1014 SPRUCE ST.PDFiiiiiiiiiiiiii
13291
1014 SPRUCE ST
i
ifie City of Edmonds
APPLICATION
for
SIDE SEVER PERMIT
OUTSIDE JZ INSIDE ❑ REPAIRS ❑
CARD No . ..........................................
EASEMENT No . ............................................
OWNER .......
.....F.'..../.,!%4...:5..?..^...!?.......................................................................
CONTRACTOR ......%�7.2AT.Q.% .....Goi...Sr.........L.fi.....................................
PERMIT No./..
HOUSE No.
.....l.G. f. �........S.,C' `'.�..�. �--' .......................
......................
STREET
...................... AVENUE LOT No..............................................................................
BLOCK No.............................................................
NAMEADD .............. ........................................................... .... ..............
....... ......... -..... ,!
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CITY OF EDMONDS
LOT APPROVAL STREET
NAME ADDRESS I Ili .I
ADDRESS OF PROPOSED BUILDING
LEG
TYPE
AL
DESCRIPTION: LOT BLOCK ADDITION
OF US N0. OF BEDROOMS_,2_ SIZE OF
LOT [_._._.=
SOURCE OF DRINKING WATER: Public Supply � Private Well
a. SURFACE DRAINAGE
1. Is disposal field site well drained?
2. Any water course (stream, drainage ditch, etc. through site? alj=
b. TOPOGRAPHY
1. Any heavy slopes in field area? �/►„ .�--
2. Will present topsoil in field area be removed or graded before field tiles
are installed? °
3. Will any fill materialbe used in he disposal field site?
If ges, how much?
c. SOIL CONDITIONS
1.
2.
Has- a hole at least 4 feet deep been dug in the disposal field area to deter-
mine the type of soil present?
After hole is dug record the soil conditions at the following depths. (Re-
cord as sand, gravel, clay, packed sand, loam, etc.)
12 inches _�„� ,�,,� b � 30 inches
18 inches 36 inches
24 inches '�.,A8 inches tc
3. Any ground water encountered before reaching a depth of 4 feet? \L
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 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 seep away.
Record this time below.
Number 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 performed
I hereby certify the above information to be correct and -the above tests were
performed by me as prescribed.
Signed
Address
NOTE: A septic tank permit is issued on the basis of the above 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 Required absorption area. For single Family Dwellings.
Percolation Rate ( Time in Lineal feet of 4 inch tile
minutes for water to fall using trench with width of
one inch) two feet
3
150 minimum
4
175 "
5
190 "
7
225 "
10
250 "
12
265
15
285 "
30
375 "
Over 30
Soil Unsuitable
0
.,RECEIVED
9 u = 19 COMMUNITY- WNI.CES
City of Edmonds
Critical ,Areas Che"b"Wist......'A:._
The Critical Areas Checklist contained on
this form is to be filled out by any person
preparing a Development Permit
Application for the City of Edmonds prior
to his/her submittal of a development
permit to the City.
The purpose of the Checklist is to enable
City staff to determine whether any
potential Critical Areas are or may be
present on the subject property. The
information needed to complete the
Checklist should be easily available from
observations of the site or data available at
City Mall (Critical Areas inventories, maps,
or soil surveys).
An applicant, or his/her representative,
must fill out the checklist, sign and date it,
and submit it to'the City. The City will
review the checklist, make a precursory site
visit, and make a determination of the
Subsequent steps necessary to complete a
development permit application_
,
With a signed copy of this form, the
applicant should also submit a vicinity map
or plot plan for individual lots of the parcel
with enough detail that City staff can find
and identify the subject paroel(s). k
addition, the applicant shall include
other pertinent information (eg. site
P11a][4 tOPOgraPhY map, etc.) or studies in
conjjunc Lion with this Checklist to assist
staff in completing their preliminary
assessment of the site.
I have completed the attached Critical Area Checklist and attest that the answers provided are
factual, to the best of nay knowledge (fill out the appropriate column below).
Owner l Applicant:
Name
Street Address
City, te, - Phone
7 9
Sigr} cure Date
Applicant Representative:
Alsr
Name
Street Address
City, State, ZIP Phone
Signature Date
Gritical Areas Checklist
X
Site Information (soils/topography/hydrology/vegetation)
Ts
1. Site Address/Location: D/ �PevC� S/"— D CJL C/C S� 2
roperty rTax Account Number.—QQ
3 . j Approximate Site Size (acres or square feet):
4!4is site, cV.urrently developed? yes; no.
If yes; how is site developed?
T
5. Describe the general site topography. Check all that apply-
.
Fiat: less than 5-feet elevation change over entire site.
Rolling: slopes on site generally less than 15% (a vertical rise of 10-feet -over a
horizontal distance of 66-feet)-
Hilly: slopes present on site of more than 15% and less than 30% (a vertical rise
of 10-feet over a horizontal distance of 33 to 66-feet).
Steep: grades of greater than 30% present on site (a vertical rise of 10-feet over a
horizontal distance of less than 33-feet).
Other (please describe):
6.' Site contains areas of year-round standing water. `' ;Approx_ Depth:
7. Site contains areas of seasonal standing water: /V O ; Approx. Depth:
What season(s) of the year?,
8. Site is in the floodway floodplain of a water course.
9. Site contai s a creek or an area where water flows across the grounds surface? Flows are year-
round? Flows are seasonal? (What time of year? }_
10. Site is primarily: forested ; meadow ; shrubs ; mixed
urban landscaped (lawn,shrubs etc) '
11. Obvious wetland is present on site: .
n For City Staff Use Only
I. Site is Zoned? !" 5
2. SCS mapped sohl type(s)?
3_ Wetland inventory or C.A. map indicates wetlan present on site. ''o
4:*• .. ;Critical Areas inventory or C.A. map indicates Critical Area on site? /VO
5.. -Site within designated earth subsidence landslide hazard area?
6. Site designated on the Environmentally Sensitive Areas Map?
DETERMINATION
-`-''STUDY REQUIRED CONDITIONAL WAIVER
WAIVER
Reviewed by:
P aaner Date
R&WOMM