarding Ordinance 11.16.030 and Regulations governing side sewers when you get permit. NOTE No. 3—Top of side sewer must have at least 30 Inches coverage at property line and 12 inches inside property line; minimum grade of 2%. No bends in grade sharper than % will be permitted. NOTE No. 4—Trenches in street must be water settled and surface of street restored to original condition. Contractors shall be responsible for failure due to Improper work which may develop within one year of completion. NOTE No. 5�—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. STREET Ffla& OF EDMONDS DEPARTMENT OF PUBLIC WORKS 250 Fifth Avenue North, Edmonds, Washington SEPTIC TANK INSTALLATION PLAN (Submit in Triplicate) ADDRESS OF PROPERTY .......... 17316 - 73rd Ave. W ............................... Lot No ....................... Permit No ...... 3.3.8 .......... ................. I ....... ........................... Owner------ - Dr.__..F.....K..T9pham ............ ........... . Address ... --------------------------------- ......................... ... Phone ........................ 8704 - 182nd P1. 4 W Builder ....... ...... Address ----- . . .. ... ........................ i 2q. � ........... Phone ........................ Designer.... Pro --- F,,..K._.Tpph_am ............... I ........ Address ..................... ............................................... Phone ........................ Installer ..... Richmond Concrete Prod . ....... Address.. _171.1-9 --- Fiighw.ay --- 99 ------ ......... w ........ Phone .... 7.43.-3.22.3. ...................................... ............... -- -- - ---- -- .... . .... .... .... . 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 ............. . .......... 4/3169 ................. .... have been complied with. .......................... ........... I ........................................................................... Signature of Designer Date TO BE FILLED IN BY CITY ENGINEER ONLY Accepted .................. X._ .......... ................. ...... ... Date ........ �4/181.69 ........ Not Accepted .......... D e ....... ------ ------------- --- Signature of SmTibfirian ........ C --------- &� . ............. Remarks: ...... ....... ....... ...... 'Ir e�' 410 ........... .................................... ................ 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- loadin,g 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 (2y2-3 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 ove'r 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. SEWAGE DISPOSAL PERMIT Septic Tank ............. CITY OF EDMONDS No. ............ Disp. Field ....... '/'�)__sq. ft. Department of Public Works Other ------------ Name ------ --- — ------------_--_ --------------------------- -------------- --- As hereby authorized to install/ repair sewage disposal system at ------------- ------------ --------------------------------------- ......... ---------------------- ----------------------- ............................................................ Date issued on_ --- ------------------------ Permit ex ires one year from date of issu p e 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 Cit y of Edmonds Resolutions. Signatureof Installer ---------------------------------------------------------------------------- Date Approved D"' Disapproved Date ----------------------------------------- ---------------------- By ------ -------------- ...... ...................................................... Remarks: ------------------- ------------------------------------------------------------ ----------- ---------------------------------------------------------------------------------------------------- SANITARIANOR DESIGNER ------------------------------------------------------------------------------------------------ Date .................... This permit shall be ...................................... -posted in a reasonably conspicuous place on the job until inspection has been completed. 7 7 4: CITY OF EDMONDS DEPARTMENT OF PUBLIC WORKS 250 Fifth Avenue North, Edmonds, Washington APPLICATION FOR A SEWAGE DISPOSAL SYSTEM PERMIT (Submit 3 Copies) f", ��10 _� Permit to be issued to: ................... D;e ............ ----------- ............. ... ........... ..... For installation at: (street address). ......... 1_773-0 ---_--- I- ........................................................................... V;,, V C, 16C Addition or Subdivision.A enipo .... ? 75b% r ..... 0?9 ... 770.14�! Wn(-Vz Ldt_� .. ..... lo'c ................ Type of Building: New .... ��Existing ............ Single family residence ...... ��umber of bedrooms ------- .......... Other: �specify type or use) ..................................... .................................................. _ ------ ......... ................................................ Builder ....... ..... . C6 ---- - --------- ---- Address ------ .8 X-191 ------ Designer......................................................... ........ ---_-------- Address ...................... ........ .............................. ------------- ------ Soil Log Hole.No. I A,1 40' ......................................................................................................... ........................... .............................................. ..................... SoilLog Hole No. 2 ......................................... ......................................................................... ................. .................. Elevation of Water Table, if encountered. (Distance from ground surface) ................ 410 ................................... Corrections to control surface water if needed .................................... ............ : S5 -.4 t. 4 ..................... .................................... .............................................................................................................................................. I ...................... *,bl 5.,5- Specify if any removing or grading of topsoil in field area— ........ . . ..... ........ ....... I ........... ........... ..................................................................................... ..................... ............................. ............................ .............................. Percolation: 'A�j5o'pp ,- t2w_ Test Hole No. I —Average Rate ........... 61.1-6 ............... (Fall in ininutes/inch-bottom 6" test hole) Test Hole No. 2 —Average Rate ........... �57_I�_7 ----- .................... .. .. (Fall in iiiinutes/inch-bottom 6" test hole) Test Hole No. 3 —Average Rate ............ . ............. .. .... (Fall in minutes/inch-bottom 6" test hole) '& Ply, Average percolation rate on which to base drain field design ............... 7r ....... . Date Taken_,:5�74' Septic tank requirements based on present rules and regulations: Septic Tank Size ------- 17.0_0� ........ gallons. Z_ Amount of Square Feet of Disposal Field ................ Signature — Designer .......... ...... ................ Date ........ '//sAcl ................... DO NOT WRITE BELOW THIS LINE (To be completed by ISSUing Agenc Permit issued (date) .......... ------------------ * ..... Permit Number.. ;;V ....................... -------- ------------------------------------------------------------------ Remarks:.---- - ---------------- ------- - ----------------------------------------------- 5.# 0 4t �17 46 4,9 0 .7-opha t" ke .5 I'de t"OPC 6, - 1-->Z 0 / /7