HomeMy WebLinkAboutSEP1977-00351 SEP1-1 - 3S' 1
'.03 E. Caroline OLYMPIC HEALTH DISTRICT Receipt No. , ! i� i `k
Port Angeles, Wa. SEWAGE DISPOSAAL PERMIT olo
457-8583 Submit in Duplicate Builder t-+ t1 f: ',
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802 Sheridan DATE ' f 9 '2 n
Port Townsend, Wa.
385-0722 Installer . NR .
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OWNER ADDRESS PHONE , ,x
DIRECTIONS FOR LOCATING SITE \
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INSTALL NEW SYSTEM REPLACE SYSTEM PARTIAL REPAIR TANK/DRAINFIELD o ui 4 ke
TYPE OF _ NO. OF SITE z *
BUILTTNG / �>46' - BEDROOMS 61 BASEMENT ENT Al') SIZE gq, �iZ. x '�'�i.
DRAINFIELD LENGTH 80f WIDTH -5' DEPTH .2. #LINES ! TANK SIZE OOC) GAL. o �� °`
TWO COMPARTMENT v2i , ..
DRAW DETAILED PLOT PLAN BELOW. STUB PLUMBING OUT ABOVE FOUNDATION FOOTING x ('t * .,
C' V SOIL LOG: ro *aa'
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ANY CHANGE IN BUILDING OR SEWAGE DISPOSAL PLANS, OR LOCATION INVALIDATES THIS PERMIT 0-C
UNLESS PRIOR APPROVAL IS OBTAINED FROM THE HEALTH DEPARTMENT,
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APPR•, : DATE INSPECTED PARTIAL/FINAL DATE 7`�'
SANITARIAN'S COMMENTS: Q i
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li SEE REVERSE SIDE FOR AS BUILT
'OHD 2-77 #54
DRAW x, f :ELM
I CERTIFY THAT THIS SYSTEM WAS INSTALLED IN A MANNER APPROVED
BY THE HEALTH DEPARTMENT
INST LLERS SIGNATURE DATE DATE INSTALLED