17505 69TH PL W.PDFiiiiiiiiiiii
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17505 69TH PL W
The City of Edmonds
APPLICATION
for
E
UMVVERNEIT
S4��—Zzl &I--- REPAIRS 0
OWNER.........................................
ADDRESS .17 . ........... .........................
0
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wl.,
PP'ROVED
EASEMENT No . ................................
URN' PLANT � / �0 //, -/
CONTRACTOR 4.� .. sdo? - 4
.................... PERMIT No.
LEGAL DESCRIPTION: LOT No-14S ................................ BLOCK No . ........................................
8 1 ER57- a;.-
,5- ",q &- 17Y,-- S6, 710$'W A=
NAMEOF ADDITION .........................................................................................................................................
01-- A��- we-157, A CrO It 61,-- 4.07-
Approved:
DATE 2.7.w?A�12P ............. By .... ...
CITY OF EDMONDS
CaJJ PRospect- 6-1107 when work
CIVIC CENTER WATER-SEMMR DEPARTMENT
Is ready for Inspe'etion. (No inspec-
ions Saturda�y, Sunday or holidays.) N -0 3580.
SIDE. SEWER PERMIT
ADDRESS ............. 1 --- 7-5. -�0.5 ... ..... 69th ... P l.aQp
........... ..... ... ........................................................................................................
...............
OWNEIC ............... De-a-n ... Fergu.s-on ........................................
.... .. .. ..... .. .. .... .... CONTRACTOR ...... Xggjq?�a ... S.e.W.e.r
Permission is granted Fehr-uary ... 2.4 ....... 197.0..., for ........................ days to REPAIR or CONNECT a side sewer
,with City Sewers in accordance with applicafion 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.
N—v, No. 2—Obtain full information regarding Ordinance* 11.16.030 said Regulations governing side sewers when you get permit.
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 1/s will be permitted.
'140TE:No. , 4—Trenches In street must be water settled and surface of street restored to original condition. Contractors shal I I be responsible . for
failure due to Improper work which may develop within one year of completion;
NOTE N , o.- 6=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-
tenanceg except to Insert the pipe Into the wye.
FOX 0 N D S
DEPARTMENT OF PUBLIC WORKS
250 Fifth Avenue North, Edmonds, Washington
SEPTIC TANK INSTALLATION PLAN
(Submit in Triplicate)
,Rv,ee4r4
ADDRESS OF PROPERTY .... ...... Lot No ....... AC .......... Permit No._Z.�S...
Owner...... ..... .. __ .................................... ............... Address . . ...... - ............... ...................... .... Phone ........................
Builder__4�Z Address. Aul.: p7V
.. Phone 10%. P'91�11 7�5.vig
............
Designcr..__,;w? .. .. ................. ... Phone-P,
05�jeA ----- Address
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
gra( ated..4.!7�0-u/,,ef
I" fillS, SUrface/rams, etc.) listed by me on my scA,a,,-c disposal system permit application d
.... have been complied with.
'62
........... . ... ... 1� --------
�;� " - 15 . ............. . ............. * ...........
Signature of Designer
TO BE FILLED IN BY CITY ENGINEER ONLY
Accepted. Date.../.7...Xk .... 4;
--- ?_ -'� ................ . ........ . .. . .. ......... .........
NotAccepted ....................................................... . Date ......... ..............................
Signature of Sanitarian--- ..................................
Remarks: -------- Approv.ed..per ... dea.iguer I$ ... cAr.tif icati.on .........................................................................................
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 harin the action of the septic tank and
disposal field.
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SEWAGE DISPOSAL, PE'RMT
Se ti ''Tank.
C. . ........ gals.- 'No. 4 . .................
C I T Y 0. F E 0 N'D
A�p�. -Field: ....... :.450 q. f t. Department of Public Works
.............. �s
-Other, .......... -------------------- I ---------
.-Nam,
-r4�1'ke.r -------------
.. .................... ..... .. ....... . ....... ..................... is li�reby aiuthoriz d.:t6 t�
ins,
repair sewage disposal S'ystem at,
11��5 0 5 �69t
............................ ....... .............
. ................................... ...............................
'Date,.igsue� oii ....... S.01, -.P
yt �jphpr ... -----------------
Permit expircs,opt ..year from date' of issiie
�;DO NOT COVER-BEFOkEl" APPROVED BY' DESIGNER. OR SANITARIAN
fhereby-.ceftify this system v�a§ installed under rn� supervision and,conit'rol and complies withall provisions of Zthe bit'
y
of Edmonds Resolutions.
