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NOTICE: NO WARRANTY OF ACCURACy The Information shown on the
attached map was compiled for use by the City of Edmonds, !i's employees
and consultants. The City of Edmonds does not warrant the accu,,z:-,
anYt,"ing set forth on the map. Any person or entity requesnig a c� of
opy
skuld conduct an independent Inquiry regarding the Infor mati on shown on
the map, inc:uding but not limited to, the location of any sevier stub
S110M). Such serjer ;tubs may or may not e)dst and may or may not e)dst at
the location shown, Neither the City of Edmonds nor Its employees or
officers shall be liable for the information given On this map, nor for any oraj
representation provided based upon said map
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The City of Edmonds
REEr FILE
APPLICATION
for
SIDE SEVIrM PERIVM
NEW CONSTRUCTION ;t REPAIRS E]
EASEMENT No.
......... ... ?.!L
OWNER ........... ................................... CONTRACTOR 'R ..... --- -- - ------------------------------------------------------------- PERMIT N
ADDRESS ... ..... . w ......................... LEGAL DESCRIPTION: LOT No._* ... 4 ............................ BLOCK No . ...............................
NAME OF ADDITION ... AIV #�
........ ............. ............................
VAJ
S�
Approved:
7
DATO ..... 7 .....
.X�F
AppRoVro
SEP 5 1969
APPLICATION CARD No . ......................................
for
The City of Edmonds SIDE SEVVER PERNEET EASEMENT No.
OUTSIDE INSIDE E] REPAIRS n
IF-
tM ------- ---------------------------------------------------------- PERMIT No
OWNER ------ Hamf,!.�
.I.- ......................................................... CONTRACTOR .............
HOUSE No. 9T Ftf . - ---F STREET .................................................
Lr --- V
.Y ---------------------------- -- .. ............................. AVENUE LOT No - ----------- BLOCK No . ...............................................
NAME ADD. ..7�" ..�Peflfk ... e4 P ....
�/ ......................................................................
VV
Date Approved:
BACKFILL WORK ORDER ISSUED ................................... DEPOSIT, $ .............................................
SEWERWORK ORDER ISSUED .......................................... DATE ................................................ By ...................................................................
NOTICE:
. d.uy
N-o---wa r-r a n - y ... o
The -information 'shown on the attached
pil d for use by the CitY Of
map(s) was corn. e
Edmonds, its Employees and Consultants
Th,.e City of Edmonds does, not . warrant the
et forth on these
accuracy of anything s
rnap(s�. An . y person or entitY a
copy should conduct an independent
inquiry regarding the inform'ation shown on
.--ffi� -map(s)., including., but not Jimited to,
er stub shown. Sucl-
the lociation of any sew
sewer -stubs may or may, not exist. and may
or may not exist at the location shown.
Neither the City of Edmonds nor its
t0j-MP-l-o-Yee*S 0,r office-rs -shatl be l-Ja-b-l-,e- for the
information given* on this map(s), nor for
any one representation provided based
upon'said map(s),
I
CITY OF EDMONDS Call PRospect 6-1107 when work
CIVIC CENTER — WATER -SEWER DEPARTMENT is ready for Inspection. (No inspee-
tions Saturday, Sunday or holidays.)
SIDE SEWER PERMIT
ADDRESS ------------------ ... W.es-T.
N2 3430.
OWNER ........... Belt --- Homes -------------------------------------------------------- CONTRACTOR ..... B ---- ---- M ... CoRtralct.qrs ...... .......................
Permission is granted .... September --- 5 ------------ 19-6.9-, for ......... -------------- days to REPAIR or CONNECT a side sewer
with City Sewers in accordance with application on file and governing ordinances.
ATTENTION IS CALLED TO THE FOLLOWING:
NOTE No. 1—The owners of the property may obtain a permit to construct sewer inside property line. A licensed Side Sewer Contractor must
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 Regulations governing side sewers when you get permit.
