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HomeMy WebLinkAboutSEP1990-00752 .y Health Department 649x0 - 16a • Receipt No. Ave. Fee: d, WA 98368 22 Date: EVALUATION OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM AMID/OR iWTER SUPPLY Information Requested: Individual Sewage Disposal System — Water Supply Public Private Applicants Name (1),1c./L 7)lam', Mail. Completed Report To: Owners Name Address // g`P 1G h j ;%/+2.. Phone: Number of bedrooms Previous Owner. ( if Kncn) Year Installer? Legal Description: Section )t Township .2".1 Ra! _e Street Address 31 �Yi�d 111, 0 cir.) r . Directions to property C) FOR HEALTH DEPAFTh1F T USE ONLY - DO NOT MITE BELOW THIS LINE 61 SEWAGE DISPOSAL SYSTEM* Permitted system f yes no Installed prior to permit requirement yes ✓ no Sewage noted on ground at time of inspection* yes ✓no House is unoccupied therefore an evaluation of drainfield performance is not possible at this time. A review of our records indicate that this system was designed to 3. service a bedroom residence. This system is"not considered adequate for a bedroom residence unless it is sized per current regulations. Septic tank should be pumped if not done within past 3 - 5 years. WATER SUPPLY Well casing 12" above ground yes _ no Sanitary seal in place _ yes no Well 100' from drainfield yes _ no Water sample taken yes no Sample results "cefrc da.S It cf rIst,ct., [e.i '_ ✓ � - \vd c7F '��Cl�h�5 � A fi �J 17�vi� / tea Pt"' 4'1 N1 ct., t,r, i- cs),' r R.-LJ Se � 4-15 e1l Of 0 Date C- l-1 o Time i°00 PI"' Environmental Health Specialist * This report does not constitute a guarantee, either written or implied, that O the system will continue to function properly. This report constitutes a summary of findings only. 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PORTION OF THE NE 1/4, NE 1/4, SECTION 10, • r . .. .• . . TWP. 29 N, RGE 1 W, W.M. . JEFFERSON COUNTY, WASHINGTON . . . . . . . - • . ., • 1"411 eW4V7 4,r. . %pm. Ngat• • . .. . 0-14, : .. .„ 4' . *IC-#'). ' • ' •• (OW vv. . • • .• • . .. , . • • • •. . . *"' .. . - • 49 .5• 340:. 51:::5 --.."'-----.4j.,)4.,D.j"'ra' 't"-l--------------"---'.v't;)..44,f . Alwd"..464"wilaw7.3 a.: . '' ...:..: •. ' '.'. . a III . . 4 elk '' ■■ . iv 'a h' t •. 0 fACC153 ??, 040 AWIA' LOT I 0.41‘19 N"fi,g7alt 41 ...\\di$17ir.77:-.6f7t11*-2.1t:AvrAtSe:AI MZieNitr...austaz.°e7f4 r/a 4:5(24 '' •4 . .- . . NI. ..' • II . . , . k 4 ; . . . . ••• 04 N ' I 4 . . / • ' . r.4,s.. •,";,),. . • 1., - 14 q , e ittil : ■ 9 aNu . q . . II § . n R 14 - . . pi . .. . •. . - • . . 1! ,,, I. • • • •ikti :.'. k , • , . Z • e 6.,o . . . . . .s; ' I II - • ?A'oeit dot . k I , '.•;,, q . . 'A , itl'( •••• . • . ) • • • 1•A OM ..it ■*a +4 • ■ ck • , • 4441 ' ti , . • • k . , 0 . . . • kgielibnia : . N °+. 10. 44- , . /5.. ...) . . .1;1: ' • .. • • P,-,., . . , • . -C.4 • • .. • ' .WAILS.I*.40' : : . 1111141.11000111PTION :.. , • 4"/V•IP4 AT 7'4:Z) ,. . . , ser 441-ll'ire4R_ sal .1M ranted/KO fest Of tot tonterV 300 Net of Ow ealltivreet wortio• , • 4.8. e04•Att IA CAP . • ,• the northeast WNW of us netlheNO quested of*Won 10,lownsidp SO .. • • .• folrio/444,1• • NI*RanStr1 Welk WirrellOOSiddents.40/101mmtllowlp,WahleOln • • ., 140 N • • . ■ MA T ORSCOWTION . , . • • .• • ,...4•4001:Aw• az ' • . . auk. rim, NW pagan of Ihe neatness*wow•Ownorlheael row*of Salon 10, • Township 30*MIL Noise 1 Wat, VelisneMla Stoddlin deetelbed es • APP ON/Lay if 44(44_,111,2L. . . . ' ' 'Odom . . . . i • ,., • . . • .. lesohnIng at Me nanheael comer of geld Mallon 10 from which lho east • A-2., /‘..7X.kitowtioo.tier•--) INICLANATION , • wallow owner beers•t•112 AT•end INe 244434 WM&WM 1herwe . . 14 str so' w w 110110 the nor*One et said Section 10,•detente al iitriNit C01•4111100•11111 Know ell persons by these prow*WO ws.Oa walsrolowd,wan Who Lamas kw to Me nonliving owner of Iha northeast quad, al the • ,..— ; . • ..., ..