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1032
6728 174TH ST SW
APPLICATION
for
The City of Edmonds 0%'V' IT FILE SIODE SEWER PERYaT
b I FEE NEW CONSTRUCTION REPAIRS
V
OWNER. ......................................
ADDRESS ............ ,!� .............................
........ . .. 4�
A*
EASEMENT No . ..........................................
CONTRACTOR . . ......... . ............. PERMIT No.
LEGAL DESCRIPTION: LOT No . ............................................... BLOCK No . ......................
......................
NAME OF ADDITION ....... ..............................................................................
J-7-
Approved:
DATE.�tg..—../4 ... . .... 2p ....... By .........
..................
APPLICATION
The City of Edmonds for
SEDE SEWER PERMIT EA.SEMENT No . ..........................................
NEW CONSTRUCTION p-- REPAIRS E]
ACTOR ... 4�P . ........... PERMIT No . ......................
OWNER O.W. C..5.r .... /Z . . ............................................ CONTR ....... J
V .........
z -3 r 5e��
ADDRESS ............. /7-� ............................................... LEGAL DESCRIPTION: LOT No . .............................................. BLOCK No . ............................................
NAMEOF ADDITION .........................................................................................................................................
1-07- 6,e-pc-11
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A.pproved:
DATE................................................ By ......................................................................
Z.
CITY OF EDMONDS
Call PRospect 64107 when work
CIVIC CENTER — WATER -SE WER DEPARTMENT
im ready for Inspection; (No. Inspec-
tions Saturday, Sunday or holidays.) N2 3569
SIDE SEWER PERMIT
ADDRESS .................... 6728 - 174th Street S.W.
....................................................................................................................................................................................
OWNER .......... Forres.t.-Pell .................................................... CONTRACTOR ....... We.q.te.r.n ... S.ewe.r .....................................
Perinission is granted FO.bT�V.ary ... 1j5 ........ 1.9 ... 7Q, for ........................ days to REPAIR or CONNECT a side sewer
with City Sewers in accordance ivitli 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 po�tion of sewer before it has been inspected.
NOTE No. 2—Obtain full information regarding Ordinance 11.16.030 and Regulations gbverning side sewers when you get permit.
NOTE No. 3—Top of side sewer must have at least 30 inches coverage at property line I �nd 12 Inches Inside property line; minimum grade of 2%.
No bends In grade sharper than 1/s 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.
CITY OF EDMONDS
MENT OF PUBLIC WORKS
h
F , I . e North, Edmonds, Washington
SEPTIC TANK INSTALLATION PLAN
(Subrnit in Triplicate)
ADDRESS OF PROPERTY ........ 67.2.8-717.4t.h ... �S....W� ......................................... Lot No ....... 14.6 ......... Permit No ...... 3.0 9�....
---- -- -- .. ..... .... .. . - _ .... .. .. ....
Owner- -Briggs Building _. Co ....... __ --------- - Address .24.32.2—l07th_.Pl....W ................... --- PhoneJJ ... 2-.3579.
Builder. -same - -- - --- -- -------- - --------------- Address. ---- ------- - It- - ...... __ ............... ---- Phone ........... I ............
Designer R4skin_ Tisher-6 _A_s_s_o_c_._,_j_nc* Address ------ 1-7.9.6-2--lMidyale --- Ave. No
sl�atile ..... Phone-LI ... 2?I�3141-
Installer_ Richmond Concrete
-- -------- ------- -------------------------- ....... Address ----- 17119--.1-lighway ---- 9-9 ----------------- ...... Phone .... 743rn3.223_
I hereby certify the accompanying drawing is an accurate 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 sewage disposal system permit application dated-... ------------
- ------ V8168 ..................... ....have been complied with.
.-SAe --- trapsmi-ttaLl --- letter .... ......................................... 4naa....
Signature of Designer Date
TO BE FILLED IN BY CITY ENGINEER ONLY
Accepted------ ------- XX ..... I ............................ .1__... Date ----- 4/4/.6.8 ........... .........
