20531 85TH PL W.PDF111111111111
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20531 85TH PL W
NOTICE:
The Jnfo rmation'shown on the attached of
map(s) was compiled for use by the City
Edmonds/ its Employees and Consultants.
The City of Edrn.onds does not - wa rra nt t,
accuracy of anything set for.th on these
Map(�_). Any person or en.tity -requesting a
copy should conduct an independent
o -ation shown on
inquiry regarding the inf rm
_ff�e -map(s), Including, but not limited to,
th'e lociation of any sew-er stub shown. Such
sewer stubs may or may* not exist and may
or may not exist at the location shown.
o nor its
Neither the city of Edm 'nds
empto-yee-s o-r office-rs -sh-a-1.1 be Viab-'Fe for the
information given on this map(s), nor for
tation provided based
any one represen
upon said map(s).
-w
Y APPLICATION CARD No . ......................................
7 '
for
The City of Edmonds SIDE SEV171M PERMT
EASEMENT No . ..........................
4 M. 0 UTSIDE E] INSIDE REPAIRS E] ............
IRE
................................................... PERMIT No . .........................
........ .................. CONTRACTOR ................ ge-�� 41, 0
�z STREET
.7 q A-1:V1 AVENUE LOT No. ............................ BLOCK'No .. ...............................................
HOUSE No. ---- ---- ------ 4.1 ........... ................ 16"J7 ------------
NAME ADD - ---------------- -------
-.4& .....................................................................................
'f'o-
I,V�$ 14111C -9/
Date Approved:
BACKFILL WORK ORDER ISSUED ................................... DEPOSIT, $ ---------------------------------------------
N C,
ON
SEWERWORK ORDER ISSUED .......................................... DATE ................................................ By ..................................................
I, —
APPLICATION
The City of Edmond! for
SIDE SEWER PERMIT
NEW CONSTRUCTION 0 REPAIRS
EASEMENT NO - ---------- .................... ------------
LID NO. ....... ASMT. NO.
OWNER CONTRACTOR ............................................................. ---------------------- PERMIT NO.
---------------------------------------
JOB------------- --- L-- --------------------- LEGAL DESCRIPTION: LOT NO . ...... 3q .................... BLOCK NO - ------------------------------------
ADDRESS ........ A -- ---------- ----- --------- IN -
----------- I .......................................................................................................................................... -----------
L/J
NAME OF ADDITION ----- . . ..........................................................
- 6V
1W
1 0
76
A Wtc
Approved:
DATE .......... B,---.L . .....
RECEIVED
JUN 6 1974
."5
i� am.
ITY OF EDMONDS
REET F ILEc
DEPARTMENT OF PUBLIC WORKS
250 Fifth Avenue North, Edmonds, Washington
SEPTIC TANK INSTALLATION PLAN
(Submit in Triplicate)
/1 -.4--
%.. 04,61'r
ADDRESS OF PROPERTY ............ ... . .... Xs: 5 4 r .. /J ... Lot No ...... 'If-19 ....... Permit7N'...-/'75/6V...
Owner_ ... ... ............. . Address ... JWvrnz.4F�. Phone ............ ...........
Builder.......... . ... .. ........ ------------- - ---------- .... Address ........................ .... I ............ ......................... Phone ............. ..........
Designer.... _,,0.,T ------ ....... .... Address .................................................................... Phone ........................
Installer------------- --------------- __ ---- ......... .............. ..... Address ................................ ........... ....................... Phone ........... ............
I hereby certify the accompanying drawing is an aCCUrate representation of the system installed at the listed
address. I also certify all recommendations and restrictiODS (concerning plumbing stub elevations, maintenance of
grades, fills, Surface drains, etc.) listed by me on my sewage disposal system permit application dated ...... .......
. ....... .... ............... . .......... --- have been complied with.
ee�..
. .................... .. ... ...... ...
_'�.�7�j.jDesigner
i nat i:
TO BE FILLED IN BY CITY ENGINEER ONLY
Accepted ------ --- .. I .... ...... ....................... Date....
NotAccepted ... ... . ..... ...................................... Date ........... ............................
Signature of Sanitarian_ . .. .... .. .....................
Remarks: .......................................................................... .............................................................. ................................................
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
Zn
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 tissue.
5. Detergents and bleaches used in normal household quantities will not harin the action of the septic tank and
disposal field.
