HomeMy WebLinkAboutSEP1971-00021903 East Caroline
Port Angeles
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OLYMPIC HEkLTH DISTRICT �`, , : v` `'-Court House
'SEP rl I — 00 all Port Townsend
BUILDING SITE INS1E' TON APPLICATION
Submit �..n Tom.$ cc: 4e � 1640 -
AN APPLICATION IS HEREBY MkbE FORUAPPROVA OF THE ABOVE LOCATION FOR A
STRUCTURE WHICH WILL BE SERVED BY AN INDIVIDUAL SEWAGE DISPOSAL SYSTEM.
EESIDENCE__jj9 COMMERCIAL BUILDING OTHER.�'Y
NO. BEDROOMS �,. BASEMENTSITE SIZE/ -0&c, SOURCE OF WATER
TYPE OF SOIL DEPTH TO WATER TABLErl'
DRAW A SKETCH in the space below, indicating location of building in rel&t,on
to other b dings, property lines, well, streams or other bodies of water
Indicate proposed location of sewage disposal system.
Date of Site Inspection. 5Z5Z21
Approved* ,,/� )isapproved
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* See reverse side for remarks. 5�
THIS IS NOT AN APPLICATION FOR A SEWAGE DISPOSAL PERMIT. A SEPARATE PLRi�,IT To
NECESSARY PRIOR TO THE INSTALLATION OF A SEPTIC TANK AND DRAINFIELD.
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