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REGARDING: 20114 - 83rd Avenue West
(address)
R E C 0 R D 0 F C 0 N T A C T S
NAME PHONE NO R
DATE
. I
ADDRESS of CALLER
CON4ENTS ACTION TAKEN
INITIALS
S/l/74
William McLain Certified
Letter No. 406316 sent Letter.received.
TE
requiring
hook-up within 60 days.
6/26/74
Came into
office and obtained permit
TE
#4899.
7/1/74
Certified
Letter No. 406567 sent Letter received.
TE
requiring
response by July 12.
7/5/74
Connection comnleted.
TE
I
SENDER' iure to f6(io.'*jn#r'u'i:fJonS 0'' cith-erside
p RNISH (S
-LEASE FLI SERVIC_ INDICATEb"BY OHECkEb PLOCK(S)
(Additio?ial'cha',Tgq;:re4uired for th6e serv" s) RECEIP FOR CERTI ED
kcq __T F1 MAIL—__30e
Show add'ress,,,`.` _;� ,�. ..: - ----p _(')1us-,postage)
c er ONLY
El" where delivered'� o —01500
Aq addr 419
essee POSTMARK
REll MICLAIN, W. J. F DATIE
bere
Ae;ei:�eqJhli n6irl dorficle described bePdw
20114 83RLI AVE. W.
EGISTERED -NO.
kS.1GNATUl NA ME 7F- DRES,_,EE t b,d -filled, in) EDMONDS, WASHINGTON
S
98 0 2
!C RTIFIED NO� -1
e
F I
''1! 1311 IONAL 1EES
OPTIO
4 0 6:3-1 SIGNATURE!OF ADDRE(SA S AGE T IF. AW— - i RETURN 1. Shoris to w
om nd date delivered
lTiSIMED NO - 2 �'7 With deiiver to addressee oniy
Shows to whom, a
and here delivered 350
W th deliver t addr ssee only ...........
LLIVLH TO ADORE
........................... ...... . ... ....... .
DATE� IDEL'I'VERED SHOW�RE �DELIVERED (Onlylif �requnted, and -include ZZP-��dQ SPECIAL DELIVERY i,, required) . .................. _.. 5014
..........
S Form
pr. 1971 3800 NO INSURANCE COVERAGE PROVIDED —
(See other side)
NOT FOR INTERNATIONAL MAIL G"; 1970 0-397-458
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STREET FILE
SNOHOMISH HEALTH DISTRICT
Division of Sanitation
3011 Rockefeller Ave.) Alpine 9-.2061
Permit No.- Everett, Washington Date
APPLICATION FOR PERMIT TO INSTALL OR RECONSTRUCT SEWAGE�DISPOSAL FACILITIES'
Name (Wic ctx,- n-,N- Address
Address of Proposed site
T?VI-* Y
Legal Description: Lot Block Add-�fion
Type of use
(4Z" . No.
y .
.60
of bedrooms Lot Si ze
—
length
Septic tank
Capacity_
7So gallons. Disposal field
mls
Sketch:
-3-3
vo %
;z �
emarks: 10 - / C1 -
Date -Inspected by,
13'
/4— 10,
9
I
1, 1 fl -11�z.�
V
Installer
Approval Mailed to 11 Date
Re c .. L�
t
7- �
--Lfi
2-
190.
t .; -P 0 0
.-,%,10.00 fee for permit
SKOI-110'.041SH HEA1.1711 Pl,�TR�CT
30-11. RooktiLZIAr., ArfeELwL_
Everett, Washington
LOT APPROVAL SHEET
Phone ALpine 9-2061
NAM
ADDRESS
ADDRESS OF PROPOSED BUILDING
LEGAL DESCRIPTION: LOT BLOCK ADDITION
TYPE OF USE C1 �Ve NO. OF BEDROOMS 7- SIZE OF LOT X IS-6
SOURCE OF DRINKING WATER: PUBLIC SUPPLY_4 _ PRIVATE WELL
A, SURFACE DRAINAGE
1. Is disposal field site well drained?
2. 'Any water course (8ATAaq* drainage ditch, etc.) through site? /V'O
B, TOPOGRAPHY
1. Any heavy slopes in field area? / C-11
2. Will present topsoil in field.area be removed or graded before field tiles
are installed?— yr-)
3. Will any fill material be used in the disposal field sife?gIf yes,howmuch
C, SOIL CONDITIONS
1- Has a hole at least 4 feet deep been dug Wthe disposal field area to deter-
mine the type of soil.present?