00
00
SNOHOMISH HEALTH DISTRICT
Division of Sanitation
3011 Rockefeller Ave., ALpine 9-2061
Permit No.— ['�� 31 E
Everett, Washington
I's
Date
APPLICATION FOR PERMIT TO
INSTALL OR RECONSTRUCT
SEWAGE DISPOSAL FACILITIES
— If-- (9&Yo —�;-X�F— " 5- �—
WZA,�Jl- Address
Name
Address of Proposed site 0- KI
Legal Description: Lot Block Addition —
Type of use o. of bedrooms :> Lot Size
Septic tank Capacity, 0 0 _gallons. Disposal field length
tarian I q I Sketch: --1 110 - � 57
F&f-071x�
S
Date Inspected by,
Approval Mailed to
Installer
Date
Rec - #1
Y-6
. 0
9 HEALTH
IS
DiTSion of Sanitat,*,"On
3011 Roqket-0.13:�,r Av-en P
$10-.00 fee for permit EUPett, yaso�ington Phone�-,ALpine 9 2106
LOT APFROVA� SIMET
NAtq ADD
U.ap
ADDRESS OF FROPOSE� BiGRING A
IIGAL DESCRIPT16II: LOCK �(ON
FRIVATE WEI�L_4,,.� SIZEZO MMBq 'RtDR
'A" 4L/10' . 1'1'�
LV
A. SURFACE &PJNAt�'
1. Is 4- §posal f ield bite well 4rain�,d?
2. Any water course (stre nage Ut 0 S�' �P ?.
am., drai chj etc.) tbP
��-Bv TOPOGRAPHY
1. Will t6psOil it field sxq� be Faded befOre fie�d ti2ty s
p e 4efalled?,,"
ell
1,4614 s I ch
Will any fill MIt'erial be u�ipd in the d�spoga�
421; Yes,46w mo
0. SOIL CONDITIONS
1. IL4g 2 holes at least 4,ffeet deep in t6 disposE41 field a to difto-Atiiie the
tyipe ot q�il -preident.
2. After boleb are dug r4cord thojso�l cbtq�'��ons at thb fdl�' ing 4epths d/)'
as RaA4,, 'gravel, play, packed gan#, loam, etc�.) Y
Soil lot #1 16 inches . . . . . . (log iA
1
36 inicheS2411,1" s
J,
48 inthes�
46 n, sgQ4
f
4. AnY gwoluid wa-t&--F e4p e r
-,9-uAtere4 b6for qa( g af) de^,,y oi 4 f &)e
f so,, at what 04p�th�
px�
j
D. PERCOLATION TESTS
At least 3 holes required.
1. Dig test hole at least 36 inches deep in the drainfield area.
2. Fill hole with water. Now let all water run out 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 in6hes from bottom left in hole.
h- Note how many minutes it takes for this last 6 inches to seep away.
I
Perform the above procedure for each of the 3 holes and record results below.
Test hole row, . Test hole #2 '�n? Test hole -W- . Z
6 91,
I hereby certify the above inf6rmation to be correct and the above tests were
performed by mo a�_prescribed on (date) 41T
Siped IV
Addre s s
5,,7 I?Ve s--3-0
NOTE: A Geptic tar4 permit is issued on the basis of the above infor4Mtion. ;f
there are any changes or alterations in the above stated soil conditions it may
result in the installall2n being rejected at the time of inspec#oi.
Do not srite E—elow these-li—nes.
Average perc6lation rate on which to base drainfield design,
Septic tank size MIlOns. Amount of sq. ft. of diBposalfLeld
0 0
00
5el
,67 C r ®r
-.1 Ilrecomo-ow
SNOHOWSH HE A L T'H �-",'DISTRICT
CLIFFORD ANDERSON, M.D., M.P.H., Director 3011 ROCKEFELLER AVE., EVERETT, WASHINGTON
August 6, 1965
C— J* -hj 6 -)c Ed kn 0 n ds-
To Whom It May Concern:
Sewage disposal system permit #13318 issued by this department
on March 25, 1963 is still in effect, under regulations of
this department. Permits issued prior to January, 1964 had
no expiration date.
The percolation data and inspection form for this permit
was forwarded to your office when this plat was annexed into
the City of Edmonds.
Very truly yours,
Clifford Anderson, M.D., MPH
District Health Officer
James Larson, R. S.
