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HomeMy WebLinkAboutSEP1988-00283 • o g E/P�1.-P G2a.,,.--- ill ��/�� T r -. . � .oi.4' v,-1,4)-40. ?=rr.� 61SOR CC INTF !•9rr.t_TH is�EP'ARTIfLNT 802 SHERIDAN AVENUE INSTALLER j.. L_Cr-v ceis _ PORT TOWNSEND,WASHINGTON 98368 RECEIPT NO. i40cZ. (206)385-0722 ,.5-o.o a• BUILDER - SEWAGE DISPOSAL PERMIT DATE rd -04&- f2 c u&1 c & wo P D. -cam t,,r. w A %'"3 a s . {er- . r' a. OL • s. . .: .«•i •A.1/11 %? .�R5-344.4 m `_ N Owner Address , Phone 4/ L. - s- _ , , : et frya p u Z. >� Directions for loc:ainp site cn p';; Z E d C) INSTALL NEW SYSTEM❑ REPLACE SYSTEM❑ PARTIAL REPAIR® TANK/DRAINFIELD ■e• 8 - O TYPE OF NO. OF �Z. �CCY i"`\<�.4 v ),.` SITE , t� Z BUILDING mob i It. BEDROOMS BASEMENT SIZE 9S .. . :13 Previous site evaluation by SOIL TYPE DESCRIPTION Health Department Yes x No 1)Depth to maximum seasonal water table > 7.2- ' [: Source of potable water supply 2) Public X Private Source type: Drilled well ' C ,) -P.r. .Dug well 3) to Other < _ . in v EVERY APPLICANT HAS THE RIGHT OF O 2 APPEAL AS PER JEFFERSON COUNTY ORDINANCE 2-77. 4) c SIGNA RE OF .1571 41. Z ANY REMOVAL OF OR fiVJOR DISTURBANCE OF SOIL IN THE PROPOSED OR APPROVED DRAINFIELD cc O AREA MAY CREATE SITE COND 1 T I ONS THAT ARE UNACCEPTABLE FOR THE INSTALLATION OF A oo SEWAGE DISPOSAL SYSTEM. ANY CHANGE IN BUILDING OR SEWAGE DISPOSAL PLANS (INCLUDING A i PLU•'BING STLBOUT LOCATION) AND/OR LOCATION OF HOUSE OR DRAINFIELD ItNVALIID4TESaTHIS te t, PERMIT UNLESS PRIOR APPROVAL IS OBTAINED FROM THE HEALTH DEPARTMENT. r P for final inspection). STUB OUT PLUMBING ABOVE FOUNDATION FOOTING. 0 Drainfield Length Trench width Trench depth No.lines Tank size > Soil type and application rate used for design GPD/ft2 -- 0 4 CO : -4 \ \c..e_9- - ten.- CS o�t_(w...--- ck 1C,3�k N eA .e ,o ' OS )<q.;1 f S-ibi4,:ited lio -lo-$`l by M. - K =ec. ti -I -4c .(_c9` \ ... y II- I h -1 o OE- ` -s` -D APPROVED DATE INSPECTED PARTIAL/FINAL DATE 0 I certify that this system was installed in a manner approved by the Health Department m z INSTALLER'S SIGNATURE DATE DATE INSTALLED 9 JCHDf7-,8'4 LL; goyr . zueeei i_ /J`` - ,e/' /e# 1,40 ___3 Gem: 'i;/ 01--24. e . . , • . , . ... I . r , r al .1;5 ,-. a. ' d s-- \ <-)- ,...:. S' 1' cc : ) r '4 I ... •-z > S) S a --7-- 4- b..... --„.„ cr, 0 c, is6TH I t V 4-- q. ----;\ 4 N 1 s -.... - . Mi I ( ( ,1 Or ri, . . riff i e •;-- C--) L.... 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II. 1 i 'r fi -t 1 ,t; J c 3 ,C ? . 1/4.) i - III I 1 I I , 1 . 4I I • y I I I 1 t1 `' I I t1 t L 4 t , f--‘..0 ei_a_r- tio R0,r°v —' N • 0 t. `Sl E � '1p i/\ c� o �t` l \9y 'eg1/4 ,-,'- '6)% / - I a �i ra ' K` Li Lu tte` --... -I L 4 I -•- is I, !' •4 °v.2 ir 1 t J + ' a- r P I ( G `oI I to e % sq a `h e ei I .a 461 WP Lee R4Q, • �I I, I i I i H. I SOIL INFORMATION Owner : 66taLict. 