23921 76TH AVE W.PDFlill 11111111
6447
23921 76TH AVE W
APPLICATION CARD No . ......................... ............
for
The City of Edmonds
SIDE SEWER PER -',$UT
OUTSIDE E] INSIDE REPAIRS E3 EASEMENT No . ................... ..................
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OWNER ........ .................................................................
SVEU .... FLEACTOR ..... ............. . ................. ................... PERMIT'No.
STREET
HOUSENo. -I ............................................................................................................ AVENUE LOT No . ...................................................................... BLOCK No . ............... ...............................
NAMEADD . ........................... ......
2,1_
�! 6 44
CA
3
1�
CIO
7/k
Date
BACKFILL WORK ORDER ISSUED ................................... DEPOSIT, $ ................................... .........
SEWER WORK ORDER ISSUED ..........................................
Approved:
12 'z
DATE . ... ... ...... ..........
By
eowy%QL ONDS
L 0 T A?WPS NA
NAM ADDRESS
ADDRESS OF PROM(ED.. BUILDING: Z/--
LEGAL DESCRIPTION: LOT BLOCK-..,,. ADDITION
TYPE OF USE&:,,�,-g. NO. OF,.)BEDROQM� SIZE OF LOT
SOURCE OF DRINKING WATER: Public Supply Private Well
a. SURFACE DRAINAGE
1. Is disposal field site well drained? ler
2. Any water course (stream,'drainage ditch., etc.) Th—rough site9 ffo,.-
bo TOPOGRAPHY
1. Any heavy slopes in'fieia area?.
2.. Will present topsoil in field areabe removed or graded before field tiles
. are installed? /Ve,
3. Will any fill material be used in the disposal field site? :�_le
If yes., how much?
I 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
_30 inches r Aa. I -Vot
18 inches, �6 inches r-,&- , / )Y,§;—/
24 inches 48 inches / A(-e
3. Any ground water encountered before reaching a depth of 4 feet?
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 hole at least 36 inches deep. Use a shovel or post hole digger —
size of hole makes no difference --only depth.
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:r'un 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 seep away.
Record this time below.
Number of minutes for last 6 inches to seep a
5. Divide this time by 6 to obtain the rate per
6. Date water test was perf omed
I hereby certify the above information to be correct and the above tests were
performed by me as'prescribed.
Signed
' 4 Q
Address
NOTE: A septic tank permit is issued on the 'h—i- ��F _'_'ove information. If
there are any changes or alterations in the above stated soil conditions it may
result in the installation being rejected at the time of inspection.
Percolation Rate and Reqj4red Absorption Area. For -single Family Dwellings,
Percolation Rate (Time in Lineal.feet of 4 inch tile
minutes for wa:ter to fall- us�ng trench with width of
one inch) two feet
3 150-minimum
175
5 190
7 -225
10 250
12
15 265'
285
30 375
Over 30
Soil Unsuitable
IT
ockef e-12juir
tts Waahingtaa V�k_.mel Au1,4VuTz_- 9-2061
$5-0V 4 TT 1EET
NAME Gary 7ohnson
WT APPROVAL SHMIT
ADMEW 7806 218th S..V1.9 Edmonds
AnM Mq OF PROP09M L2 3 V, ---> / - - 117(�" 1 a)
T- I ADDITION
.,_nAL DESCRIPTIM. LCT J-31OCK
=P, OF ISExesidence M. OF BED11OOMS 3 SIZE OF LOT 10p625 #.#.sq. ft.
x
SCLECE OF DRIMM WATU5,.- JPIASUC SUPPLY PRIVATE WELL
A. SURFACE MLAINAGE
yes
1.* Is disposal J-cield eit-_ drained? -no
2. Any -,;ater course (etreamm, d�rw�nage ditch, etc.) thro;:01 site?
j -8. 'TOP
.OGRAPHY
1. Any heavy slope6 iz fiej_,�fft axea? No
2. Will present topprAl im field area be removed or graded before field tiles are
installed?, NO . . . a
3. Will any fill material -te used in the disposal field site? 90 If yes, how much
C. SOIL CONDITIONS
1. Has 4 holi� &1�4- least L..
,_eet d9p been dug in the disposal field area to determine
'k
-;Oil pr,_r-1_B:tA
the type of a
2. After hole is dug rec,,,rd the soil conditiona at the folloving depths. (Record
as sandA grave clay, packed sand, loam,,,etc.)
12 inc�-848M 30 inches Clay, Sand 6.-rock
18 inches 36 inches_
Sandy loem 8: (graveil 48 inches Clay r rial v ComanTieQ
24 inchecs
4. Any ground water eaco-urtaaared bef ore reaching a dej�h_cxf_ - 4 feet? LIO If so at
vhat depth?
D WATER TEST
A simple water test will ehvt; bow wel.1 this soil vill drain or percolate cratet.
perform this testl: Y�
1. big a hvit s�t IpLast 36 inches deep. Use a shovel or. post hole digger
size of hoW m�?Qljme iao W Terence --only depth.
2. Fill hole -,.6ith Noy let all water run out of hole. This soaks the
ground n_,Ld give a more accurate reading.
3. Again po-or i)-a hole to a height of 122, inches from the bottom. Let
water rlm o-ut uatil there is just 6 inches from bott6m left in hole.
4. Note hov m&-,Xv rA-Avtes it takes for this last-6 inches to seep away.
Record the tiae, ALtiber of minutes for last 6 inclViteta below
5. Divide %him tt—m_ by 6 to obtain the rate per i "146X - - - .
&Mt 101%e- VM,�.elfbj�qh P8499* p4 in, ., Tkm3-�#3 - 4 min.' per inch.
1. here -by, certif�-
the a�tc�,Te
information to be correct and the above
tests were, per -
formed by me as
preecri1b�
R"
signed
Addraea
9:: -
&&Z, '2&-Xl
NOTt:� A septic
twak =xmith
jis issued on the basis
of the'above ififotmation.
". If thGr.(
are chemged
SAY
.4ted soil condition z
or aterr-�,c-` , s ir, the above 'at
il
b t*7 result'-ift
the installation b-tfo�r
.
�&t the time iwPection
w
w
V)
LOT I
R PERCOLATION TESTS
SEPTIC TANK 900 GALS S- SOtL LOGS
DRAIN -FIELD I - 7 5 - VEET E- ELEVATIONS
SCALE 2Q
�)ATE - 9 2 1- G I
OWNER- J HNSON
DESIGhER - J. E. HILLIKER *A'rERL'NE
DR'6VELLS
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REGISTERED
11 T,
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JOHN E. HIL L
STATE OF WASH
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SITFJROOF PLAN
OWNER: U.S. BANK WASHINGTON TRUSTEE OF NIALL GLANVILLE
C/O U.S. Bank Washington Trust Real Estate Department
1414 Fourth Avenue
Seattle, Washington 98101
23921 76th AVE W1 LEGAL DF%SCRTPTTON:- All of the north .125 feet of the West 85 feet
of Tract 8j Block 6, Lake Ballanger Land
EDMONDS, WA 98020 Co.'s Plat Subdivision No.1, according to the
plat thereof recorded in Volume 9 of Plats,
pages 57 and 58, in Snohomish County,
Washington; TOGETHER WITH an undivided
APPROVED BY PLANNING one-third interest in and to the south 25
feet of the west 170 feet of said Tract-8.
TAX ACCOUNTANT NO.: 48880060080305
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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).