Sanitarian
JL: as
K - '? D 0
SHOHOWSH HEALTH DISTRICT
EVERETT, WASHINGTON
go IS.
Di sp-. -Sq. Ft.
Other
221PkE M1
M-1=1111
4 LA 04
PL'.4N1Bv,,iG PERWTS REQUORM
hereby authorized to construct or alter a
P h 3
Sewage disposal system at )w
in accordance with the plon5 and specifications atpproved by the Snohomish District Id'alth Officer.
The Sewage disposal facilities constructed or altered under the authority ri
of this P. mit shall not be covarad of
used until it has been inspected by the District Health Officer or his duly designated agent. This permit is loauad
by the Snohomish Health District in accordance with the Sanitary Code of Snohomish County adopted December 23,
1957. concerninq the construction and/or alteration of sewage disposal systems. This permit shall be posted In a
APPLICATION CARD No . ......................................
for
The City of Edmonds SEDE SEWIM PERMT EASEMENT No . ......................................
OUTSIDE INSIDE 0 REPAIRS El
---------------------------------------------------- PERMIT No - -------------------------
- -------------
OWN-ER, Z,xel - - ----- --------- / ----------- CONTRACTOR
Y i,:�
Vol STREET
............ BLOCK No - -----------------------------------------------
cv�---
EIOUSENo.—.4;� 71 ........ - - ---------------- 41 ----------------- AVEJITTLTE LOT No . ............... -Z ..............................
............... 4�,
NAME ADD. /zo 4 r- -0 7 -------------------------------------------------------------------------
-. ---- ------------
Date
BACKFILL WORK ORDER ISSUED ...........
�SEWER WORK ORDER ISSUED ................... .......
AV
DEPOSIT, $ ----------- --------- ----------------------
C, 0
AP-11,91 ra,$ -6049k�,�7 6�1�
Approved:
DATE--- — -------------- - - ---------------- 13Y ---------------------------------
RECEIPT FOR CERTIFIED MAIL-30� (plus "postage)
2 —02250 OR . 'bi
2
FREITAG, ROMMEL
/Y" AR
20531 85TH PLACE W.-
EDMONDS, WASHINGTON
OPTIONAL SERVICES FOR AiD T ONAL FEES
delivered ........ ... 150
1 Shows to whom a d t
q:3- RE "URN with delivery to addressee only .......... . 65d/
RECEIPT 2� Shows to whom. date andlrovi�,'ere delivered .. 350
SERVICES With delivery to a d s 'e orily ............ 850
--6E—LlV[R—TCT--A—DDRESSEE ONLY ..... 5Ud
-7—PEC1-l. DELIVERY (extra fee required) � ..... . .............
P S Form 3800 NO INSURANCE COVERAGE PROVIDED— (See other side)
Apr. 1971 NOT FOR INTERNATIONAL MAIL QPO� 1070 0.397-400
WJ.ns rue.fions. qnoth
77
.,PLEASE 'FURN X*� INNCATE'V�,BY-ICH
jqH;;SERVICE(S ECKED;BLO
�(Addjtjo�;j'�J,ojja,- rres, fur'the�e scrWc4' "j,
Show,address e iver. ONL'Y'
-'where'delivei-6d: e d"e,
to-add�, 4s
:;RECEIPT,�
Recei.ved the n6n6c. ed ici'rticli de��crib' d'bci W.-
REGISTERED:INO. ".-SIGIffA�fURID-M
L
K'NAIVIL LIF ADURESS S w $
0 filled,ln��:
CE RT I F I E D 7.
-ANr
4-06,3'�' -�',SIGNA 4RE,OF',ADD - [E!S,AGEN IF,
T,'
INSURED W.
ZATE.. DELIVERED
low- WHERE��DELIVLREO (only if reque6ted;,,aizd.inc1ude zlp�codcy.-'..
7
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REGARDING: 20531 - 85th Place West LIL2.2
(address)
R E C 0 R D 0 F C 0 N T A C T S
DATE NAME, PHONE NO., & COMMENTS ACTION TAKEN
ADDRESS of CALLER
5/l/74 Rommel Freitag Certified Letter No. 406337 sent Letter receiVed.
requiring hook-up within 60 days.
6/6/74 Dry line was installed years -ago. Connection completed.
Resident came in to obtain permit
#4842,, as was neglected at the time
connection was made.
INITIALS
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