18532 84TH AVE W.PDF1111111111
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18532 84TH AVE W
SEWAGE DISPOSAL PERM&T
F%E
111
Septic Tank ............. le)"e gals. 5 0
............... CITY OF EMS TID FILE
Disp. Field ............ ft. Department of Public Works
Other.................................................
Name ....... .. ..... . .................... ................. is hereby authorized to install/
repair sewage disposal system at
P73
. . ......................................................................................................
.................... _�Z - P
F�
Date issued on ......... .....
---------- * ............ -------- --------------
Permit expires one 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 with all provisions of the City
of Edmonds Resolutions.
Signatureof Installer ................................... ........................................... Date ..................................
ApprovedE] Disapproved F� Date ........................................ .. ..... ............. By ............ ........... ......................................................
Remarks: ----- ...... ................... ............................................ ................................................................................................................
SANITARIAN OR DESIGNER.. ........................
.................. .......... .......................................... Date ..........................................................
This permit shall be posted in a reasonably conspicuous place on -the job until inspection has been completed.
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: --- Qharl�pv ... A., .... Tian.sjon ........ ... .........
For installation at: (street address)... ...... ------ /h.— . , y -m .......................... .............................
_ _ _q . .....
Addition or Subdivision .......... S.e.a.Y.i.e-w --- Fo_r.e.s_t .... Di.v ..... . 4 ....... ....................... Lot ....... 2 ...... Block ................
..... .. .. .. . ..... ..
Type of Building: New ... ?� ----- Existing ... ........ Single family residence. ... X _ ...... Number of bedrooms --- : ...... 4 ..............
Other: (specify type or use) ................. .......... ...................... ...................................................... ....... .........................
Builder ...... QhEX1_e_s ... A ...... H-an-Sen ............... Address ..... ...................
Designer --- S.o. -..s no.... ..3 e.pt lo ... T-ank ... De.8i gna.- Address .... 5_2.0.8!!-!..1 8.0.1. - th a 7. .... ... Lyxmwood -----
Soil Log Hole No. 1 ----- ___..0"_-3.0 --- Ssnd-y ... �-t4m;- -- 30"_-_-48.'_1.'- S-and.y/'C-1.9-7 ................... ..... .....
............................................................................................ ----------- --------- Z .......... I ------- 1 ....................................................
Soil Log Hole No. 2 .......... ....................... .......................................................
_ -- _ _ ..... .. ..
...................................................................................................... ........... ........ .................... ...... .......................................
.ilevation ofWater 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 ..... ....................... .... . (Fall in ini.nutes/inch-bottom 6" test hole)
Test Hole No. 2—Average Rate ....... 1.2 ............................... ..._(Fall in minutes/inch-bottorn 6" t st hole)
Test Hole No. 3 — Average Rate .......... 5 .......... .......... : .......... -- ------- (Fall in minutes/inch-bottom 6" test hole)
Average percolation rate on which to base drain field design . ......... 8 .. ......... .............. . Date Taken .... 7!r'�.6�6.3
Septic tank requirements based on present rules and regulations:
Septic Tank Size ....... �Q.0.0 .......... gallons.
AmouAt of Square Feet of Disposal Field ------ 59.6 ..... . .... ..... ...
Signature ....... - ------- ........... Date 7-27- 63
.... ... .......... . ..... ..... .......
DO NOT WRITE BELOW THIS LINE (To be complet�d'by ISSUing Agency)
Permit issued (date). ......... ( . ........................ Permit Number.. ...... -'_2ARn ............... ..........
Remarks: .......... __ ........... .......... ................. ........................................................................................................ ............. .........
.............. ................................................................
-- -----_-------------------
2 4 t�- W.
sl, e
Drive
Harold 61son
5208- 1801 th S. W.
Lynnwood . Wash.
B , ase men t DI
;35�
1000 Gal. S. T.
L -ft. of
in.
draintile
596 Sq. ft. req.
31 wide trench.
01
Per. Hole
Soil Log
411 Tight Line
4 1 . I Drain Tile
Scale 1"--201
NOTICE:
Cy
Nowar-r-an Y
The information'shown on the attached
map(s) was compiled for use by the City Of
Edmonds " its Employees and Consultants.
Th.le City of �Edm.qnds does not - warrant the
accuracy of anything set forth on these
rnap(�_). Any person or entity -requesting a
copy should conduct an independent
-ation shown on
inquiry regarding the inform
including, but not i1mited to,
_tFe -map(s),
-er stub shown. Such
the lociation of a.ny sew
sewer stubs may or may, not exist and may
or ma . y not exist at the location shown.
,--;ty of Edmonds nor its
Neither the k-., I
h. a I I b e Vi a. b-'Fe f o r t h e
e M pl-o-ye e-s o-r off ice*rs -s r
information given' on this map(s), nor for
tation provided based
any one represen
upon . said map(s).
APPLICATION
for
The City of Edmond 7.:� . . A , ' EASEMENT NO . .............................. -------------
r SIDE SEWER PERMIT
NEW CONSTRUCTION 0 REPAIRS Ej LID NO . .................. . ASMT. NO. ............
..... . .....
c
CONTRACTOR ... .... 777 --------------------------------------------------------------- ---------- PERMIT
OWNEII . ......... --------------------------------------------- ------------- w NO . .. ...............