NOTE No. 3—Top of side sewer must have at least 30 Inches coverage at property line and 12 inches inside property line; minimum grade of 2%.
No bends in grade sharper than % will be permitted.
NOTE No. 4--Trenches in street must be water settled and surface of street restored to original condition. Contractors shall be responsible for
failure due to improper work which may develop within one year of completion.
NOTE No. 5---It is unlawful 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-
tenances except to insert the pipe Into the wye.
41 i - I
STREET FILE'
CITY OF EDMONDS
DEPARTMENT OF PUBLIC WORKS
250 Fifth Avenue North, Edmonds, Washington
SEPTIC TANK INSTALLATION PLAN
(Submit in Triplicate)
ADDRESS OF PROPERTY ...... Q09.9.1-08# ... ................. Lot No ..... <� .......... Permit No.3././" .........
Owner... iZf )�h4� Address '-71;2— /016( 4VSZ .................. PhoneBle
Builder ........... Address ........ . Or ...... ... ......... I ......... ...................... Phone.. 0 .............
Designcr.&&,,�-. N.- 1�0. Zad. �OA _.� A.fO C$Address 111W-,11V ... 15�.7.7� ................. Phone
-C ' o 2 /1 � 7 Al. �, WZ 2� ......... PhoneP
Installer./3.- ... Address
I hereby certify the accompanying drawing is an acCLIFatC 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 sewaloe disposal system permit application dated ................
—6. 8 ........... ....have been complied with.
1��. ......... 4P.6 .....
.............. ....... --------- **/ /11
Signature of Designer Date
TO BE FILLED IN BY CITY ENGINEER ONLY
Accepted ...... xx ................... ........ ........ ............... Date ....... � -5 [816.8 ............. _..
NotAccepted ............................... ........................ Date ........................................
Aist..Engr. -1
Signature of immim.. � ...... . &,&U& ... ... .
Remarks: ...................... Based �!p
.9p designer's certification.
.............. ....... . . ................................. ....................................... ....................................................
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 inay 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.patic, 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 liarin tile action of the septic tank and
disposal field.
6
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: ............... THOMA.S..E..__BELT
—.,r �-' ol,� 6e_,1'
For installation at: (street address) ........... - C.? O� -- -? I _2&.
....................... .................................................
Addition or Subdivision ...... ... S'Pae.. Rey.er_se - -_--_--- _ -------- ..... ............................................ LoC .............. Block .......
Type of Building: New ..... X .... Existing ............ * Single family residence ...... X ....... Number of* bedrooms 4
Other: (specify type or use) ......... ..................... ............. _ ................................................................. ........................................
Builder .... .................................................. Address-911 2 JOTH AV!� ... --- W.
............ ................
Designer. KIDs ... ... INC., ... Address.;�24�_.MA.0 ... STR99T, ... __�PMPRPP.,_VN.� ------- ........
Soil Log Hole No. 1 ..... .... 2.411151r.owln .... S.a.n.d.y...�oam; 16" Gray Sand and Clay; 5" Gray Ha.rd..Pa.n.
Soil Log Hole No. 2 ............ 3Q.'. I ... f3.rQwn ... 5Q.nd-y ---- loam.;_..9.'.1 --- Gray..Ftar-d ... Qta.y..�ud ... 5jan�, ............................
.......................... ................................................................................. .............................................................................................
Elevation of Water Table, if encountered. (Distance from ground surface) ......................................................................
Corrections to control surface water if needed .......... NQ..RQQF..P!3 ... D.ftlnWAY ... Q R. A J. N.A!X A ... C.T.C., .... 4.14 4.�. 131E .....
DIRECTED OVER DRAINFIELD AREA.
......................................................................................................................... .............................................. ......................
Specify if any removing or grading of topsoil in field area.- .......... GR4jQj.Rq ... IN ... PRA.INF.I.9JL.P._ARJF�A ... $. ti A 1.1 ..........
.... J1E..MV11J4AL ... 10 .. PREISEMUE ... TOPSO.L.L.ME.P.T.14 ........................... ...................................................................................