NotAccepted ................................................ . . - --- ------ ------
g�"ngineer
Signature of .............. .........
f
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-
loadin,g the septic tank or disturbance of the drain -field may 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. patio in, on, or ove'r 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 the action of the septic tank and
disposal field.
City of Edmonds, Kashing' n
City Engineer's Office
FRO/W
Ra" 57ede4 & A"cm&a, Vote.,
Civil Engineers and Land Surveyors
17962 Midvale Ave. No. Ll. 2-3141 or LA. 2-5690
P.O.. BOX 7068
aedtfle YVdbnlnq[Un 701.3.3
6728-174th S, W., Edmondsq Wn. DATE 4 3 68
Parcel "C"l being a poA-ion—'�
Attached are three copies of as built plan for
of Tract 146, Plat of Meadowdale Beach# Snohomish County*
I do not have the as built forms available to fill out but believe all the
necessary information is on the attached plan. ThanIc you.
SIGNED
5
F *-;�
SIGNED
SFIND PARTS 1 AND 3 W1111 CARBON INTACT PART 3 WILL 131: RETURNED WITH REPLY,
Redil? rmg 4S 472
Septic Tank .......
....... ....... gals.
Disp. Field .... . t �/ ......... sq. ft.
SEWAGE DISPOSAL' PERMIT
CITY -OF EDMONDS
Department of Public Works
No. Y� ........
Other..: ........... ---_--_-----_--- -----------
Name ....... ......................................... is hereby authorized t6 install/
V, repair sewage disposal system at
.......... 7 ...... ............................
....................... ............... .................. .................................................................................
Date issued on .... ....... .... .......... .
Permit expires one ear from date of issue
DO NOT dOVER BEFORE APPROVED B)� 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 Fil Disapproved E] Date ........................................ ....................... By .... ............ I . .................... .
S
... .................................. ,4.1 ................. o ..........
.......... . ......
SANITARIANOR DESIGNER .................................................................................................. Date ................ ............................................
This permit shall be posted in a -reasonably conspicuous place on the job until inspection has been completed.
C2:%3pf Edmonds,_-4 Washingtori;�j
SNOHOMISH HEATH DISTRICT
ENVIRONMENTAL HEALTH DIVISION
Court House, Everett, Washington 98201
68.452-0
APPLICATION FOR A SEWAGE DISPOSAL SYSTEM PERMIT
(Submit 3 Copies)
Permit to be issued to: --- ..Cb.�,4 24322-107th Place Edmonds" Wh.' LI:- 2-3579
# -------------------------------------------------------------------------- 1� .......... I ----_-----------------
For installation at: (street address) .......... ..... ZZ/ .....................................................................
Addition or SubdivisionA-..portion..of..Tract-.146- -'HeadowdAle.-Beach ---- ------- Lot ................ Block ----------------
r- h%
(see complete legal att.0
Type of Building: New .... In.... Existing ----- ...... Single family residence -------- T ...... Number of bedrooms ------- 3 ---------------
Other: (specify type or use) ...................................................................................... I ....................................................................
BuilJ.riggs Bld90'j Co.q 24322-1-07th Place %1# Edmon& MQ TI: 2-3579
------- ---------- Address ..................................................
---------------------------------------------------------------------- ......................................
DesignervA_k$_T4!��rg ................................................... Address --- MARX 7o68 . Seattle . wh;-� 98133 LI:. 2-3141
.............................................................................
Soil Log Hole No. I ---- 45 ff --- t_a_.firm-_Q".Ao .. 4.T_.3.QaM-_A_" ... to .. 45"llwoo_
-rodd sand
...... 3 5h -----------------------
..........................................................................................................................................................................................................
46" to firm-011 to 4" loam-4" to 4611 loose reddish sand
SoilLog Hole No. 2 .............................................................................................................................................................
