HomeMy WebLinkAboutSEP1973-00162fr
t Wo eo�
903 E. Caroline
Port Angeles
r' S ep -I it 10 Z_
OLYMPIC HEALTH DISTRICT
SMIAGE DISPOSAL PERMIT APPLICATION
Submit in Duplicate
Court House
Port Townsend
1 /o
MJNER — ADDRESS
DIRECTIONS FOR LOCATING S ITE_7&_ jj J 143 4)CS7—
Permit No. 3
Builder
Date /
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APPLICATION IS HEREBY MOB TO: INSTALL . Nal SYSTEM k:::jTWAIR EXISTING SYSTEM
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DRAINFIELD LENGTHAQQk ► DEPTHS�.#M=I=EPTIC TANK
DRAY! A DETAILED PLOT PLAN BELOW. SEE INSTRUCTIONS. SOIL.TYPE
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PERMIT UNLESS PRIOR APPROVAL OBTAINED FROM THE HEALTH DEPAR
DATE OF INSTALLATION�/o %IGNATURFLg LICA
A PROM ✓ DATE ` A/ 3 INSPECTED BY DATE Li/� ��
SANITARIAN'S COMMENTS:
I CERTIFY THAT THIS SYSTEM ':1AS INSTALLED IN THE MANNER APPROVED BY THE
HEALTH DEAPRTMENT DATE_
INSTALLERS NA1v1E
YPE OF BUILDING
N0. OF BEDROOMS
I BASEMENT
SITE SIZ NAME OF INSTALLER
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DRAINFIELD LENGTHAQQk ► DEPTHS�.#M=I=EPTIC TANK
DRAY! A DETAILED PLOT PLAN BELOW. SEE INSTRUCTIONS. SOIL.TYPE
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0 -
PERMIT UNLESS PRIOR APPROVAL OBTAINED FROM THE HEALTH DEPAR
DATE OF INSTALLATION�/o %IGNATURFLg LICA
A PROM ✓ DATE ` A/ 3 INSPECTED BY DATE Li/� ��
SANITARIAN'S COMMENTS:
I CERTIFY THAT THIS SYSTEM ':1AS INSTALLED IN THE MANNER APPROVED BY THE
HEALTH DEAPRTMENT DATE_
INSTALLERS NA1v1E
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L MU i i t.1AE31LtTY for an Io.,.-..-
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COMPANY. T
Owner
Lloyd and Dorothy Olson
Address 261 Old Anderson Lk Rd. Ph.
Chimacum Washin ton 98339 732-47'
Occupant Ph.
same
Instructions for Showing:
Call listing office for appointment
Additional Remarks:
Seller's Signature:
Date:
- . -4
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Z � i
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5
NAVAL x
RES y
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oa
1st T.D. 30,000 At 9
Payable $ 440
Type of Loan mortgage
Held ByGreat northwest
2ndT.D. At
Payable $
Title Preference
s=
NORTH
FORREST ALDRICH,
,INC.-
APPROVED
INC.
APPROVED FOR DISTRIBUTION
T. s rr. Nr]V_ 3 _ 1 cIRR
NAME OLSON
P313 1 SIMS WAY
Bdrms.
Baths
Age
Lot Size
View
Sq. Ft. AssenorsFigumOnly*
Price
5
23,
1 1973
1 6.9 Acres(approxi
privacy
2168
$97,000
Properly Address
Map Code
Foundation concrete
Dishwasher Kitchenaid
261 Old Anderson Lake Road- Chimacum
500
Ext. Const. wood
Roof comp
Disposal yes
RangeWhirlpool dbl
TERMS
Office No.
Cash, new Financing or Cash to assumption
8J8
'Sewer— Septic X
Wood Stove Wd cook s
Water city
Fireplace with insert
Sign
Zoning
Possession Date
Yes X No
county
at close
Ileat FA Electric
Patio/Deck
Wired for 220 Yes
Refrigerator yes
Listing Agent
ph.
Floors carpet,vinyl
Cindy Thayer
385-4301
Garage DBL plus
Carport
Taxes 1002.38
Spec. Ass.
Le al Descri lion: of the SW% of th
P That portion of the NE n 4
,SE4 of S10,T29N,R1W Lying SW of County Rd EXCEPT the
Fence
N 225 ft. of W 330 Ft. of said NE4 of SW4 of SE4
Overall Remarks: Parcel No: 9U1 lU4 Uu / ana vbj uuu _ nu4
This home affords the utmost privacy. Heatilator fireplace with wood stove insert PLUS an
,old fashioned wood cook stove. Wood boxes on either side of fireplace for access from outside.
Double pantry. Wired for intercom, but not installed. Property has been surveyed on 3.sides.
The following personal properly is NOT included:
The following contained herein is from sources considered reliable. Offering is subject to errors, omissions, withdrawal and/or prior sale.
*Assessor's square footage is a representation and not necessarily an accurate measurement. Purchasers are encouraged to verify square footage.
11 ll&rlte,1&",t—
I
ver.
OVE
I,
802 Sheridan
k Port Townsend, WA 98368 Fee:--
206-385-0722
ee:206-385-0722
Date: Y/
EVALUMOK OF 1ND1VIDUAL MOM DISPOSAL SYSM AMID/OR MM SUPPLY
Information Requested: Individual Sewage Disposal System
_ Water Supply --�K Public Private
Applicants Name & ef- Mail Completed Report To:
Owners Name LA 4 s f" A 11 -IL
Aaaress o . P Ida
Phone: 's - { Number of bedrooms
Previous Owner (if Known) a Year Installed 1973
Legal Description: Section �D TaAns 'A 2�lli} Range f
Street Address o2 L, ( /) 1A -A -% .l! .p r i . L- _ 19Z-- KD P'..
Directions to property_ P-19 th't v
FOR RM7K DEPAR MENT USE ONLY - DO NOT 1FRITE SEEM WIS LINE
SFMPM DISPOSAL SYSTEM*
Permitted system 5 yes no
Installed prior to permit requirement yes X no
Sewage noted on ground at time of inspection* yes _)L no
House is unoccupied therefore an evaluation of drainfield performarxme is
not possible at this time.
X A review of our records indicate that this system was designed to
service a _'� _ bedroom residence. This system is not considered
adequate for a S bedroom residence unless it is sized per current
regulations.
Septic tank should be pumped if not done within past 8 - 5 years.
WATER SUPPLY
Well casing 12" above ground yes no
Sanitary seal in place yes no
Well loo' from drainfield yes no
Water sample .taken yes no
Sample results
cote: Sep4 c +o^n L baVoes need to je rep%aced. one bm+f le wa,
n,o4,'ce 4 ov% +he ba4-}ow. o{ +tie Se jDVoL ta-A k , 5e',_ +0, k huA
beerr� t-ecert+l
a
04-'¢—
i•.S�eci:�•�.
pec► - n o s.QA40a � 1 #% -LV t
� tc�. k .o n
-�►e Lt e
-rhe �vt�:u►�e1� aQpecu•ed is
IaQ �cfiv�.:•.�
Pra�l�,
Date 11-3o - g 8 Tim 12: 3 0 •
-I4ivirorgnental Health Specialist
* This report does not constitute a guarantee, either written or implied, that
the system will continue to function properly. This report constitutes a
of
eummeu�y fi;�dir�s only.
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