SipatUre �of installer .......................... ..... ....... .................
.......................................... .... Date ........
Apprgyed,.[] Disapproved F� Date ------------------------------- .................................... By.,� ........................
.............. ---------- ...................
-Remarks: .................................................
............................................. ....... .................... ........... ....... .................................. ................
... .......
v,
SAM k
TA IAN OR DjESIGNER .....................................
....................... .............. ate ....................... ....................................
This� peimit, shall be -pwted- in a reasonably conspicuous place on the -job.,. vintitdrisp6ction has been completed.
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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: ............. ............ 4 ow.
For installation at: (street address)... ..... , Py .. -404e .................... .............
...... ......... . ........ ...........
4,
'0��
Addition or Lot ................ Block ................
Type of Building: New..-X... Existing ............ Single family residence.X_o*..f.. Number of* bedrooms ...... !-F ................
Other: (specify type or use)
Builder- ------- 0�,f99A�_gr,6,_e ... -------- .,.'.___,Add,es,..'0V 0 oe 4—
V:;v
Designer ..... 41�4v 4V ........... ........ --- Address.,'�'0/—/0P?66--'01'
Soil Log Hole No. I ...... 0 ....... ......... 4-
------------------------------------ ef- _4z".001:0,
..................................... ........................................................................
-v.- 37"'
Soil Log Hole No. 2 ...... P4,0ew'.J1 ....... _ ..........
............................... .... ...... ............... I ...................... __ ..............
Elevation of Water Table, if encountered. (Distance from ground surface) _.A1,0A10 .............................................
Corrections to control surface water if needed...'e-5�W.'V4 .... C7--'W I-Ae"74.4 ..... APIAIIoe-C.47 ..........
oo—,
e
..............
Specify if any removing or grading of topsoil in field area.— ...... _A4A1&_ ................ .......... ............. ................ ......
Percolation:
Test Hole No. I
—Average
Rate ...... 57,4�
_&V.. 3. 1.* ...... (Fall in ininutes/inch-bottom 6" test hole)
Test Hole No. 2—Average
Rate....01*11.4 ............
39. ............ ..... (Fall in iiiinutes/inch-bottom 6" test hole)
Test Hole No. 3—Average
Rate --- 41.4 ............
... . . . ..... (Fall in minutes/inch-bottom 6" test hole)
Average percolation rate on which to base drain
field design Date Taken --- 7.—!R.7491
Septic tank requirements based on present rules
and regulations:
Septic Tank Size .....
041.0 ..........
gallons.
Amount of Square Feet of Disposal Field ....... 4.6-4—....
ZSignature — Designer ................ �.;. Date
DO NOT WRITE BELOW THIS LINE (To be completed by Issuing Agency)
Permit issued (date) ............ Z ........... ............... Permit Number --- N�w ..........................
Rernarks:. ------------------------------- ------------ I -------- -------------------------------------------
401
102 /,Ode
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. .. .........
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7301 - 17". S,
EDNIONM, WAS141NGTON '7411-01 . e. I
PERCOLA71ONTEST
01-PLANS
I e--25;Le.10
F-144705
n1-_qrRIPTjOj4
The North 85 feet of the South 218 feet of the East 110 feet of -the
West 280 feet of Lot 145 MEADOWDALE BEACH, according to pl!E�t thereof
recorded in volume 5 of plats, page 38, records of Snohomish County,
Washington;
TOGETHER WITH easement:
An easement for ingresss.egress and utilities over and across th'at por-
tion of the East 135 feet of West 280 feet of the South 413 feet of Lot-
145 MEADOWDALE BEACH, according to plat thereof recorded in volume 5-of -Y
plats, page 3.8, records of Snohomish County, Washington, thereof:,-,Begin-,-
ning at the Southwest corner of said Lot 145; thence East along South..
line of said Lot 145, a distance of 170 feet to the point of begin-
ning; thence North 1046110" West parallel to the West line of said
lot 145, a distance of 313 feet to the point of tangency of a curve
to the right having a radius of 25 feet; thence along said curve
to the right thru a central angle of 90*, an arc distance of 39.27
feet; thence North 10461100" West 18 feet; thence angle left 900
to become tangent to a curve to the right having a radius of 2.5 feet;
thence along said curve to the right thru a central angle of 90*, an
arc distance of 39.27 feet; thence North 1046110" West 32 feet;
thence West parallel to the South line of said Lot 145, a distance
of 25 feet; thence South 104611011 East 413 feet to South line of
said Lot 145; thence East along said South line 25 feet to the Point
of beginning.