23439 76TH AVE W.PDFlill 11111111,
6428
23439 76TH AVE W
ITYi1-OF'�-EDMONDS
LOT APPROVAL STREET
NAME ADDRESS
ADDRESS OF PROPOISED, BUILD#G
LEGAL DESCRIPTION: - LOT- BLOCV '---.ADDITION'..
TYPE OF USE��,�_- 0 OF BEDR06MS_.�-_ SIZE OF LOT
SOURCE OF DRINKING WATER: Public Supply Private Well
a. SURFACE DRAINAM
1. Is disposal field site well drained?
2. Any water course (stream., drainage ditch,,<6tc.T_through site?
b. TOPOGRAPHY
1. Any heavy slopes in field area?
2.. Will present topsoil in fleld-area-be— ved or graded before field tilbs
, �remo
are installed? __1
3. Will any fill materiaX'be used in the disposal field site? _16/111__::LJ
If yes., how much? 62--e�> 4
c. '�'SOIL CONDITIONS
1. Has�a hole at least 4 feet deep been dug in the disposal field area to deter-
mine the type of soil present?
2. After hole is dug record the soil conditions at the following depths.' (Re-
cord as sand, gravel, clay, packed sand, loam., etc.)
12 inches__:;�7_,m;� L,__,-75O inches
18 inches- t7 a 36 inches-
24 inches-.,/ f 48 inches
3. Any ground water encountered before I reaching a depth of 4 feet?____P___1<:,,
If so at what depth?__
d. WATER TEST
A simple water test will show how well this soil will drain or percolate water.*
To perfom this test:
1. Dig hole at least 36 inches de . ep. -Use a shovel or post hole digger —
size of hole makes no difference—oftly depth.
2. Fill hole with water. Now,1et all.v'�`ater run out of hole. This soaks
the ground and, will giv*e.a'. more accurate reading.
3. Again pour water' ' i ' n' hole -'to a height of 12 inches from the bottom.
Let water run'out�until there is just 6 inches from bottom left in hole.
4. Note how many minutes it takes for this last 6 inches to s�qp away.
Record this time below. . I
Nuraber of minutes for last 6 inches to seep away
5. Divide this time by 6 to obtain the rate per inch
6. Date water test was Derfonned
I hereby certify the above infomation to be correct and the above tests were
perfomed by'me as prescribed.
Signed
Address
NOTE: A septic tank pemit'is issued on the basis of the above infonnation.
there are any changes or alterations in the above stated soil conditions it ma
result in the installation being rejected at the time of inspection.
91
StAGEr FILE
Percolation Rate and Required Absorption Area. For single Family Dwellings.
Percolation Rate (Time in Lineal feet of 4 inch tile.
minutes for water to fall us�ng trench with 'Width of
one two feet—,,',.
3 50 ni-mum
4
5 190
7 225
10 250
12 265
15 285
30 375
Over 30 Soil Unsuitable
A
NOTICE:
No warranty of accuracy.
The information shown on the attached
map(s) was compiled for use by the City of
Edmonds, its Employees and Consultants.
The City of Edmonds does not warrant the
accuracy of anything set forth on these
map(s). Any person or entity requesting a
copy should conduct an independent
inquiry regarding the information shown on
the map(s), including, but not limited to,
the location of any sewer stub shown. Such
sewer stubs may or may not exist and may
or may not exist at the location shown.
Neither the City of Edmonds nor its
employees or officers shall be liable for the
information given on this map(s), nor for
any one representation provided based
upon said map(s).
01
CIT'w OF EDMONDS SIDF IEWER PERMIT
WATER -SEWER DEPARTMzNT
PERMIT N? 5 4 2 0
Call 775-2525 for side sewer inspections BFFORE covering any Portion of the construction.
Inspection will I., be provided within 24 hours after requst. NO Sat., Sun., or holiday inspections.)
ADDRESS LOCATION OF CONSTRUCTION ..... .... 7.6th.Amenue ... Weat ..................
...................... . .......................................................
