18909 94TH AVE W.PDF9182
18909 94TH AVE W
APPLICATION
for
The City of Edmonds SIDE SEWER
HUM No.
NEW CONSTRUCTIONFRMIREPAIRS t_f.�
VNER -------- #- .. ........... - .................................... CONTRACTOR ... ........
........... HURT NO.
OV PL
ADDRESS ..4Kq.0-f .......... ;�� ---------------------------------------------- ........... LEGAL DESCRIPTION: LOT No . .............................................. BLOCK No . ............................................
NAIM OF ADDITION ...... Qj ..... 0/y ...... E .... f.... ....... ......... 0 ............................
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Approved:
- -- /:? -
DATE... ...... . .............. r ...........
A P P
MAR 12 1968
CITY OF EDMONDS ASSET INFORMATION SHEET
NEj� STREET FILE ASSET NO. o .
ADDITION ADDITION TO ASSET NO.
RETIREMENT
DESCRIPTION
L—J A Tibl sfl 12 u tc- 17 L rl
SERIAL NO.
LOCATION DEPT. NO.
I E CZ I/ 7t P-6-0 I
-xo 2-L
"PURCHASE ORDER NO. *PROJECT NUMBER
PURCHASE ORDER DATE PROJECT COMPLETION DATE 3o - e (3
COST COST 2- - 6
B.A.R.S. ACCOUNT NO. q1 3 6:3
1-3
ESTIMATED LIFE
�lcl
INITIATED BY DATE APPROVED BY
11
"SUBMIT ASSET INFORMATION SHEET WITH FINAL PAYMENT REQUEST
*SUBMIT ASSET INFORMATION SHEET UPON CLOSE OF PROJECT
ACCOUNTING ONLY
Rl DEPRECIATE
MONTHLY DEPRECIATION AMOUNT
ANNUAL DEPRECIATION AMOUNT
G.L. ENTRY
REFERENCE
INITIAL
VERIFIED BY
PROCESSED
BATCH NO.
bqp
�:7)
4o CITY OF EDMONDS Call ppospect 6-1107 when work
CIVIC CENTER - WATER -SEWER DEPARTMENT Is ready for inspection. (No inspee, N? 2809
v, Sunday or holidays.)
tions Saturda,
SIDE SEWER PERMIT
94th Avenue West .....................................................................
18909 . ............. .......... ------------------- . ........
ADDRESS--------------------------------- - ---------------------------------------
Art Deyour ------------------CONTRACTOR ....... Wastarn-_-S.ewer -_---------------------------- ------
.... ...
OUTNER ........ ....
for ------------------------ days to REPAIR or CONNECT a side sewer
PeriTdssion is granted -_----_--------
with City Sewers in accordance with application on file and governing ordinances.
ATTENTION IS CALL D TO THE FOLLOWING:
to construct sewer inside property line. A licensed Side Sewer Contractor must
NOTE No. l.—The owners of the property may obtain a permit
be employed to construct side sewer in street area. Do not cover any portion of sewer before it has been inspected.
NOTE No. 2--Obtain full information regarding Ordinance 11.16.030 and Regulailons governing side sewers when You get permit.
12 inches inside property line; minimum graide of 2%.
NOTE No. 3—Top of side sewer must have at least 30 inches coverage at property line and
No bends In grade sharper than % will be permitted.
shall be responsible for
NOTE No. 4—Trenches in street must be water settled and surface of street r estored to original condition. Contractors
to improper work which may develop within one year of completion.
failure due
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-
NOTE No. 5—It is unlawful
tenances except to insert the pipe into the wye.
STREET FILE
CITY OF EDMONDS
DEPARTMENT OF PUBLIC WORKS
250 Fifth Avenue North, Edmonds, Washington
SEPTIC TANK INSTALLATION PLAN
(Subnat in Triplicate)
ADDRESS OF PROPERTY ..... 18909_-...9_4t.h ... W-9 ........... ............................. ...... Lot No ...... 4T ........... Pe,.it N.15-1 ...............
Owner ... Fred Davis Lake Rd. A.AI,,
--- .................................... ... ... . Addmss!.420 ------------ ......... .... .. .... ................. Phone ........................
Is Is of it it to
Builder---- ... ....... _.. - ......... ..... .. . .... ......... . Address ..... .................. ................... .................. Phone ........................
DesignerM* ... B.c. Meyring ------------------ ----------------- Address ... 200.19--Hiwa.y.-99 --- Lynnwood .......... Phone. —PH .. 6!-!t3loi
Richniond Installations
Installer ........................................ ............................ Address ------- 17.1.1.9 ... U.S ... 99 ..... Ly1q;WQQA,_..WA. Phone..74a .. .... 3223
1 hereby certify tile 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 ................