7d. Legal Description: Section 1/ Township 29A) Range / 0, u0,rv2. Subdivision 4O-e-hn.e.r Shor-f- Ia.:t Division ' Block Lot Date Logged: /p-a- Rec' Include soil textural characteristics and the depths at which significant changes occur . Be sure to include depth where mottling or impermeable layers occur. Soil Log #1 TYPE 2/1/2 Sol] Log #2 TYPE .1 0 to ep in. Trio,/ 4 to k in. s.c/z..s 4 to ,2y in. Ten /11.4-1. sndlgr to in. Tan 'k—u.e.sc.snligr. lit to S3 in. ra.h -IL ece. a/4igv: to in. :i3 to loy in. T1A -ems c, to in. Anticipated water table > Co+/ in. Anticipated water table > (,2 in. Roots to 5..2. inches Roots to 60 inches Soil Log #3 TYPE L- Soil Log #4 'TYPE to (o in. S.c-1 L. s to in. / to 46-* in . -00 tl.ese t to in. to in. to in. to in. to in. Anticipated water table > (.S in. Anticipated water table in. Roots to lea inches Roots to inches Soil Log #5 TYPE Soil Log #6 TYPE to in . to in . to in. to in. to in . to in . to in . to in . Anticipated water table in . Anticipated water table in . Roots to inches Roots to inches USEFUL ABBREVIATIONS FOR SOIL CLASSIFICATION DK. - DARK SND. - SAND FN. - FINE BR. - BROWN LS. - LOAMY SAND MED. - MEDIUM TN. - TAN SL. - SANDY LOAM CRS . - COARSE OR. - ORANGE SIL. - SILT LOAM GRV. - GRAVELLY GRY,. - GRAY SCL. - SANDY CLAY LOAM COB . - COBBLY YL. - YELLOW SICL. - SILTY CLAY LOAM RK. - ROCKY BL . - BLUE CL. - CLAY LOAM CPT 'D. - COMPACTED C. - CLAY CMT 'D . - CEMENTED V. - VERY X. - EXTREMELY MOT. - MOTTLES RT . - ROOT DEPTH FNT. - FAINTLY DIST. - DISTINCTLY PROM. - PROMINATELY 903 E. Caroline OLYMPIC HEALTH DISTRICT Receipt No,277 9 Port Angeles, Wa, SEWAGE DISPOSAL PERMIT 0 Z) 457-8583 Submit in Dup irate Builder ti ,N Q 802 Sheridan Date /6 -/.. -77 tn oq Port Townsend, Wa, H 385-0722 fa / 6,3 e7- Installer y/ 34'495 . it OWNER ADDRESS NONE DZ'ErT2^NS FOR LOCATING SITE / gCack Aloe-. o . . .. ,a ,c ' 1--". . ., v, 0//S44414(1 2ft/ leenc7 i.) /..r OA)e /s ., nr.vccoay, I-3 -o INSTALL NEW SYSTEM !r REPLACE SYSTEM❑ PARTIAL REPAIR Q TANK/DRAINFIELD o'' , TYPE OF NO. OF 3ITE ?tt 0 BUILDING L/e_. HnMe_ BEDROOMS BASEMENT SIZE ,(21© 'h DPAINFIELD LENGTH/(„ i WIDTH -:.'- DEPTH #LINES TANK SIZE/6"4( ` GA + ro TWO COMPARTMENT. DRAW DETP.ILED P. PLM ;ELM , STUB PLUMBING OUT ABOVE FOUNDATION FOOTING , SOIL LOG: v (`��IA . — ilk) —1-6 o �7 Sew ��, � Mobile Home :71. 1-- I H .k 0 4 1 60 14.___7e)/----- 1 ' 1,2e i &jet ,r9/4 rhiva /ti;K / \>\ t �Y3 NY CHANGE IN BUILDING OR SEWAGE DISPOSAL PLANS, OR LOCATION INVALIDATES THIS PERMIT Ri od/r6 UNLESS PRIOR APPROVAL IS OBTAINED FROM THE HEALTH DEPARTMENT, ? A 5.. CorPIE r,p ( / �' •7' �1ia C tip... z°.-ax-R� , r05 APPROVED: DATE INSPECTED PARTIAL/FINAL DATE SANITARIAN'S COMMENTS:/) Ci j rifefe er�cV02 CJ,Ie;INGC I�e..e. /9.404, - ■/ ' /,. (J//�e 0 e' er 11 c_e.)/tkvi n1l'e �., /9-9u-..) 7�,FerS` e5 key C ,sze u e 2 /of 'sw) LC:??dq e-e., ,09`t tfie '4-47';' ALpv�s - 9-) 3) 0-%'v4 L A uef C;'!0--J /* ci i e 157/04 ' Cc clew,,J ACS 0 /0/77 1/,fA',) r,e,/,i)(e-, -7---0 d/0,:. 0:eci /rJ ,6,9C t ex- 4,9i SEE REVERSE SIDE FOR AS BUILT -„r. n '71 *FA r • w 72;21,S fi J /S "Z)0 T -7-07 tee UcS 0 l• , I too .p i 0 Mo+Rjit ,c, a So IIIMIDa I �. -------- ,,"' Y /f .9-fr /oci, 4) ro ` '/e", r/sope.97-? At'6 ,2,4s. /0 4 �a� )n-2----e/ Ii v& O<Eq, !,? 3 r"-/ 9 ) 01 r e!.,) #42(U ? So -co/09-7— / ' cSl5,-,r 'r - S / '9t-‘J 0icE74 ( 0,19e16 .QePES f) icy' ,z)/?'O, ' 1S;- i-49ie,f1 zkev? t--) �i f-/17 <:,;cloPet-,7c.� e-)• ;- � t- °' cz w `S t4. ci�"sS�v e s 3 ' 11'' ''4\j 7 I/i i \\1,141_ -0 1 c I CERTIFY THAT THIS SYSTEM WAS INSTALLED IN A MANNER APPROVED BY THE HEALTH DEPARTMENT: INSTALLERS SIGNATURE DATE DATE INSTALLED