20023 MAPLEWOOD DR.PDFIIIIIIIIIIIIII
12219
20023 MAPLEWOOD
DR
The City of Edmonds
APPLICATION
for
S11DE SEVVER PERPM
NEW CONSTRUCTION K REPAIRS 0
EASEME:NT No.
K6,4i�
CONTRACTOR .... CA -)&C -5
.......... , &&e ------------------------------ PERMIT if Q.--
--------------------
LEOAL DESCRIPTION: LOT No . ........... 34-
................................ BLOCK No . ............................................
NAME OF ADDITION /t-//9
..........
---------------------- * .... .... ........................................................
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NO WARRAMT� OF ACCURACy The Inform, cl
fo'� usc- by the CRY of Edn-,,'�
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CITY OF EDMO IDS SIDE� SgWE-R plERMff
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WATZ&-SEWM DIM""N"
PERMIT
NO 13931
Call 116-11*7 for Bid# newer '"OnctiOns DEFORZ covering any Portion of the oonstruction.N
Inspection vdll be Provided within 24 hours, after request. NO Sat., Sun., or holiday inspections.)
ADDRPS 1 2M23 t4aplewood Drive
WCAMN OF CONMUMON ........... I ............ ............... . ............
Psopzwy LjcGAL DESCRIMOq ..... Th.e ... w.e.st .... 82! ..... of ... th.e ... e.ast ... 224.1... of the i�e.st-half ... o.F...L.21 ... 3.4 ...................... .. .
..... .. .. .. .... .... ..... .... .. .. ........ .. ..... .............. ...... .. .... ..........
.'a-Aewood 11-1111s
...... . ............. . .......... ............... . ........... .......... . .................................................... . ........
.. . ... . ....................................................... O'Vlrl+l= -�M/" BUJ[W= .... -ftjgt� ... Conard
.......... I ... . .... ................................... : ............... . .......
E4
coN=Amows NAmim a Meadowdale- Road JUM
April 14 gakiNE ............................
18 graided ......... . . .......................... . . .. . ............ for repair and/or connection of a s6de Sewer to the ejt.V WWjtM7 sewer
M&MIn accordance with City of FAbnm& ordbumom
tARENVION 18 CALIAD TO THE FOLLOWING:
NOTE No. I —The owners of the property way obtain a permit to construct sewer inside property lirjL A licensed aide Sewer Contractor must be employed to construct
side newer in street area. Do not cover any portion Of Newer before It has been inspected.
NOTE No� 2—All work Performed in city rigbt-of-waar r*Wh'ft RD Invamim of RIght-0f-W&Y FOrralt Obtainable from the City Engineer's office.
NOTE No. 3--Obtain full information regarding Ordinance 11.16-030 and Regulations governing side mowers When you get permit.
NOTE No. 4—TbP of side newer must have at lea&t 30 inches cove a at property 11 12 1 c inside
sharper than % will be permitted. rag De and n hes property line; minimum grade of 2%. No bends in grade
NOTE No. &—Trenches In street must be water nettled and surface of street restored to original condition.
Contractors shall be responsible for failure due to Imp er
work which may develop within one year of completion. rop
NOTE No. 6--It is unlawful to alter or do any other work than to Provided for in the permit, or to do any work on the main sewer or its appurtenances except to in -
soft the pipe Into the wye.
DJSA-vPWVED [] Date .. . .............................. -... By ....... . ....... Date ...... . .. . .. . ................... By ......
APPWVJM j@
.... ... ..................
Ranarks:
Date.............. . ... ............... By ................
—DWH Permit Copies DWST 139 Signed By Owner of Firm Performing Construction PlUOR To Request For Inspection
I ..... ...... ................. . .. ..................... ... hereby certify that the side sewer ineWlation constructed
7 e-r—o-f-c—o'n-tracting Firm Perf Construction) under t1jis'li4ftilt
Ili r
�Ir�ea in accordance with oil gov g ordinances of the City of Edmonds.
Dated
I
�Wor Otbar
ell . J*
CITY OF EDMONDS
DEPARTMENT OF PUBLIC WORKS
250 Fifth Avenue North, Edmonds, Washington
SEPTIC TANK INSTALLATION PLAN
(Submit in Triplicate)
ADDRESS OF PROPERTY..20.023..Mapl.ewood..Dr .................... .................... Lot No .... B ................. Permit No ... 302 ............
Owner. Oscar -.Anderson ---- ---- ------ --------- - ------ Address P-. -.OL--Box - 535- Edmonds ----------------- Phone.778-r9.01B...
Builder.OScar- Anderson - --------- ------- ............. .. Address_P_,___O_,_. -Box..5-35--Edmonds ----------------- Phone. .77.8.-9.0.18 ...
Designer.C-....R...,Ly.on..E.ngi.neeri.,ng..-. .... .... AddressP. --- 0-. --Box 1 a7--Lynnwood-jWn ----- Phone.774-4159...
