HomeMy WebLinkAbout19132 59th Ave NE_3031_2026 PERMIT TO INSTALL AN ON-SITE
SEWAGE DISPOSAL SYSTEM
Division of Environmental HeSnohomish Health District
County Administration Building, Courthouse, Everett, Washington
Acct. No. lz ios-- l_,�r.- � Cl Permit No. r C '�r�:7
Septic Tank gals. 4.r.1L)I i a'lLLZ46t Z'_'�,
Disp. Field :30 0 sq. ft.
Trench: Depths Width.-tom t n
Date n J '" C1>
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUE
Sanitation Office — 259-9473 —
DO NOT COVER SYSTEM BEFORE FINALLY APPROVED BY SANITARIAN —
! r:.:i:,1Ci Addrrss t:tEst ►� :i.isr.r ` r'r�ti r+:<�)11: Telephone
Builde>Q Ur_ln.n c;gfiStrtlCt''.�v, c - -
Designer ;,41'Tv Addresx
7l11 liC`+�Ri:! '�vhisi":. Ve1t�t1 'l}l License No. 15f,-4:-7i i
Soil Log Hole No. I 11rown rilesn"fill\i spn4lV lots i. ' 1 -:li3r' f.irt'V Irfjv ',Iv
Soil Log Hole No. 2 - (i—'r�lr' IiPUN'Yl �'!'• V;'I '� 5€dllCi�! IC>krf ! )'t�3 �r t;il't' Ti'f+VE'�I �8lfiti r ]f: i 1
Elevation of Water Table, if encountered. (Distance from ground surface) rione
SNOHOMISH HEALTH DI 10� P,086 �Z
STRICT s
Sanitation Office — 259-9473 �� ��•IZ
ON-SITE SEWAGE DISPOSAL INSPECTION CARD
Post This Card
ACCT. NO. � •A/�• Short Plat/LTS No. __ Lot
NAME //�� a
, et.A _ChX�'j&*ffV 4) ADDRESS—W�!==
I hereby certify this system was installed under my supervision and control and complies with all provisions of Snohomis
Health District Sewage Waste Disposal Regulations.
Signature of Installer Date
Approved __ _ Disapproved __ _ Date By
Remarks
Engineer or Designer Date
DO NOT COVER BEFORE HEALTH DISTRICT APPROVAL
Final Approval — Disapproved Date_ By
Remarks
Sanitarian
_— _ Date
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DUNN CONSTRUCTION COMPANY, INC.
GENERAL CONTRACTORS • ERECTORS DUNN"191B2
PAGER • MESSAGE: (206) 743.1252 or 259.9124 : OFFICE: (206) 347.3411
7429 EAST HEATHER WAY, EVERETT, WASHINGTON 98203
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SNOHOMISH H AL TH D/STR/CT !: 1
EnvironupAlw..ieajth Division
Courthouse, Everett, Washington 98201
APPLICATION FOR 'A SEWAGE DISPOSAL SYSTEM PERMIT
(Submit 3 copies) �•
.Acct. No.
Permit to he issued to ±:,.-nn ( lonstructi--n Inc.-
For installation at (street address)
Sec. 15 Twp. I Rg. ;i Short Plat No. Lot 23 Plat r`,.rlirzi;y)n lit-rC}11'tt'ti+'�t1 i'"ri, Lot Blk.
Type of Building: New '� Existing Single family residence No. bedrooms
Water Supply: Public 1#\ i l ,'�F1+ilKtOt1Privat,- Other: (specify type or use)
Builder T-)tInn '`;t)Ct tl'uctia}! ( '0-!11C:Address 1,"29 Epst Jeather F`.' +V ?`k'erett 9Li1L Telephone `'47--,l.)1l
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Designer 1,&Pi"J 11. 1)t°W1 Ci i` Address 101 H(?w h I /kV¢nun .'yej`ett 2,'-?2 1 License No. 258-079
Soil Log Hole No. 1 10--2?." HT-OVI111 f,ir935'0ly swwly tooth. N-4g01 Qrey f 1j-p efly s&l?tiy 1wilt;
Soil Log Hole No. ' _ 111--2 4ie i4ne n f"novelly sam.y jollftl. 24el!411 (!Pr'y ;"1'•}VE'1{x .4tir,iV 1(gjj 1
Elevation of Water Table, if encountered. (Distance from ground surface) (10TtP.
Corrections to control surface water if needed .lot tlr?�x�CC
Fill needed: (Amount) none
Percolation:
Test Hale No. 1 Average Rate ;t hii*Anc h (Fall in min/inch-bottom 6" test hole) Depth test taken
Test Hole No. 2 Average Rate 3 ,,,in li rT,•„ (Fall in min/inch-bottom 6" test hole) Depth test taken :3 F,'1
Test Hole No. 3 Average Rate 3 r:=lt1/ilu•Ij (Fall in min/inch-bottom 6" test hole) Depth test taken -
Average percolation rate on which to base drainfield design :1 :ldn. •( c inc'it Date taken 1)c-opiTiher
Septic tank requirements based on present rule and regulations:
Septic Tank Size 1-10011/2 "Orrin. gallons.
Amount of Square Feet ofDisposal Field ( s( uarr• `t. Tr. Width '4f' Tr. Depth 2 4n
i
Signature of Designer *^.+ Date his 1989
DO NOT WRITE BELOW THIS LI (to be completed by issuing agency)
No. Permit Date Sanitarian _Pending
Permit to he issued DaIe t.j i.Sanitarian_
Rechecked Sanitarian Wet Winter Months
Check Received Cash Received Permit Renewal
Called for Inspection Installer
Permit issued (date) / Permit Number
Ho-1 4 .