6906 174TH ST SW.PDFiiiiiiii lill
1039
6906 174TH ST SW
CITY OF EDMONDS
r%or PARTMENT OF PUBLIC WORKS
0 1 FEETFI Avenue North, Edmonds, Washington
SEPTIC TANK INSTALLATION PLAN
(Submit in Triplicate)
ADDRESS OF PROPERTY .......... 6.9.06 ..... ... 1.74t.h ... SAWA .................. .................. Lot No ....................... Permit No ... aQj5 ..... ......
Owner ...... ..... Gordon..Gogert ......................... . Address . ...................... Phone ........................
Builder ................. It .... ......... 1.11
................... . ............ .. Address.....-Y -------------- 1.1 ............................ ............. Phone ...... ....... .........
Designer--------- --- to ------- Address_ ----- ------------ .......... ............... I .............. Phone ........................
....................................................
Installer. ........................... . ............................. ....... Address -------- . .... Phone .......................
I hereby certify tile 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, filis, surface drains, etc.) listed by me on my scwage disposal system permit application dated ................
................................. have been complied with.
.......... 1___1 ............... -------- .......................................................................................
Signature of Designer Date
TO BE FILLED IN BY CITY ENGINEER ONLY
Accepted............................................ ................... Date ......... .. ...... . ..............
Not Accepted ..................... .. .... ....... ... at
Signature of Sanitarian ... F . ... ....................... .... ........................................
.. .......... .........
.............. ...... ......................................................................
See original design for as built
................................................. .................................................................... ..................... .............................................................
INSTRUCTIONS: Use tile 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 (2v2-3 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 tile action of the septic tank and
disposal field.
/ SEWAGE DISPOSAL PERMIT
Septic Tank..... ------- gals. CITY OF EDMONDS No. .........
Disp. Field ..... ���..sq. ft. Department of Public Works
Other... ----------------------------------------------
Name -------_- --------- ..................................................... is hereby authorized to install/
repair sewage disposal system at
.................. . ... .. ..... . ..... .................. .......................
...... ............. ........ ----- ........... ....... -------------------------------------
Date issued on ............ ...... 40or
-------- ---- -----
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 I provisions of the City
of Edmonds Resolutions.
Signatureof Installer ---------------------------------------------------------------------------- Date ----------------------------------
ApproveDisapproved Date ---------------------------------------- ----------------------- By ------------------------------------------ ...........
---------------------------
-------------------
Remarks:_ ----- --------------------------------- e ---------------------- ........ --- I ---- ------- --------------------------------
Da --------
SANITARIAN OPAWBESJMM� ----- ... !n! ....... ...... .. .... ------------------------------
job until inspection as been completed.
This permit shall 17e posted in a reasonably conspicuous plac
0
im
SNOHOMISH HEALTH DISTRICT
ENVIRONMENTAL HEALTH DIVISION
Court House, Everett, Washington 98201
APPLICATION FOR A SEWAGE DISPOSAL SYSTEM PERMIT
(Submit 3 Copies)*
Permit to be issued to: .......... .1ord-on .. Gogext ------------------------------------------------------------------------ --------------- I ---------- -------
... ... ...... ... .. . ........
For, installation at: (street address) 64404.74th..3-9 ---- ----------- -- ------------- ----- /._7_1W.'__.'_5 ....... -------
Por.
Addition or Subdivision ..... 90RdQ.Wdn1,0 ... V-0aeb -------------- -------- ------------ -------- _ ----------- Lot --- 146 Block --------
Type of Building: New..X, - ------ Existing. ----------- Single family residence.-.X ---------- * Number of bedrooms ---- ;< 2W
...........
Other: (specify type or use) ------------------------ 1 ----------------- ---------------------------------------- I ----------------- -------- ....... ------- ------------------- --
Builder ..... 0OX"Clon --- UGre-r-t ....................... ------- --------------- Address ------- ffi, 0.0 ---_------ ------------------------------
P
Designer --- 6. 4 i a a G-0 gpp - t 1-8 ... Addre-M-011111FER" d ...........
Soil Log Hole No.* 1 ............. 0".!!�38! ...... ;-'�E"ndy!!4'0_aM -- ------ ------------------ ------- ------ --------------- ------- --------------
Soil Log Hole No. 2. .............. Some - --------------- -
............ ----------- I ----------------- ------------------ I -------- ........................................... ........