2. After hole is dug record the soil conditions at the following depths.
(Record as sand,,gravel c 1 packed sand loam, etc.)
ay , S
12 inches 30 inches
18 inches 36 inche
24 inches 48 inche::
4. Any ground wat'
er encountered before reaching a depth of'4 feet?_ -AZ
If so, at what depth?
D. WATER TEST
A simple water test will show how well this soil will drain or percolate water.
To perform this test:
1. Dig a hole at least 36 inches deep. Use a shovel or pos� �ole �digge�
size of hole makes n� difference - only depth.
2. Fill hole with water. Now let all water run our of hole. This soaks the
ground and will give a more accurate reading.
3. Again pour water in hole to a height of 12 inches from the bottom. Let
water run out until there is just 6 inches from bottem left in hole.
4. Note how many minutes it takes for this last 6 inches to seep away.
5. Divide this time by 6 to obtain the rA-te per inch.
6. Date water test was performed.
I hereby certify the above informatio0to de c;i7rect and the -above tests were per-
formed by me as prescribed.
Signed 2,(
Address
NOTE: A septic tank permit is issued on the basis of the abov1'e*'inf'qkrmation. If
there are any changes or alteration in the above stated soil conditions it may
result in the installation being rejected at the time of inspection.
0
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: ------- Chp.rlpia .. A.# ... 4me-en ----------- ......
For installation at: (street address) ----------------- 1,910 _7 ... ...... ................................ I .............
Addition or Subdivision.. Os c or S. Jense Senttle Swb. �Irks.
.......... .......................... __ --------------- .......................... ............ Lot...l..O- .......... Block ....... 5 .......
Type of Building: New ... X ..... ... Existing ............ Single family residence ...... X.. . Number of Ie&ooms . 3..._ ......
Other: (specify type or use) ..................... ------- --------------------------------------- .................. ................. ..............................
Builder .... �hprlqe --- Ai .... !�.Onsorl ................ ................... Address .... ISCU ..................
Designer .... .0'_.__Snq0 ... sentle --- "iP n U --- PW fM.5 - Address... 5200.,!�10_0.tb ... 4 .;�ynnroad. . ........
Soil Log Hole No. I ------------
........... ... ondy_l
09m.-
............................................. ........................... I ..................................... ............... ............................. ........................ ............
5sme.Soil Log Hole No. 2-. --- ........ ............. ................. ................. ...................... .......... .......................................................
Elevation of Water Table, if encountered. (Distance from ground surfac�) ...... .............................................................
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 .... ... 10 ....... I ............... (Fall in inintites/incii-bottom 6" test hole)
............................... ................ (Fall in iiiinutes/inch-bottom 6" test hole)
Test Hole No. 2 —Average Rate ........ S
12 Test Hole No. 3'— Average Rate ................................. . ......... .. ....... (Fall in minutes/inch-bottom 6" test'hole)
Average percolati . hich to base drain field design .. ... 10 5-7-65
ion rate on w .... _ .... .... ................... . Date Taken .......................
Septic tank requirements based on present rules and regulations:
Septic Tank Size ----- 000 ....... _ ..... gallons. HOLD STUD OUT 11GH
Amount of Square Feet of Disposal Field ....... 4.95 .... . ..... ...
Signature — Designer... ....... //'Oooev ..... ................. ------- Date 5.-10-65.
DO NOT WRITE BELOW THIS LINE (To be completed by Issuing Agency)
Permit issued (date) ........ ....... ..... ............. Permit Number ........
_2
Remarks: ....... .......................... .............................................................................................. .................... ............. I .....................
..................................................................................................... I -------_---- . ......... ........ I ..................................................................
SIGINE. R J
Harold Olson
520B-180'th S.
Lynnwood, 'Wash.
goo Gal. S. T.
Lin. ft. draintile
31 vide, trench.
'495 Sq. ft. required.
