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HomeMy WebLinkAboutSEP1970-00084///VVVf l��'444 �o �J'¢ �/• L Sq 903 East Caroline OLYMPPIC HEALTH DISTRICT Court House Port Angeles Port Townzend ! BUILDING SITE`INSPECTION.'APPLICATIO D Submit in Du 3i dte -c OWNER Z ADDRESS DATE. -a7-,7 LEGAL DESCRIPTION =� o 6 �t DIRECTIONS FOR LOCATING 'SITE. �5.. • �a AN APPLICATION I HIRE -Y MADE FOR APPROVAL OF THE ABOVE LOCATION FOR A STRUCTURE WHICH WILL BE SERVED BY AN INDIVIDUAL SEWAGE DISPOSAL SYSTEM. RESIDENCE COMMERCIAL BUILDING, OTHER 1I NO. BEDROOMS BASEMEN SITE SIZE S SOURCE OF TYPE OF SOIL ���G�' DEPTH TO WATER TABLEi__I D. -RAW A SKETCH in the space below, indicating location'of building in relation to other buildings, property lines, well, streams or other bodies of waters Indicate proposed location of sewage disposal system. —� i R ,• 1 I 1 a �9 A4V4 Date of Site Inspection Approved*`X Disapproved * See reverse side for remarks. ii N PLIC SIGNATURE Sanitarian THIS IS NOT AN APPLICATION FOR A SEWAGE DISPOSAL PERMIT. A SEPARATE PERMIT IS NECESSARY PRIOR TO THE INSTALLATION OF A SEPTIC TANK AND DRAINFIELD. 7.7 ti up v ll� �II h { n I - uLI'lrq-C1IL;.-; .40 C4.40-Clj 'C- ,I - ` a 0.xc? s-E,".aaj. p.-I.Io , Wa's a��rnas -e jo p.xooax-o.0 putt tt '� -sem ,a - sLjnuola +� .ao teueo T.J.a.- Xqt�aZ.s�s- tLg patT'3swc, sr'q &Im aogtj2'Tau ano.1 j'o UoT coal, JO @W(,U'Frtno.O. nOZ qT 04 oaadT L: oStc-t.;`�Y 6m I 070.I ,,IeTj4ouL- pui-j o1. £a:rscaoou oq 'ClzrA Vt saoq:g2-iou .anol' .10 nod ©4 .p;z u�i� L��`[ atj ,zo sou stnu: e.sauooaq ao/puu. -[vu-e POOH, s0�.nTtaci .' puno.T oz� o� uo` 4no s3juaag pug ;�.zo;.; e c u TXoAa- aq! uZ.. ��'Z � noF L[.Zt?W7a 0 �''n[u '�► `: T' xaaj j 'soaarlo„ 'spa,au alno ..'CnS oq `a� K't1�)ajJ�' _sL S"�ati�01 lij q:-pau z:: .o Qu oip -p -c 6' pzaTs - s ? aZ �tno^ paa1aoaz - s _ uo uzusw" °.za�su� 2 antii �agTWA n _ 0661 `.61 ,xaqu �aaokl , .'a0,42uT 04 spdo0u o L 4.10,; s Map Output Page 1 of 1 in County does not attest to the accuracy of the data contained herein and makes no warranty with to its correctness or validity. Data contained in this map is limited by the method and accuracy of its AmIMS HTML Viewer Ma sa a reawrea sa aoei , TOWM }�, syiseam. �Vi6PFVi7, �b� -/� ♦ if ,� mots Mat�16A is in County does not attest to the accuracy of the data contained herein and makes no warranty with to its correctness or validity. Data contained in this map is limited by the method and accuracy of its 2,07 �TOX 3C� Yid Avo, WA 99 -Dote 'App' rlDve&.- h. Area r :z> --I -x x- cD m -0 CD —I cc -Fs x —I —1 tv CD cv m -- -- nm -s 0) x — Q C7 r+ x n -v nm o — -v CD 0 tv v -C Q m 0) — CD C3 m 0 r+ o CDD :t# r -s E CD r cn O =3 O c —► M: 4+ m C7 O cn O rn O � W O O � = ry � -4 Q ry o rrcn — 4h. -.. O m O C.0 w cn -89- � cn O —I� o r+ w — w _ cn ccs n = O O C3 —I cn m H --,1 7} H - — C r m T ry CD rc"�oac-:) Om W r -z xc"o -cr*3M- _ • C= CM mr—I m -C r. OCD —I zmxcn --I c- ■ �o m v ry Q c:; co v m —� rn • ry oo C7 m ry r o —t 71c -P z M v m r rV O • vz = _ `.x —Icer. • mmvo = v r-ry M3 = r . O H r C" • g r c-3 -n r r n —I oo -P a z= m m = o -C —► 3> = z a - x —� r- v 00 H C7 O -P O c,3 zrn7qc oC� - CM z a C7 r to coo E3 `, cv I m o c =3 co C� c CL w r C"3 -P r-� c m m cc CD CD O O -0-0 ao z m C-3 C7 Cr CO�- 1 O cm C. cn H c C3 C7 z cc G7 "5 cn m 71 cu m m cn C7 O w H C7 `. z Q- cD c co H cO --A3 J