Percolation:
Test Hole No. 1 —Average Rate .......... ................ ... .... .. (Fall in minutes/inch-bottom 6" test hole)
Test Hole No. 2—Average Rate .......... 8..-.0 ........................................ (Fall in ininutes/inch-bottom 6" test hole)
1 1.0
Test Hole No. 3 — Average Rate .................... ....... .. `-(K411 in minutes/inch-bottom -6" test hole)
Average percolation rate on which to base drain fieldo ' L'� I, r VNI. Date Taken 21-2-.6.8 .......
Se tic tank requirements ba�ed on present rules andAreg ions. 7k
p 41 %'k
Soo ff _1 tr-r' ' ,
X
Septic Tank Size .... i.;7. -e ---- ....... gallons. N,
quare Fee_L of Disposal Field ..........
Amount of S 7WO . ..... .....
�G/ST0
— De ig ...... . Dat ------- ---- ....
Signature s ner..I;��te,.� �_ ...r
DO NOT WRITE BELOW THIS LINE (To be completed by Issuing Agency)
Permit issued (date).-..J. kf�1'6 ... e�_ ........................... Permit Number ...... 1� ...........................
i ..... &XV ... ......... .
Remarks:. ................................. ...... ....... . ............................ ....... -
.................................................................................................................... . ............................................................. .......................
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LEGAL DESCRIPTION:
The South 80.00 feet of the North 612.00 feet of the East 100.00 feet of the West
125.00 feet of Tract 4, Block 5, Alderwood Manor No.-,9, according to the plat
thereof recorded In Volume 10 of Plats, on page 6, records of Snohomish County,
Washington. (Also known as Lot 6, Tommy Park Addition No. 4, according to the
unrecorded plat thereof).
2 1 C ;:T T-" 1;T
I T- I I
SEWAGE DISPOSAL PERMIT
Septic Tank ..................... ...... ga s. CITY OF EDMONDS No. ..........
Disp. Field ........ ........ sq. ft. Department of Public Works
Other...............................................
Name ......... ..... ...... .... .. ........... .. - - ------------------------ ---- is hereby authorized to install/
repair sewage disposal system at
rX 1�e;q
---------------- ---------------
............................................ . .......... ................... ............ ------------------------------ * ---------- -------------------------
I /
Date issued .....................
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 ..................................
Approved Ell" Disapproved F-1 Date -------- 4 �� 3 ------------------------------- By ----- Q4UAAL 00
1%41 - -------------------------
Remarks: ......................... ...................................................................... ................................................................................................................
SANITARIANOR DESIGNER ................................................................................................ Date ..........................................................
This permit shall be posted in a reasonably conspicuous place on the job until inspection has been completed.
vLOT PLAN AND DRAINFIELD DESIGN FOR: THOMAS E. BELT
The S outh 80.00 feet of- the North 612.00 feet of the East 100.00 feet of the West 125.00-feet of Tract 4, block 5,
Alderwood Manor No. 9, according,to the plat thereof, recorded In Volume 10 of Plats, on page 6, records of Snohomish
County, Washington. (Also known as Lot 6,. Tommy Park Addition No. 4, according to the unrecorded plat thcreof.)
$CALE: I" - 20 FEET FEBRUARY 5, 1968
PERCOLATION TESTS SOIL LOG DATA
No. Rate No. Rate
P-1 8.0 min/in —L-7 24" Brn� Sa Lo
P-2 11.0 min/in 16" Gray Sa & Cl
P-3 11.0 mIn/In 5" Gray.Co1hpact CI
Av.Rate 9.0 min/in L-2 36" Brn Sa Lo
4-rW 9" Gray Compact C1 & Sa
Provide 525 square feet of trench area In two laterals of approx. equal length for main floor. (36" X 881 1g)
�07
Provide 225 square feet of trench area In two laterals of approx. equal length for basement. (3611 X 381 1g)
System shall conform to City of Edmonds regulations.