HOLD STUB OUT IaGH
D I
0 er. Hole
0 Soil log
411 Tight Line
4"' Drain Tile
Scale.0- ill-201
60
I
I
The City of Edmonds
APPLICATION
for
SIDE SEWER PERMIT
NEW CONSTRUCTION Ej REPAIRS
�n
OWNER Z-��-�4 .. ....... Y 7 -- " � -
JOB ADD -------------
EASEMENT NO. -- ........... ----------
LID NO. —1-61 ------- ASMT. NO.
CONTRACTOR --------- ------ ---------------------- PERMIT NO.
LEGAL DESCRIPTION: LOT NO . ....... ...... ----------------------- BLOCK NO - ------------------------------------
--ow
----- -------- ---------
------- - . ...... . . ..... 21
--------------------
/ ------------------------
NAME OF ADDITION -- ---- -----
Approved:
DATE............................................ By ------------------------------------------------------------
4,oq
0 It 7 4—
CY c r. I., , .- -A-
SEWAGE DISPOSAL PERMIT
Septic Tank ......
_X-Od ...... gal,
CITY OF EDMONDS
Disp. Field ..... ... sq. ft. Department of Push
,.lC;oPs ET FILE
No.
----------
Other .............. �:I --- : —
. ...................
Name ----------- ...................... -----_------------- is -hereby authorized to.install/
repair sewage disposal system at
.......... ............... ---- — -_-------- P,
.............................................................................
Date issued on ................. 0
-- ----------------------- - -----------------
Permit expires one year from date of issue
DO NOT COVER BEFORE APPROVED BY DESIGNiR OR -SANITARIAN
I hereby. certify this system was installed under my supervision and control and complies with all provisions -of the City
Ed-mands Resolution*s.*
Signature of I
�staller ---------------------------------------------------------------------- ---- Date ----------- ----------------------
Approved C] Disapproved E3 Date ---------------------
--------------------------------------- By --------------------------------------------------------------------- ...............
Remarks: ..........................
--------------------------------- --------------------------- - : ------------------------------------------------------------------------------------- ........ ............
SANITARIAN OR DESIGNER ---- --------------------------------------------------------------------------------------------- Date -----------
......................... ....... ............
This permit shall be'posted in a reasonably conspicuous place on the job until inspection has been �complete'd_
APPLICATION
The City of
for
SIDE SEWER PERMIT
EASEMENT NO . ............................................
CONSTRUCTION REPAIRS E]
LID NO . ..... !.-.-ASMT. NO
OWNER ------
--------- ....
CONTRACTOR ------- .
............................................ PERMIT NO.
JOB ADDRESS ---- NN - \tq
---------------------------------------------------------------------------------
LEGAL DESCRIPTION: LOT NO . ............................
--------- BLOCK NO.
----------------
------- ---------------------------------------------------------------- -----------
NAME OF ADDITION -------------------------------------------------------------------------------------------------------------
Z
_0�> (4,
4(.
Approved:
71
DATE y
----------- B ---- - -------- ------------- �T
-IT
RMIT
SEWER -"R
WA, If E'k� E`
r
�.j
4-
Ail ;.4
IV.
dhe �con�t��Ft
e ,Inspe�ti�n wi�!;. p,rqvi, !�i �w'it�in hours '�fj�'r ctiqr�s
oliq�y, in�p.e
-C6NSlf UCTION--.; ............................. ......................................
ADDRESS; LOCATION, OF it 83,"d
................ . ............. ..... .. . ................................. ......
T LEGAL, DES ...... .............. i.... .......... B V, -"000 ........ .. 12 �of TP.'4
PROPERT ibR11P.T110m:.: ... Edm'nds Ac `,�t . I v -.�* ' I" '* * Q- 2;'
................................................... .........................................
.. .................... .................. ................... . ..................................... .................................
......................... ........ ............... ..........
...OVrN . EA'AN
i i I fam:'J McLaft zr%%
UILDE W I
........... . ..................................................... D R ...... ............................. ..........
a )i
---------- . . . . .......................... ..... ....
RE C
;,661S�tRA&(W8.14AME4 'A' D_ 6 i6m, 14U A q 20114- i.83rd�-.Ave�ue,,.;.14es-t;'.�:tetmond's..,
. ................................ ........ ...........