PROPERTY LEGAL DESCRIPTION ..................... South IM ... la ........................ k 4
............................. of Lot 9. B
...... !Q(; ......... 3 ...............................
............ LC!k_A9J1iW9K-1 ... CQA ... P1xt_.5ub.divj_5iQn ... #1
C* ............... ** ...... * ------- ---------------------- - -
................................................................ OWNER AND/OR BUILDER --- IMNM BERGSETH
..................... ............... . .................................. . .......................................................
CONTRACTOR'S NAME ADDRES9 ....... TQ1AJQ�;1r1qff
...............................
...................................................
Permission Is granted .......
Mi9b --- 12 ............ . ............ 19-7.6- for repair and/or connection of a side sewer to the city sanitary sewer
-system In accordance with City of Edmonds ordinances.
ATTENTION IS CALLED TO THE FOLLOWING:
NOTE No. I —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—All work performed in city right-of-wav requires an Invasion of Right -of -Way Perrrdt obtainable from the City En-gineer's office.
NOTE No. 3—Obtain full information. regarding Ordinance 11.16.030 and Regulations governing side sewers when you get
NOTE No. 4—Top of side sewer must have at least 30 inches coverage at property line and 12 Inches inside property H , permit.
sharper than % will be Permitted. ne; minimum grade of 2%. No bends in grade
,NOTE No. 5--Trenches in streeet 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. 6--It is unlawful to alter or do any other work than is provided for in the permit, or to do any work on the ma4n sewer or its appurtenances except to in-
sert the plpe Into the wye.
DISAPPROVED 0 Date ... . .... ............................. BY --------- ------ Date. ...... BY ................ Date ..............
. ................... BY ......
APPROVE (-OBY.
D Date.. ..... .
.. . .. . .. . .......................................................................................
Remarks: ....... . ...... . .
......................... . ... .......................................................... . ...................................... . .............. . ................................
.......................................................
.............. . .............................
..................................................... . .................................. . ............................................. .........
—BOTH Copies I ST Be S1 ed E Owner of Firm Performing Construction PRIOR To Request For Inspection
W� Y
........ ................... hereby certify that the side sewer installation constructed under this
wner o e or g Construction) -plermi"t
,in th
Ce
vhw Installed in accordance al ove ordinances of the City of Edmonds.
p
Dated this ............... . ........... day of ............................................................ ....
4 N' Check BEFORE you dig for: Water C], Gas 0, Telephone [:], Power [:1, Sewer [], Other F] V 4
APPLICATION
Tfie� City of Edmonds
for
SIDE SEWER PERMIT
EASEMENT NO - ----------------------------------- --------
4
CONSTRUCTION REPAIRS
LID NO. NO.
.-AP ----.ASMT.
OWNER ----- P ------- 1 p 7-�- 71
CONTRACTOR 7774=� - — ------------ ------- -5 -------------------- PERMIT NO.
JOB ADDRESS
------------------------ --
LEGAL DESCRIPTION: LOT NO - --------------------------------------
BLOCK NO - ---------------- -------------------
--z. . I/z.
L-4c>-r C-z!> I E5L-gc�c-bav -4
1--blwmm .
. . ............................... --------------------------------------
0
vj
0
BY--------------- 7 -------------- YUYE
The City of,,,Edmonds
NO. ............. ................... -
LID NO. ... ASMT.'NO - ------ : -----------
,<)WNER ....
----------- ............................. ......... CONTRACTOR ..................... PERMIT NO.
7 14 141,
447 e,—o
JOB AD OCK - ------------------------
Doss . .. .... ------------------------------------------------ 7 -7 ........... LEGAL DESCRIPTION: LOT NO - -------------------------------------- BL NO.
A., 0
....................... ...... J;*
k.174..J� -h -1 ...............
--- ---- ------- ------------------------------- .........
NAMEOF ADDITION ........................................................................................................
9
APPLICATION
for
'SIDE SEWER PERMIT
NEW CONSTRUCTION REPAIR9
0
It/ Lol,
FECEIVED
JM 12 1976
)Ubhc Works Dept