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FILE #3291A
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CITY OF EDMONDS
PUBLIC WORKS DEPARTMENT
RIGHT - OF - WAY CONSTRUCTION PNVIREET FILE
A. *A C
,1ress rviainity o
0 Owner:
Name'
Mailing Address
j- 0
City, � State, Zip Code
Contractor: 6AMOX /Irf Churc-k
Name
- 1 5�?.2 "? Ce T-e-e-n LA) obd
Mailing Ad ress
V P�
City, State, Zip Code
Permit No. 8,;? --2q (P
Issue Date 101.2
* Permit Issued To:
9 Type of Work to be Done:
9 Work in Connection With:
El Sub or Plat 21 S' ngle Family
3
El Comml. / Ind. El Apt. Condo.
Pavement Cut: 0 Yes 1�1—�o
State License Number
'3 L9 q - IRSOS
Telephone Number
* * NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE * *
B. APPLICANT TO 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, foreseen or unforeseen, that may be made
against the City of Edmonds, or any of its departments or employees, including or not limited to the defense of any legal
proceedings including defense costs, court costs, and attorney fees by reason of granting this permit.
Upon issuance of this permit, the contractor is responsible for workmanship and materials for a period of one year
following the final inspection and acceptance of the restoration by the Engineering Division.
Funds held from the Security Deposit (estimated restoration fee) will be held until the final street patch is completed, at
which time a debit or credit will be processed for issuance to the applicant.
Work is to be inspected. Restoration to be in accordance with City Code. Traffic Control to be in accordance with Traffic
Section of City Code. Street to be kept clean at all times. A 24 - hour notice is required for inspection by Engineering.
Call 775-2525, extension 220.
I understand that this permit must be available at the job site for inspection purposes at all times.
signature: 1-5� "o/'X A—ee"e'14. Date
6—wner OfQgent�
THIS PERMIT MUST BE POSTED AT THE JOB SITE FOR INSPECTION PURPOSES
CALL DIAL - DIG PRIOR TO BEGINNING WORK
C. Issued By
a elk, PermitFee: "41"30'oo
Time Authorized: Vold after "" LJ days Security Deposit:
Special Conditions:
Ammendments:
Receipt No.:
Fund I I I Fee:
Street Cut Dimensions
X
NO-WbRK TO BEGIN PRfORzTO PERMIT ISSUANCE
Eng. Div. December 1978
FIELD INSPECTION NOTES
(Fund. 111 - Route cony to Street Dent.
rnmmpnt-c-
Diagram:
Contractor called for inspection Yes No
r
,Alork Disapproved By: Date: By: Date:
Work Approved By: Date:
Inspector:
Ena. Div. December 1978
A�'80M7
PLOT PLAN AND DRAINFIELD DESIGN FOR: THOMAS E. BELT
The South 80.00 feet of the North 612.00 feet of the East 100.00 feet of the West 125.'00 feet of Tract 4, Edock 5,
Alderwood Manor No. 9, according to the plat thereof recorded In Volume'10 of Plats, on page 6, records of Snohomish
County, Washington. (Also known as Lot 6, Tommy Park Addition No. 4, according to the unrecorded p.lat thereof.)
$CALE: 1 20 FEET
PERCOLATION TESTS SOIL LOG DATA
No. Rate No. Rate
Olt, -P-7 6—.0min/In 24" Brn—§a—Lo
P-2 11.0 min/in 16" Gray Sa & Cl
P-3 11.0 min/in 5" Gray Compact Cl
Av.Rate 9.0 min/in L-2 36" Brn Sa Lo
9" Gray Compact Cl,& Sa
Providea 751 square feet of trench area In two laterals of approx. equal length for.maln floor. (36"/;`//`�..-' /-)S,
Provided '-,:,Ysquare feet of trench area In two laterals of approx. equal length for basement. (36"&z"**'�f '/( '�'
/)'1Z -,VIto City of Edmonds regulations.
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FILE #3291A