JOB ADDRESS ------------------------------------------- - -- --------- ----------------------------- LEGAL DESCRIPTION: LOT NO - ------------ ------------------------- BLOCK NO - ------------------------------------
.... .... . .
.................................................... ------------
NAME OF ADDITION
-----------
APPLICATION
The' City of Edmonds for EASEMENT NO . ...............................
SIDE SEWER PERMIT .............
NEW CONSTRUCTION REPAIRS LID NO . .................. ASMT. NO . ..................
OWNER ---- ------- IS�-- -2
---------- .......... CONTRACTOR ----- /�� .................
....... ------------ PERMIT NO. 7f5�e�-,-
JOB ADDRESS ------- ------- ----------
-------------------- LEGAL DESCRIPTION: LOT NO. --------------------------------- BLOCK NO . ....................................
.................
------------------------------------------------------ -------------------------------------------------------
NAME OF ADDITION
<-- /V
-5-,
Approved:
DATE-------------------------------------------- By ---------------------------------------------------
A0
-D I PE f
C07 IT, Y.- Q�
f.."E .7M NDS) --�S PERMIT
4zw..-? W,,�EIZ
W ',A- -EW., -DE
—1 ABTIMEM;*,-��,,.''*
T
'5 18''.
(.Call .775-2625. 16r,,gide -sewer,-.InsP'edt1_"st :BEFOI�E- covering iany, po uctlor!'
rtlLn-,of ifie' -c6nstr
�Inspe�tlo .within% 2'4 "hours 'after re uiLv,.-No,`. Sat.,, Sun., or- hol - ida
Y, inspectiidns.)�'
'n.
�-AMDRESKEOCATION OF CONSTRUCT -ION ......................................
.............. ....... ............................................ ................................. ........................
PROPERTY �:LVGAL DESCRIPIX
ON ............ ...... ..............
......................... .................
.. ............................................................
...................... ..........................................................
..........
.........................................
ER ........... t
............ ........................ ON, .. ............... f2-4NRX-2.�
............ W?EA",WP/QR, BUILD
...........................
-t7
c _0 itu�O .... . ............. ...... .
& ADDRESS ......... . ............. . . .........
V-`�ni`ss' lowlsigrahted'.,
.. ... ....... .... 19-7r.lovrepah- RlWoi �onnilekti6n� of a side 'sewer to, the city'sairittary sewer
Edrnonds
�TT-!;NTION IS1,CALEDITOL THE FOLLOWING'
T
NOTE'_No? 1�. he,,owners,of the *pr,)perlY' may. obtain a permit to construct: -sewer. inside property,line.. A licensed Side Sewer Contractor must be employed, to construct
sldc� se,�TF-�!n street area� Do,not cover any portion of sewer before it has been Inspected.
NOTE. No. 2=.'All,,work�- �erformed . in city right-of-way requires an ln�dsion-'o -of-W y)�,prmit obtainable from the City . E . ngineer's office.
Right . a
_n, U, I 1'.i6.00, and Regulations governing -side, w erm,
NOTE No._�i2ldbtai� f ll,�fnfbrrns�tl�.,�egardlng Ordinance sewers, *fien you get: p ' It.
"OT"N ;i. : I � 1. . -
o. 4=..Top, have at- leastL 36 .:inches coverage..at :property Mn I e an&12,inches I inside property 'line; minirnum:grade of '2 0/j. lqo��bends,iri, grade
§�arp,crtSiri'!r2A ',�;ill,�be �permitted.
VOTE,'No.,'&--�Trench�s . in, 1. st� re , e - t , m ; ust be water settled' aj I id surface ot,sfreet restored' to riginal, condit . ton Contract ors, sh&II* be
, , 1.9 1 , I responsible for fatlure'�.du'e�,to Improper
�wbrk,',whtcfi 4iia , d. velop, within one year '9f completion.
NOTE No. 6—'It is u
niaw,fu'lkiyo a,61ter,,or d6�,&ny ther work than ls�- ovided for in -the* p`ermJt,.,6r. to do anyowqrk on the%main,
0 pr sewer or its appurtenances,, except to in
ertAfie;iiipe, Into 'the wye�
DIS"..PROV ---J.,`Date� ......... . ......................... By ................. Date ....... ..................... . By.: ....... ...... Date ..................................... 'By ...... .........
�EIQ r
A,PPROV.Ep,;7., -7 . . .................. B
............. . .. . ....................................................................................... .
......... 4 . 'y
---------------------------------- * ...... ........
......... ............................................................... I ....................................................
................... ........ .................................. . ................... ........... ............................................
....................................... : ...... .............
................................................
�P,6iinitl Copies, MUST- Be Signed:,By 20,wner -of Fl*rml.,Performinz,�-Q(jii8truttioxy PRIOR. To Request For, Inspectioh
r
.............. ....... ...... .. .................. ................ .... ihereb thdt,ih��SldeSe"Wer instd1lation', 6onstructed.Lundee this� permit
Y,
��'Contractlng. Firm Performing, Con�gt�uctlon)`
'Wa6.,installei _R%c�bidii:ncewith,:all governiniK,,Ordihaii'cds��bf,,thd- City of.!Edmonds;
f_7 ...............................................
DatefttNs ....... kyio
............... �9. 191.; ....... . .
lm�rqRE: you d.l.gfor: Water--O,,: nei;E31 �'P"ower 0,:- Sbwer,-:[); Other E]
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