. ...... .... V25/44 .............. ..have been complied with.
5��Ve 7/16/64
......................... .............. ................. ................................................
Signature oi__&,', . gne, 7 Date
TO BE FILLED IN BY CITY ENGINEER ONLY
Accepted ------ -
Not Accepted ........ ....... .. .....
Signature of Sanitarian.. ....................
. . .. . Date. . _-1
----- - ... . Date ....... - --------- . ....... ..... - -
... ............... ...... ............. .................
Remarks: .................... ......... -----_-------------_---_-- - .......... ...................................................... ........................................................
INSTRUCTIONS: Use tile 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:
1. 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 tisslie.
5. Detergents and bleaches used in normal household quantities will not liarin tile action of the septic tank and
disposal field.
s ry
.. . . ...... .... .
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 ....... F X.e d ... Da.vi-s ....................................
For installation at: (street address) --- ...... 1090.9 .. .... q40 X.
Addition or Subdivision ......... 9..UR0j1d$ ... Seaview Por. -, 47 ....... Block- .............
.................................. I ........... 1 ........................ Lot .....
Type of Building:. New ..... -51� Existing ............ Single family residence - Number of* bedrooms ............. y ...........
Other: (specify type or use) ........ ----------------------- ......... .............. .......................................................................... ..............
'Builder .... Fred.-Da-vi-s. .............................................. ...... ...... Address. 1AXe Alderwood Rianor
... Rd., ...................... ............................
Designer.My ... B.....Me 1. ... P.,,110,...Bo.x ... 3.9 ... Ly.nnw-oo.dy ... 1.11a-sh-; ..................
_yr. pg ....... - ----- .... .. . .. .... ...... . .. ....
............................. -------- --- Address.
Soil Log Hole No. I ....... 0 .. . ..... Z2"...Sp.poy .. 22" — 44" sandy clay loam
....................................................................... ........................... ........ .................................. ..........................................................
same as above
SoilLog Hole No. 2 ................ ------ ------------------------------------------------------------------------------------- .........................................
............ ...................................................................................................................... ................................... ........................ .........
44ins.
Elevation of Water Table, if encountered. (Distance from ground surface) ......................................................................
Corrections to control surface water if needed ..... fre.mct ... drq.i.Ajor roof andjooting drains
........................... .............. . ....................................
Specify if any removing or grading of topsoil in field area ... .................................................................................................
............................................................................................... 7 ........................................................................................................
Percolation: 15
Test Hole No. I —Average Rate ..................................... .... .. (Fall in ininutes/inch-bottom 6" test hole)
Test Hole No. 2—Average Rate ............... 1.5 .............................. ..... (Fall in ininutes/inch-bottom 6" test hole)
14
Test Hole No. 3—Average Rate- ................... ........ ........ . - ------- (Fall in minut.es/inch-bottoni 6" test hole)
Average percolation rate on which to base drain field des' 15 3 13/64
ign ............... ......... .............. . Date Taken ---- /
...................
Septic tank requirements based on present rules and regulations:
Septic Tank Size .... 9.00 .........
... ..... ... gallons.
Amount of Square Feet of Disposal . Id --- 570
_Iie --- ...... A—
............ .. ...
Signature — Designer ...... ................. ��/ ------------ - 7 ........ .................. Date -----
V
DO NOT WRITE BELOW THIS LINE o be completed by Issuing Agency)
Permit issued (date) --- ........ ........
ermit Number .......... /J7 ..........................
Remarks: ...... ..... ... ............... ............. ... . ... ..... . ........ ..... .................. -------------------------- .................
.................................................................................................................. . .....................................................................................
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SEWAGE DISPOSAL PERMIT
Se tic Tank ............. 17�eP ..... gals. No. ..........
p CITY OF EDMONDS
Disp. Field ------------ 4'70 ----- sq. ft. Department of Public Works
Other---------------------_----- ----- ------
Name --------------- ------- .......................................... ------------------------------------ is hereby authorized to install/
repair sewage disposal system at
Z9... . ......... - ----- ------ ................................................................
---------------
Dateissued on--. ......... ----------------- : ....... ....................
Permit expires one yea"r i 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 Fj Date ---------------------------------------------------------------- By ..................................................................................
Remarks: ------------------ ...... ----------------------------------------------------------------------- ----------------------------------------------------------------------------------------------------------------
SANITARIANOR DESIGNER ------------------------------------------------------------------------------------------------ Date --------------------------------------------- ------------
This permit shall be posted in a reasonably conspicuous �place on the job until in.sp ection has been completed.