HomeMy WebLinkAboutSEP1971-00074r -74-
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t CaroliOLYMPIC FZALx7 DISTRICT Permit No., -;,69 � ...
""P. -Ang les Fee Paid $ e_0
SEWAGE DISPOSAL PERMIT APPLICATION
Submit in Duplicate
olden, Paul lvf 4le-� C-
um. ain. Qhjjrlj& AA ADDRESS Nordland DATE 1-4-71
IIEGA.L DESCRIPTION n of Gov Lot 49 Sec. 4 T29N R1E WM PHONE;,
DIRECTIONS -FOR LOCATING SITE Meade Road, turn left on Marrowstone Rd, Lots marked
VIA H si n -someone alwa s there. , h" a®�. �� �y'es�' SELL ®& /11�ravrsl
APPLICATION IS HEREBY MADE TO: INSTAU NEW SY$ EM.j..REPAIR EXLT=_G SYSTEM
Residence 2 128 x at lea t 2 baths none Shold
E OF BUILDING NO. OF BEDROOMS BASEMENT ISnA&R. NAME OF INSTALLER
_ ON THE REVELS SI E, DRAW A DETAILED PLOT PLAN GIVING THE FOLLOWING INFORMAL';
2-* -property
2*_Location
nines
7.
Driveways, patios: carport# etc.
3.- Location
of building
8o
Streams or bodies of water nearby
• Location
of septic tank
9•
Location of percolation test holes
of drain.field
10.
Septic tank size, _.Z gaiLms
.-.Slope of land
"ater lines "& well(if applicable)
11.
12.
Length of proposed drainfield
Depth to water if encountered.
PERCOLATION
TEST
RESULTS
--.Vv r.Lme required to Percolation rate type o= sv-..i
of hole seep last 6 in. (divide time by 6)
Ferc. No. 1
Parc.. No. 2
Perc. No. 3. y ....�,...�.
"AINFIELD LENGTH b d WIDTH- DEPT I c,2 N0. OF LINES
-IS HEREBY A REED THATT$E.PROPOSED INSTALLATION WILL BE MADE IN THE MANNER
Ari --DESIGNED AND APPROVED ON THIS APPLICATION.
APPROJC.... DATE OF INSTALLATION March 15 approx. Signature of kfplicant
SANITARIAN 13 COMMENTS:SiI-ubb,ny PIw...6i 0� 1--n . • :r(- ya j Is is &'Filler(
ke �l®ar plo� _fo 544,06-ale.515,44,tesir¢l 64 _kip 73+-14 4f dvai�t*tj
PLAN. APPROVED DISAPPROVED DATE- �t2
ITARI
REMARKS:
5-68
O
N
let
Screen: 01
Parcel # 000921042030 Geo Cd 292104203210
S4 T29 R 1 E
TAX 40
Mode: INQUIRY
Auto Roll: OFF
Nbad Cd 3210
* Taxpayer Cd GOLD 0840 GOLDEN, ANNA J TO Chg Dt 9/17/1997
* Title Owner T/P Chg Usr KELL
Tax Code 0211 Status TX TAXABLE Land Use 1100 RES -SINGLE
Affidavit Vol/Page / C/U Code S/C Cd A
1 1 A A 7A /AAI1 r%f%r, % 7 /A P% i f%nAr'AA lf%f% 7 A -------L