Installer -North ... End.. Septic -lank -Co --------- Address.- 7720 ... 2-1.0--SW- Edmonds-. ------------------ Phone-.776-0558---
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
,ra es, fills, surface drains, etc.) listed by me on my sewage disposal system permit application dated ................
.6 .. ... ............ ----- have been complied with.
": - --- ------ - -- ----------------------------------------------
19nature esigner Date
TO BE FILLED IN BY CITY ENGINEER ONLY
Accepted .......... �XXX ..... ...... ....................... I ......... Date.;?/§/``§A.. ---------_ ---- _
NotAccepted ............. .......................................... Date .................... ...................
Signature of Sanitarian... .......... . . ..... ................................ .. ..Assistant City Engineer
Remarks: ..... If half.. drai2. Leld fa iLs-- before- � san-itary --- sewers --- are- avai-l-able---by --------------------------
-jeld ... will,.be --- expanded to- ..full_ size . ........ I ........................ ...... ........... ...........
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:
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.
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C R.'LY ON ENGINEERING
LYNNWOOD, WASH... 774-4J59
-drby:'--Ae-s� — date:.' '-'job.no..—,-
A
Septic Tank .... gals.
Disp. Field---,.44?'1 ----- sq. ft.
Other.................................................
VI.- : I 1 4 1 1
SEWAGE DISPOSAL PERMIT
CITY OF EDMONDS
Department of Pubfic Works
No. -62.2 ..........
Name ..... 0!:�.) ewe A- 0-7
................... ... ..... .... ........... .......... . . ... .... ............................... is hereby authorized to install/
repair sewage disposal system at
----------------------------------- ......
90
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.
Signature of Installer ..................... ........................
Approved E] Disapproved M Date -
Remarks: .................................................
-------------------------------------- By
.............. Date ------
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)
----------- .... .. I., ........ ......
Permit to be issued to:. ----
For installation at: (street address) --- --- �20023--Maplswood ... Drive --------------------------------- ......................................
Zeftt of 16 118411
Addition or Subdivision ------ ----- ..... . ..... _ ------------- ............ Lot ...... 34� ... Block .........
Type of Building: New ----- XX Existing -,. ---- -- Single family residence . ... ... Number of bedrooms. . .. 3
Other: (specify type or use) --------- ----------------------- -----------------------------------------------
------------------ --------------------
oseerTo AAdOrSOA Address
PO Box 535 amads
--------------- -----------------------------------------------
Builder. - ------------------------------------------------------------------------- - -------------
---- --
yj . Lvoll ftgi a oer ins Address
PO B0Z 187 1..Vlmwwd
_ ------- 1 ....... ......... ...... .... ......
Designer- --- - - - -------- ------ ---- ......
�jjj the Pero* test h0181% Were bSrred_tOth4D. _04""t.0d
Soil Log Hole No. -------- ....... A --------------- --- -
.......................... ider " _41 ... te ..............
SoilLog Hole No. 2 ---------------------------------------------------------- -------
---------------------- ------------ * --------------- * ...........
................ __ ....... ........................ ....................... .......... ...........
_1 .......... .......... _ .......... ....... ......................... ......
11411:10
Elevation of Water Table, if encountered. (Distance from ground
surface) .... .... ......... ....... ................ .........
Aftle............................
Corrections to control surface water if needed_ _ ...... .......... ...... I
.......... I ..................... ........................
............................................................. .......
............. I .......................................................... ..... I .... I ...................
Specify if any removing or grading of topsoil in field area ...... ....................................
. .... 1
........................................................
............... .......................................... I ..........
..............................................................................................................................
Percolation: 5.4 ...... 142")
Test Hole No. 1 —Average Rate.. * .. .... 32")_
(Fall in minutes/inch-bottom 6" test hole)
9 2'
Test Hole No. 2—Average Rate ......... ...................... ................
..... (Fall in minutes/inch-bottom 6" test hole)
Test Hole No. 3—Average Ratell-3 ....... (216"0..
Fall in minutes/inch-bottom 6" Y�7
irJA
Average percolation rate on which to base drain field design
Date Taken ----- --
Septic tank requirements based on present rules and regulations:
900
Septic Tank Size . ............ ...... .....gallons.
Amount of Square Feet of ;)isposal Field...
Nov.6919u-7
Signature — Designer -
............ Date.... -------- -- - - -- ----- - -----
DO NOT WRITE BELOW T�,JS LI E (To be completed by Issuing Agency)
Permit issued_(date) ...... eo
...... ...Permit Number .... ..
.pop—
Remar . .. ....... .. .... . ..
. .. ........... - ---------
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........................................................................................................ .. . ........ ......... ...........