.............................. . .. . .. . ......................
. . ................... ........
_a '74 ir%,and a side Sew t 'th
n; is g-r mted-!�_, ...... . ............................ . . ......... 19., -- foir,repa /or cohhef_ of , s4!i I �try, .,sewer
er 0, 0 -cits
-:4?f:Ed
's -acci�rd"ce`_� h ds offliba
YS in CAty on nces.
ATTENTION 'IS CALLED TO - THE FOLLOWING:
No. I. T'�e owfiiii- of.'the� Prope, y, rna_y,'.�bta4p p�r�!�t to construct sewer: insi e pr
d operty li.ne.. A'iicensea Sld� Seiver d6fitricio,. intift be einploy&;'io c6nit
e r) t.
�side .'sireet'area: Do. been insprctid.
nvasion,of Right obtainable'from- the City Engineer's,? me,
N6' 2—Alf -of.v�ay:requiri�s iin.j i - - '. -of:Way Peftnit if
not.*.�qve� ii�� portion of,sewer�b f6fe it' has
I.E rmed iq city ng�t'
qrs_w�hezi, you 'get' I p . er rit:
NOTE No' 3�obtain "fu fl. in'ioriY;diion r�gaAi n 'l brdin"c� 711.16.030 and Regulatioms goverxii'fig 2de �ew
sewir must have if least� 30 inche� �ov6rageat'_�ioperty "line and 12 inch�s- insiae �ro�erty'iine; mihinnum
. - ' - . : I I . - - . grade of No binds in gr�&d�
�sh t1an �fi 'will 6e i��fr6itted.
,�rper,
'T�gq7E;�N6.�.,-�Trencfi6�'ifi-strei�I ibusi be'��ater ieftled a.�d surfaLce of street restored oto original �ondlilori. Cbn'traktors shall be':,riesponsibie f , 'Or" f'"'ure dui.to iffi
-,work �,hich. nia:y' deyel6�;,Wit4Cri one - �eir 6C completion
0 . - .,:.
N 6�It i�:'u'nla`��ful to alter -or, db'.&ny 6iii�� wor&k.-�hzi�.is 'provided'fo; in th
e;perrhif,:0�, t?:Oo ;iny%wq�� 'on the main seweror its appukenancei e'�13ept to in-
.e
',DISAPPRO-�k6 ED pit&_ ....... ...... By__...� ...........
........ bate, ........
..............
�y.................. ...... ............... .............
. ............. ....... ................. .. . .......................................................... . .................
...............
------ . ...... . ... ... ...........
.. . ................ ............... ............
.......................... 7— 7 ........... . ............. .. ....... ............. .......
- ---------
B T-1�,�.eft�i�;Copie's�3MST'Be Signed.l� Ownei� of Fiftri efforl-ning o R161k lto' ri��uesV.Fo
4j, nstr,u6tio'n P; nspection.
.................... ......................... ........................ -h6reby qektify� that th6,side sew6r iiistalldtiozi cofisirulc'ted-under this permit
(!Dwz�er t ing Fihii' P��fcr� r IV
, p�ing pns�ruction),
Contra(
was. lnstalle� in acGordance �iiith -all governing. ordinances. of the City'� of- Ediyioflds*
PAted this, ..............
Y of ...... ...............
-Telephon - e� we V r
bk Ei4 or:
�Rk aij�fi 'Waier 6aS -Sewelir' Othe�
0
Ell
_LA
NOTICE:
Nbwarranty-OT
The information'shown on the attached
map(s) was compiled for use by the City of
Edmonds, its Employees and Consultants.
Th,e City of �Edm.onds does not ' warrant the
accuracy of anything set forth on these
map(§-). Any person or entity -requesting a
copy should conduct an independent
inquiry regarding the inform-ation shown on
tFe -map(s), including, but not limited to,
wn. Such
the location of any sewer stub sho
sewer stubs may or may, not exist and may
or may not exist at the location shown.
Neither the City of Edmo-nds nor its
ernp-to-yee-s o-r office-rs -sh-a-1-1 be Hilab..'Fe. for the
information given' on this map(s), nor for
ion provided based
any one representat'
upon . said map(s).