3 36" to firm.0"'to 5" loaxri..5" to 361, loose reddish sand
........... -off --- t6--4ft--3:6aU1_4"to --- 50r*--1ousw--rudd1:sh--uand ----------------------
-------- It ---------- 04; 501`t6'T!y%;
none encountered
Elevation of Water Table, if encountered. (Distance from ground surface) . ....................................... ----------
Corrections to control surface water if needed --------_----
Specify if any removing or grading of topsoil in field area .... NGW...Sur.pkus --- spoil--Ir=.house --- excavation and
.A
other cuts shall be used to level southeast lot cornerl.
..........................................................................................................................................................................................................
Percolation:
Test Hole No. I — Average Rate --- (Fall in minutes/inch-bottom 6" test hole). Depth of hole ----- 290 --------
JL-�6
Test hole No. 2 —Average Rate---- ---- (Fall in minutes/inch-bottom 611 test hole). Depth of hole ----- 3 . l" --------
Test Hole No. 3 — Average Rate ... ( it. (Fall in minutes/inch-bottorn 6" test hole). Depth of hole ----- 350161
n It! ITI 4'. 111 "' 6182
Average percolation rate on which to bLe drain field desigiZ Date taken-2�..26—(>8 ----------
Septic tank requirements based on present rules and regulations: 6-t., ave req'.! 133 sT.'j ft',",_.per bedroom x_3
Septic Tank Size ------- 9QQ ----------------- gallons. bedrooms=;399 sq'.11 ft.1 req�.! Install 2-671
Amount of Square Feet of Disposal Field ------- 4Qz--- lines=1341.of tile in 31 wide trench for
-------------------- 4a2--s4el ft.1 absorption area��i
Signature — Designer ---- _o0e Lzr.,10011:& . ....... ................................................ Date--.K is�'IJ90 -------
DO NOT WRITE BELOW THJS �INE (To be Knipleted by Issuing Agency)
Permit issued (date) .......... ��/, 6
------------------------------------ PerrPit Number .... .................. ----------
Remarks: ............... r .. . .. 41. ........ - -------------------------------------------------------------
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RUSKIN FISHER ASSOCIATESo INC.
Civil F�ngimers and land Surveyors
17%2 Midyalo Avanue North
LIncoln 2-31L42 LAkoview 2.3690
Seattle, Washington 98233,
SEPTIC TANK & DRAIN FIELD SPECIFICATIONS
.1. - Discrepancies betwoen these and drawing notea are governed by drawing notes;
2. Septic tank shall be constructed per Snohomish County Health District
apacifications; Sized as shown on plan.
3. Drain Tile:
&a 4" diameter minizmam
b. Slope-** Min. - 211 per 1001
Max. - 6 11 per 100 10
Co Open joints -i!#11 and cover viihasphalt paper
d. Have 6" of washed gravel under tile and 211 over tile
00 Under pipe located within 10 feet of trees, place 2211 gravel minimum
under tile
f. Cover: Min. - 12
. Maxe — 30"
g. Minimum center to center spacing:
For 24" wide, trench 81-611
For 30" wide trench 91-61,
For 3611 wide trench -101-6st
14. Gravel:
a* Size !all to 2 1" washed.
b. No Wavel within 24" of teptic tank or distribution box,; tee or wye
Ce Gravel shall be covered with light untreated paper before backfilling
5. Trench:
a* Min. width 24" with flat bottom or as shown at bottom of trench
b. Grade boards,, securely staked to trench bottom, shall be provided for all
field tile lines.
ce Septic tank and distribution box,, tee or wyep, shall be @onraeted .1th at
least orm (2) liai�gth of 411 bell tile.
d. Distribution box shall have one (1) length of 4" bell tile following It,
for each 31= of tile.
6. Lina from house' shall be kept as high as possible.
?. PavIng:
Wo IMervions awface shall be placed over arW part of the swaga disposal
Mten. Plant, gr"s and suslU shrubs oPQY-
8, Caratructlow
All materla2a and construction to - *=Tly witli F.HoA. and 3noh"sh Camty
Health DIstriet regulations.
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No. REVISION DATE BY
RUSKIN FISHER & ASSOCIATES, INC.
CIVIL ENGINEERS LAND SURVEYORS
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APPROVED
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