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17329 73RD AVE W.PDF11111111111111 14986 17329 72ND PL W APPLICATION -7 r--t p- for SIDE SEWER PERMT ELE The City of Edmonds S ET F� NEW CONSTRUCTIONK REPAIRS E] ............ OV*rNER. . ........ <�7 ADDRESS ... . ...... IZ2 ....... BASEMENT No . .......... CONTRACTOR ........... PERMIT No . ...................... LEGAL DESC RIPTION: LOT No . ..................... I ... 5 ...................... BLOCK NO . ............................................ NAME OF ADDITION ........... ..................... .......................... 7,3 ,-� Approved: DATE................................................ By ...................................................................... APPLICATION The City of Edmonds for EASEMENT NO - ---------------- ............... ----------- SIDE SEWER PERMIT NEW CONSTRUCTION REPAIRS LID NO. ----- ASMT. NO... OWNER ..... Fv---f Y ------ . ....... CONTRACTOR .................................................................................... PERMIT NO . .................... JOB ADDRESS ---- k -1 - -i - \,t-) - 7E-�> -------- BLOCK NO . .................................... -------------------------------------------------------------------------- ...... LEGAL DESCRIPTION: LOT NO - ------------------------------ 7-'7 .................................................................................................................................................................. NAME OF ADDITION -,j kt-zNN �- AVH \ < -- -1 V A7 I :---: - I ................................................................................................................... Approved: DATE ......... 7�1 -.-/ ----- ----------- By The City of Edmonds APPUCATION for SIDE SEWER PliRMIT NEW CONSTRUCTION El OWNER JOB ADDRESS 1-7 -A-L� - ----- 715d wkw EASEMENT NO - ------------------- ------------------------ REPAIRS Ej LID NO. ---/4-4--.ASMT. NO. ---------- CONTRACTOR ............... ------------------------------------------------------ ------------- PERMIT NO. LEGAL DESCRIPTION: LOT NO - -------------------------------------- BLOCK NO - ------------------------- ... �5 -- ----- - - C�D-u vi d U t'e . ....... t,( e 'k 5 ................ ------ ------------- - q-4� ----------- ne ?+A*W-,9F--ADDFI4GN -0 ...... Lj- L, -- ----------- c ----------------- Vvi e-J-4 3A� 0,�- ) � l-e tf,� 6 7 1 Lt 3 b 3 5- -7 ; �o " Anprn—Aw DATE BY---------- '.77 T-i �e, -SE UVER"PER) "PHZI.. "11 1 , .,yV!2i -0, FIEDM, OP, Y ..-SIDE I JGNT WOW_ 7,-: NN 7, MOM OU RM TE' T Tv 1 S. po o�l 5 C� 5 2 6 �'f olr�q i i e;, cov, lz: �n �R x4p._qp�Sflon' y 1;',`,bJ R"S p 1-0- p SAWS I,, —Cox -7— :z, 0, ......................................... . ........... ................................. DRESS��L-OCA-1-ION��'OF,�itONSTRUCTION�, ..................... ...................................... ................. ................................................... .. ... .,�Y M. MWQ G DESCRIPTION.:�'-.' ........... ... dill "Oh �v 0 lot -, V­ a -�,U�.�J,) too"? 0 t�_-:j4 -.0 23� .�zz: . - . . . . _. , . . :� ....................... .... ...... ........ . .... _�61WER"ANDY LDER*_ -------------- .... �OR,`BUI ................................ ............ ......... IS-- r CONTRACTOA,S'W' .......... . ......... ..... ...... ........ 'ide. .4 dpiL 19:� ..... .. for r ihfiftd/6'r conni��i cordan��With:-Cltyof. Edm_ bnft-, ord"6ia� '6 p es*,,ze*, :.J 'LED, 2: V NMOM-1S�CkL �TO�THE,FOLLOWR46':�- v0V obtain,aC'Permit �to;-construct-sewer-� Q Ut —,a et �arbd: -Do.noticov6r.'any-portion. POPO has,bee=bec 7--0 MQVAWW�, "IM, :from", the.,*City Engi r rTed�,i` t.�,� rig, Lm '14&E-N�q3-0 Ion,, r*dg&d In k-,Cird ina Kce'-'4`1.'4'�.*bZt6' �tn !rTW j j, 'N n'954 —Tom 0 fA6 I d L*n s 6 w 6 -:m'�k'�Iiay_e��R t -- I,e mt- 0 - i q c�es �'c? v��agc, �Lt,. P rope rt Y� I I 4�;a�na`- i i; I n�� Inslde� pi�ope�ty,_j�pe:,..n�jnj '-will'be -permitted-.-';-. "Mum M �"w I , A j ,­7�k�a . e.water.settiea:,and�,surfacc*,of-strLct �OOOleOl-nal',!c6ndition-,�'Coritractors�sLil.� e ;��Qrjk,,�vhi'61i ifiia�� d evo�p-,_�.�t t � i n� 'of 166m letim. 7 �er.,,oiL;do,any�qthqr wo�,, 1h r, t %�.ork riiili,:�or 'L.46�� -,on 4h6,-..ma,�n5` 7 . . . . . . . . . . . . L -7 Y.. Y. B .. ... :? AW N, "4r ........................... ........... ............................................................................... . SY Adz _w, �r, .......... ...... ............. i 6'� j3 Z &n*Perfonning1-6o`ns`U�ij�i �4_ Onsk hot; -sid�,��v;e�.,initalla�tibri:id6iistiiidted5 is eri ei ............ r�Zting': Fi�iri.'41&f, nii4%66nitr�cilo V �inaccor an( dl­ :eiWi tfi-Al*-. 96v erning in#j ?so .......... 7�'-� -e e-PI AW SYR, EET FLE CITY OF EDMONDS DEPARTMENT OF PUBLIC WORKS 250 Fifth Avenue North, Edmonds, Washington SEPTIC TANK INSTALLATION PLAN (Subinit in Triplicate) ADDRESS OF PROPERTY ...... 17.32.9 ..... ... 7.2nd ... Pl.ac.e ... W* ......................... I ..... Lot No ....... 5 ............ .' Permit No ...... �4.3 .... . .. .... I . .. .. ....... .. .. .. . .. Owner .... Peter.'H. Gaertner 17329 - 72nd P1. W. Phone ....... ................ . ..... ... Address .............. . . ......................................... Builder_ ----- same ................................. . ........ Address ........................ ........... ........ --------_-------_-- Phone ........................ Designer---- ..s.ame . ................................ ................. Address ........ ................ .................................. ..... Phone .......... ............. Installer AiOPPIIO.ConcretA TXo4o ..... . Address. .... ... ......... ................................... _ .......... Phone ........................ 1 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 .... ----------- . ...... Auly. --- 9.p_1969 .......... have been complied with. ............. .......................... ­­ ................................................ ............................ Signature of Designer Date TO BE FILLED IN BY CITY ENGINEER ONLY Accepted...................... X ....................... ............... Date ---------- 7/15/0 ....... Not Accepted ........ .....Date . .......... 4��7 . .. ...... �... V ........................... 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: I . Have your tank checked periodically to see if pumping is necessary (2V2-3 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 hariii tile action of tile septic tank and disposal field. SEWAGE DISPOSAL PERMIT Septic Tank ........... 777 ....... gals. No . ..... CITY OF EDMONDS . ............... Department of Public Works Disp. Field ..... ...... sq. ft. Other........ .......... ............................. /.-" . .......... ............ .................................. ......................................................... is hereby authorized to install/ repair sewage disposal system at ........... ......... ------ ... ..... - — - - - ­­ --------- - ­ ................................................................................... ................. Date issued on... . .......... .......... i ..................................... A. Permit expires on , e year from date of issue DO NOT COVER BEFORE APPROVED BY DESIGNER OR SANITARIAN I hereby certify- this system was installed under -my supervision and control and, complies �vith all provisions of the City� of Edmonds Resolutions. Signatureof Installer ............ .............. . ......................... .............. Date ....................... ........... ApprovedDisapproved E] Date. ............................. ................................. By ............................. .................................................... Remarks: ---- ..................................................................................... I ...... ............... ................................................................................................ "SANITARIAN, OR DESIGNER ............ ....................... ....... .......... ............ .............................. Date .......................................................... This permit ihall be posted in a reasonably conspicuous I place on the Job until ins�e�tion has been completed. CITY OF EDMONDS ENGINEERING DEPARTMENT 250 Fifth Avenue North, Edmonds, Washington APPLICATION FOR A SEWAGE DISPOSAL SYSTEM PERMIT (Submit 3,-Copies) -_�-ezer Permitto be issued to: ....................................................................... -7 -),el V For installation at: (street address) ....... --------- ............. ...................................... ......................... Addition or Subdivision,����� - - ............................ Lot ...... 67... Block ................ Type of Building: Existing ......... .-. Single family residence ... ...... Number of bedrooms ..... 13 ................. Other: s ecify type or use). ............................................................. _ .................... A - , t ....... ----------------------------------------------------------- -7 3 G — 7�Q L&r 4:2'0"0 "*?- V V% le �o Address �; Builder.................................................................... .......... ......... ---- .......................... ......................................... I \ Designer...................................................................................... Address ............................... N k I—, ...... ............... I., ................. I --------- Soil Log Hole No. ... . .... F ..... �ai� sa. - 4 0. ... . ........ rj.!f ........ SA ...... C7. Z ................. �J� ---- — ----t ............ I ............ %5A�.4­61.9- ......... ................ ... Soil Log Hole No. 2 ...... 0 .... -.? ............ 7o.F, ----- -- .5.4-V ......... I— ........... le .. ....... Sa .......... 41 .............................. .. .. ..... 0 I/ 3 ..... .. 3e ........... 1.5A.--Ga .............................................. ............... .......... 0910_ ............ ;r r - C 14a . ................. / .......................... Elevation of Water Table, if encountered. (Distance from ground surface) ..... . . .. . . .. ..... .... ............... Corrections to control surface water if needed ........................................................................................................................ Specify if any removing or grading of topsoil in field area ... .................................. . .... .................................................. Percolation: Test Hole No. I —Average Rate ..... lAmt ................. .. (Fall in mimites/inch-bottom 6" test hole) Test Hole No. 2 —Average Rate_+�.��..ar.. M__)yr ........... _ .... (Fall in ininutes/inch-bottorn 6" test hole) Test Hole No. 3,—Average Rate.4-5--Aar Mily. -bottom 6" test hole) . ........ 11 ... I .............. ....... ...... (Fall in minutes/inch Average percolation rate on which to base drain field design ... _4 -15' .. 9 ... I ... I ....... I . .............. Date TakenJ ... .... Septic tank requirements based on present rules and regulations: _0')n X�v 44 Septic Tank Size ......... T. -1 ........... gallons. Amount of Square Feet of Disposa i . ........ ... .. ............ ................................. .. .. Date Signature — Desl ;er7 ..... 0-P ................. eld igr..... ......................... DO NOT WRITE BELW THIS LINE (To be completed by ISSUing Agency) Permit issued (date) ..... 6-f ............. Permit Number ....... ... .... ......................... Remarks: ........... ............... ...... . ...... .... ...... ------- . . . ................ ..................................................................... ................................................................................................................... . ................... ................................................................. IV 0-1