\ sirs* of Ns lond herein dossrlbed, dada l Shalt PIN and 010 4 noshoist quarter of WO Sedign 10;Ounce'II I•33'eir W.Mona We west oseematle depidod'wean 4 be oreeted by our Iree vill and tweet* One of saki subdivision,•deism*of$70.30 Natio the northwest corr.al the southwest quarter ot the northeast quarter al the northeest quer*of •1 add Sedlon 10; Minos•or to' or I along the north Ines of oadd . • SPAM Of COMMISWONERS , , • subdivision,•distance of 331.3114•(101tio TAUS POINT OP ISEOINNIONI; . ' • . ,,.. thence conlinulrig II Sr 112 44'I*Wm mid mot aim•*WO 0• • _ .. •_ , 300.24 kW;Mews II 1°fff.31•W,a dehnee of 100.011 Net thwat•W •. 41300,4414 Ifw 4 dolt 4 ,i.ic) .Nat . . . '11,44 W paned MO eald nodh Ine,•dean=of 300.24 Sad;twat 14 ' _ t ph L. Roby Toni G. Rob t•rr 3r Eot*Wee el 101011Na No mkt norlhlts ervkliNilt POINT ‘-t • /'•- Ruby OP SSOINNIIIII. • ' , L,„-WO-kW i',...--‘.‹.. -"ff,_ • 1 • Oslo of Washingeot ) . ' . Nectar doitioanto )fo • . . . mum in,hams„Gamow.vitistromet ., • . ,JOFFERSON COUNTY moral DEPTANTMENT • County cd ) ' • . ' . • •, . • %OW person**vowed twAre mooted",A.end Leese S.Toylar, t Ot- . , • • " . '... Atoresed Ode La__dm d Q.t.tect- .reN. woo,a no a to so Inclaidurde ciseorlbed hereth and who oreceied the . . '; .-* ,. Want and brigoIng Ineinansol al Ihoir Ow gni Wien sot and do.tor , , , , i Itte wee and mandated Woralit ie I ,\,__ ( • . • • .irrInstav PtA4M",littfunorsur owg:iiiiiigNfii, ohm Awl Ode,, Iiiii•ofel,4_,,,WU. I. Loft awituf herein shel nos be furter*Med In ow meow WO* ,•.. • •poled of Soo IL owe West*11411414 MOOS tong OoL . _A/ • c't.,,, 71, 1 • ' • #43PoIld eell.F.:_li*V 0 441114Ito..•"It - • L Pitkilisid somment 101411•8,Ihe*IMO 0 k II 1 Itit Maw% e4, ---- erZ44pAzeczw. • PIS*NM;IMO. . ' 1..__. n Igtv_41. . • Airrl="67;;Fiticas - _ . :$7' f • r — . ..v4;,' CO/AIYI melding P rot foci 441;s..1.Cloy ti LA_ 19 lio.."„ . ', •:f;. or orlinn 410301: Ai 4 / ,- • i . . • . . . ,..-• • •,,,„e , • .......... • • , 1-1' • '.'r• • •ttwilasionerS . , .. 1/42011111111111111 011111PICATII . • , .., ' N. • • ,I 1. • It. Xi • t.4a.h...eci,, , . , , .. . . I,le MIkkelson.Tumours'of Allieson Cosy,VANIOrapon,Mosby so* CrV116.c..4 -dOiiiiiii4neril IMO 41 rest property Woe due and/or dspoallo NOM 4 cow WO '''''.... ontIcIpeNdl loxes on Ms property ernthiood In Ole Shad.0 • • ' ' 1'.. 2'it. '0 nud i+or'* C .r-ticie.iffe. up, • • pill to and Including M wor e 111,XL. ., . • . i ltd 40r,rAica,rei-141;.5-1_cloitoof itczniLl 19/2.4 _. 41011-11"NI. . . ... .,., )..) in boot fq of p la OS sti • fie -**New taloa& • . .h. ,, . — ' .... . Si • • -.,,..,.• 4, of `4.16,,$)c.A-'VI.InAL '1.1ZCAAC. ' 2 s:4'','• .0a, • 0 1",a,....0 r'• JEFFERSON COUNTY TREASURER • —3 . Ma IL SAWN oP's 4his clay personalty ateeare.4 before let • , , t-(... ' 6. #4141Y6 .111 . ftul• Knitun•i0••••• +0.b e 4:he.inalviaivals clescr .; •.. aim . etiCCers°n C4r4n3Y F"Hcr bAKkg;44:11-----. efetiu+ol *tie to-Min and Tore's»,Inetr araawr . - ' 0. . ' . r/a+ary.ech on4 deed tor+Ix uses and purposes men 4e1 • , . —, . . . I . JUN 0 9 1992 . . asosoo . . , eriln. vraisr wy hand snit.444tial eftia of MA. . . W4a1,61,,,trn res1Jini• •/ 4 1 r ' t:',.1 l•rif", f ,. . . . ..,„ „ • '•• VIC/MITY PAP (NO SCALE) . . .I. . . , . i--; . lirriammusc- , op-1r- il auditor's certificate icate: LIZ,' is "'"‘1:119 surveyor is certificate: • 1 si., ,i , fll*d for record thts-1.1-day of #+L4 19-1-41 4" I HEREBY =PTV'S THAT THIS SHOAT PLAT SASED UPON AN 1%.0 • w4s...4d., -t' , wow Mtn spettelleedelleas 31/41 P m. In book--a—of PMI's ol Ms la0 al the SURVEY, THAT TOE COURSES AND DISTANCES C SHOWN • s ,c, • ..-."...r"•1•2 ._1".W..T. rthOteet.41 Ci6• 1e.t r,i-vArd , THEREON, AND THAT ALL REQUIRED STAKES , — • • , 1 ' PLACID ON THE MOUND. A ,,,, _.. ,, ,, . . . /d 1 AdicirgO'G OE . ANC t (,,'! ,1 '. . • ' .....444—e—Zdj--... 2 i is a p ...1.1-... doe o..... .._- __ __. toiromm,. 1=23:=1 Jefferson•Count Auditor • ' b •- eput ailliallailt-. 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