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 a�rea ------------------ P" F
�d_ V
-excetvalt-lon .. C ut v. � 0 r ---------
----------------------------------------- !arnunrloid --- arfwn ........... ------------------------ I ------ I ------------------- ................ -----------------------------------
Percolation:
Test Hole No. I —Average Rate .......... ------------------ ------------------------- .(Fall in minutes/inch-bottom 6" test hole)
Test Hole No. 2—Average Rate --------- -------------------------------------------- (Fall in minutes/inch-bottom 6" test hole)
Test Hole No. 3—Average Rate ...... _8 -------------------------- ------------------ (Fall in minutes/inch-bottom 6" test hole)
Average percolation rate on which to base drain field design ----------- 8 ------------------------------- Date taken..._8M28'*67
.......................
Septic tank requirements based on present rules and rcgulations:
Septic Tank Size ......... PPQ_ ........... gallons. 4PLD 'ITUD ()U'Z MG-H
Amount of Square Feet of Disposal Field -------- 447 ----------- ----------
Signature _M""qFWMW1___6 ----- a ---- a �_ -------- D a t e 1_0 ........ ------------------- -----------_-
DO NOT WRITE BELOW THIS LINE (To be completed by Issuing Agency)
Permit issu�d (date)... -------- a
-------------------------------- Permit Number ---------- �P_k_ ...................
Remarks: .............. ......................... ......... ----------------------------------------------------------------------- ------------------------------------------ ---------------------
----------------- ------ ------------------------------------------------------------------ ------------------------ ----------------------------- ...... -------------------------------- -------
K&H 34060
130
goo Gal. S. T.
149 Lin.ft. draintile
31 vidds trench.
447 Sq. ft. required
HOLD STUB OUT IUGH
di or fe OedVIA2,C40 01
I
0 Per. Hole
4b Soil Log
411 Tight Line
4" Drain Tile
Scale 1"--201
FILE
SYM41 N
CITY OF ED S
250 - 5TH AVE. N. - EDMONDS, WA 98020 - (206) 771-0220 FAX (206) 771-0221
COMMUNITY SERVICES DEPARTMENT
9 0 10 CO PublicWorks @ Planning a Parks and Recreation o Engineering
June 11, 1993
f
Bogdan Gavrilovich
6906 - 174th St. S.W.
Edmonds, WA 98026
Dear Mr. & Mrs Gavrilovich:
LAURA M. HALL
MAYOR
I have reviewed your account and will allow a credit to your account
according to our City policy: the average consumption for the same
period during the previous year charged at normal customer rates, plus
the excess usage charged at the City's cost, plus a surcharge of 15%
applied to the excess only. Only one leak credit will be granted in
anythree year period.
Should you have any additional questions after you receive your new
billing, please contact Ilene Larson, Utility Billing Clerk.
Sincerely,
iz 9&0-trl -
Ron Holland
Water/Sewer Supervisor
RH/l k
cc: Ilene Larson
Utility Billing Clerk
#322000/TXTWATER
0 Incorporated August 11, 1890 0
Sister Cities International — Hekinan, Japan
J -�-Aav 4---
APPLICATION
for
The City of Edmoncl��
SIDE SEWER PER3HT EASEMENT No . .......
NEW CONSTRUCTION p--- REPAIRS
LYflH PLAPJ
OWNER ... ........ 4.Cr-0jr. ..................................... CONTRACTOR --------------------- PERMIT No. ....
5-7—
..............
ADDRESS ........ ........................................................ LEGAL DESCRIPTION: LOT No. ............... BLOCK No . .........................................
4e.P
NAME OF ADDITION
------- -,? ..... AT/V.. ca
I
9
Approved:
DATE.,;2 �,?p -.2
........................... ..... 0 ........ B:y�-�
VED
1970
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 map(s), nor for any one representation
provided based upon said map(s).
CITY OF EDMONDS
ClIVIC CENTER — WATER -SEWER DEPARTMENT Can PROSPeCt 13-1107 when work
,,, ready for inspection. (No Inspec-
SIDE SEWER PERMIT iOns Saturday, Sunday or holidays.) N2 3574
ADDRESS ..............
OIVNER� ....... ..........
-------------------------------------------- CONTRACTOR ............ Y��:�ern Sewer
Perinission is granted ........... . .........................................................
with City Sewers in accorda for ------------------------ daYs to REPAIR or CONNECT a side sewer
nce 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 regaiding Ordinance 11.16.D30 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 'A will be�, permitted.
NOTE No. 4—Trenches in street must be water settled 'and surface of street restored to Original condition. Contractors shall be res nsible for
failure due to Improper work which may develop within one year of Completion. PO
NOTE No. 6—It Is unlawful to alter or do any other work than is provided for in the permit, or to I do any work on the main sewer or its appur-
tenanees except to Insert the Pipe Into the wye.