23941 76TH AVE W.PDFlill 11111111
6449
23941 76TH AVE W
APPLICATION
for
The City of Edmonds SIODE SEWER PER3HT
SIDE INSIDE REPAIRS E]
FILET
OWNER................................................................................................................... ... CONTRACTOR AhZ4,".--
STREET
HOUSE Nor-, ............................... ....................................... - .................................... AVENUE LOT No . ...............
Z's NAME ADD . .................................
IF
11
CARD No . .............................
EASEMENT No . ......................................
'e �� ............. PERMIT'No. .
......................... .......... BLOCK No.
e
CIO
Date
BACKFILL WORK ORDER ISSUED ................. ................. DEPOSIT, $ ...........................
SEWER WORK ORDER ISSUED ......... ................................
Approved:
............
7.-
DATE ----------- -------------
V
Z
By '
?99'
*- CL
STREET FILE
C I T Y 0 F E D M 0 N D S
S E P T I C TANK.. A YPROVAL
TO WHMM IT MAY CONCERN:
This is to certify that the septic tank— for
has'been inspected and are according to City of Edmonds standards
DATE z
Insp d by: '47�0
17
3�e---
$5,00 fee fo.7 J)ulnrit,
I LOT A�PMOVAL GU,5�7
ADDRESS OF PROPOSED BMMING
TMAL DESCRIPTION: LOT BLOCK ADDITION
9-P-061
'=rE OF M_Re-aidence -NO. OF BEDRO0b0__a_S1ZE W, IM ip.-000-dq�-ft-
I
SOURCE OF DRTIMNG WATER: PUBLIC SUPPLY PRIVATE WELL
A. SWACE DRALWE
1. Ia disposal field site well drained? es
2. Any water course (stream, drainage di-tch, site?
1. Any heavy slopes in field area? . NO
2. Will present topsoil in field area be removed or graded before field tiles are
installed? No
3. Will say fill material be useT —in the disposal field site?_X0_.If yes, bow much_
C, BOIL CONDITIOM
1. Hm a hole at least 4 feet deep been dug in the disposal field area to determine
the type of soil present? I !]- cotuatiozA at the following depths. (Record
2. After hole is dug record the Sol
as sand, gravel, clay,, packed sand., losmq
12 inches Loam 30 Imches d-&-Rook
18 incheo 36 inches
and che a
24 inche6 S �am�zxawl - W 'z'
4. Any ground vater encountered before reaching a depth -of 4 f oetk,-o,. ?f so at
what depth?
D. VkM TEST
A simple water toot will show bow veU this soil will drain or percolate water. To
perform this test:
1. Dig a hole at least 36 inches deep. Uee a shovel or post hole digger -
size of hole makee no differeace--only depth.
2. Fill hole with water, Now Jat all vater run out of hole. This soaks
ground and will give a more accurate reading.
3. Again pour "imter in hole td a heigbt of 12 inches from the bottom. Le
water run omt =til there is just 6 inches from bottom left in hole.
4. Note how mwU minutes it takes for this iast 6 inches to seep away.
Record the tim. Nimber of minutes fror iast 6 inches to seep away
5. Divide, tbia tim b' 6 to obtain the rate per inch . . . . . . 1-n
. y - resul.ts beim
6. Date meter test was performed. 9/21 6
Test #1 -*,'3J min, per in, Test #2 - 3 min,,per ino TesF#3 -w 3 min, per ift"
I hereby certif)r tM above informatign to be correct and the - ab ove tests were per-
formed by me as px*scribed.
Addrers 918 % dtate. Kent 171MMAStan-
NOTE- A sept�c -tank. permit is iseved on,the bezeis -f the abolie infar-mation. If thar(
are any changes or alterations in the above stated soil conditions it may result:in
the installation being rejected at the time of inspectioa.
o T 3
V
SEPTICTANK 9C)o GA PERCOLATION TESTS
DRAIWIELD-�-GOFEET
SCALE S- SOI-L. LOGS
DATE E- F-LEVA TIONS
OA N E R - J Q ao-j\-j
DESIGNER J. E. HII.L.IKER
2
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REGISTERED
ROFESSIONAL
SAN I T�q.!��
JMN E. KILLIKER
STATE 06F WASh:'70N
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BUILDING DLi
WORK .9�
ADDRESS
OWNERIJI=��
-7=777
OLDC'. OFFiCiAl - ------
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CITY COPY
SETOM"',Q:
F110T
SIDE
REAR
HEIGHT ....... ------
FEB
?ERMIT CouNTER