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C. R. LYON EW-,INEERING
CIVIL AND SANITARY ENGINEER
19?01 SCRTFER LAKE ROAD
UNWOOD, WASHINGTON
DETAIL SPECIFICATIONS
SEPTIC TANK SDWAGE DISPOSAL SYSTEM
1. Discrepancies between detail. specifications and drawing notes shall be
governed by draw-Ing notes;
2. Septic Tank shall meet the minimilm County Heal-th Dept. specifications
for construction and sized as noted on the drawings.
3. Drain Tile:
a. 4" diameter minimum
b. Slope: Min..= 211 per 1001
Max. = 61, per 1001
c. Open joints: 3/811 and covered with asphalt paper
d. 61, min. Of washed gravel under tile and 211 Min of washed gravel
over tile.
e. Cover: Min. 1211
Malx. 2411
f. 61, - 0" min. center to center spacing.
4. Gravel:
a. Size I" to 3" washed
b. No gravel within 241, of septic tank or distribution box
c. Gravel shall be covered with light untreated paper before backfilling
5. Trench:
a. Min..width: 241, with flat bottom
b. Grade boards, securel�y staked to trench bottom, for all open joint
tile lines.
c. Soptic tank and distribution box -shall be connected with at least
I Oioce of 411 bell. til,e.
d. Distribution box shall have 1 P-toce of 41f bell tile following it,
for each line of tile.
6. Line from house shall be kept as high as possible and laid on 2% grade.
7. Paving:
Do not Place impervious surfacing over any part of sewage disposal system.
Plant grass and small shrubs only.
8. Tank C16aning:
Check septic tank at; least every two years to see if' sludge and scum need
.removing, If qOl.id.q ovnrflow In to trenches the soil will become clogF
_ed.
CITY OF EDMONDS rit No. LZ
- 1, �
COMMUNITY SERVICES DEPARTMENT
RIGHT-OF-WAY CONSTRUCTION PERMIT 6 L� I 'U�ue Date
A. *Owner: GnA "A P-,S2 B. 0 Contractor-7—P8—C
Name -Name
'7 C_ —
Mailing Address Mailing Address
wA W%a. CNO-7Z
City State Zip City State' Zip
(4 � C, - Ste -Z_,,
State License Number Telephone Number
'20 0' S1 - -
C. 9 Address or Vicinity of Construction: Z Zr)02-1 Z0019
TypeofWorktobeDone:__19 —1 S �_3' �:)o C-1
90
D. 0 Work in Connection With: 0 Sub or Plat DS' I 1plly
.1qg1e, i C)-C) El Cit Projects
M
El Commercial 0 Wu tifamily tility
E. 0 Pavemeni Cut: 0 Y _M'N - F. 0 Size . of Cut: X X`U Y
APPLICANT Td READ AND SIGN
INDEMNITY: Applicant understands and by his signature to this application, agrees to hold the City of Edmonds
harmless from any injuries, damages, or claims of any kind or, description whatsoever', forseen or unforseen, that may
be made.against the City of Edmonds, or any of its deDO
,,Tn)pAW9r empf�pye
�s, inclupLng or not limited to the defense
of any legal proceedings including defense costs, court cwts,.,dnd attorney Nes by reason of granting this permit.
en.
THE CONTRACTOR IS RESPONSIBLE FOR WORKKXNSHIPJ AND MATERIALS FOR A PERIOD OF ONE
YEAR FOLLOWING THE FINAL INSPECTION AND-ACCEPTANC F HE WORK.
Estimated restoration fees will be held until the final street patch i s completed by City forces, at which time a debit or credit will be
processed for issuance to the applicant.
CIO
• A 24 hour notice is required for inspection; Please call ngineering:1 771-3202
• Work is to be inspected during progress and at completion. RW
• Restoration to be in accordan�e with City Code.
• Street to be kept clean at all times.
• Traffic Control to be in accordance with City regulations.
.9 All street -cut ditches must be patched with asphalt'or City approved material prior to end of working day;
NO EXCEPTIONS.
I understand the above and that this permit must Ve available at the job site for inspection purposes at all times.
Signatur D . ate: !�s I-Zz
or
Permit Must be Posted at the Job Site For Inspection Purposes
Call DIAL -A -DIG Prior to Beginning Work.
>, APPROVED BY: R
Z Time Authorized: Void after EAF� days.
0
Special Conditions:
PERMIT FEE: :3>0 -TZ5 Gs� -Fa I LL E-b
Restoration F
Receipt No :, A& 1& 11+ &
I HwUlal I 16LJ
Fund I I I Fee:
Street Cut Dimensions: x
RELEASED BY: Chnsty- Dateq 112- Igo INSPE&ED By Date
0
U. . NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE
tng. uiv. marn msy
FIELD INSPECTION NOTES
(Fund 111 - Route copy to Street Deit.),—.,
Comments:
Diagram:
CONTRACTOR CALLED FOR INSPECTION 0 YES 0 NO
Partial Work Inspection by P. W.:
Work Disapproved By: —
FINAL APPROVAL BY:
Date:
Date:
Eng. Div. July 1985
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