HomeMy WebLinkAboutSEP1970-0012741,4 --13 -
1 3 East Caroline OLYMPIC HEAL7171 I ISTRICT Permit No. ' 0 �
Fort .Angeles Fee Paid
SEWAGE DISPOSAL PL...0 T APPLTCATIOH
Submit in Pu sate e � �0 '00 2•�
1(AME, ._ Frank- AA,:}, el: •��� ADDRESS4202 Lakeview Drive DATE 6-3-70
Lacer, dash. 9 501
LEGAL DESCRIPTION t 4 Sec. 89 T2 N. Rle WM Fuller's Acres PHONE
lst AM. fs f 4 -
DIRECTIONS FOR LOCATING SITE Frank Fuller lots, Marrowstone Is. Turn right off
Indian Is. bridge -go towards water don t take new grave roa a ou mile. Site
on left across road from water -is bulldozed and leveled.
APPLICATION IS HEREBY MADE TO: INSTALL NEW SYSTEM X� REPAIR EXISTING ' SYSTEMS
f
bile Home 2 No 120 x 150�i4/Or
L.YPE
OFBUILDING NOv OF BEDROOMS BASEMENT SITE SIZE NAME OF INSTALLER
ON THE REVERSE SIDE, DRAW A DETAILED PLOT PLAN GIVING THE FOLLOWING INFORMATI`1
i* Property lines 7• Driveways, patios, carport, etc.;
2, Location of building 8„
Streams or bodies of water nearby
3, Location of septic tank 9. Location of percolation a tholes
4* Location drainfield
jcp
of 10. Septic tank size',jet
�` a
5. Slope of land ll. Length of proposed drainfield
Water lines & well(if
applicable) 12. Depth to water if encountered.
PERCOLATION TEST RESULTS
Depth Time required to Percolation Type of soil
�
rate
of holeeep in. last 6 ( ivide time by �? .
Pere. No. 1
Pere. No. 2 ------ ._......,._ ..,.,._._..- r......,_......._
No. 3. - •----
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(TIPerc
.
DRAINFIELD LENGTH.,/ ....WIDTH DEPTH .z,� NO. OF LINES �•���
IS HEREBY AGREED THAT THE PROPOSED INSTALLATION WILL BE MADE IN THE MANNE
4S DESIGNED AND APPROVED ON THIS AtPPLICATION,
.
APPROX. DATE OF INSTALLATION Signature.of Applicant
SANITARIAN IS COMMENTS:
THIS CONSTITUTES A PERMIT WHEN HEALTH OFFICER'S SIGNATURE APPEARS AS APPROVED
PLAN APPROVED 2LeO6'r� DISAPPROVED DATE •-70
DATE INSPECTED 7
REMARKS
5-68
SANITARIAN
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0
0
0
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i
SKETCH PLAID ON GRID BELOW
SCALE -'-10 FEET BETWEEN LIMES INDICATE NORTH
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1 ♦ i4
903 East Caroline OLYMPIC HEALTH DISTRICT
Port Angeles
BUILDING SITE INSPECTION APPLICATION
Submit fryrin Duplicate
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Court House
Port Townsend
OWNER Frank Aigner ADDRESS 4205 Lakeview Drive. Lacey DATE��.. g
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LEGAL DESCRIPTION gash. 98501
DIRECTIONS FOR LOCATING SITE Frank Fuller lots Marrowstone Is. Turn right of
I,fndian Is. bridge --go towards water don't take new gravel road about mile,
AN APPLICATION IS HEREBY MADE FOR APPROVAL OF THE ABOVE LOCATION FOR A
STRUCTURE WHICH WILL BE SERVED BY AN INDIVIDUAL SEWAGE DISPOSAL SYSTEM*
RESIDENCE COMMERCIAL BUILDING OTHER Mobile home
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120 x 150
NO. BEDROOMS BASEMENT e�S ITE SIZE &g.. SOURCE OF WATERdri 1 12d y p.11
TYPE OF SOILgal
4c �-, DEPTH TO WATER TABLE
err rrrirlwrY la+fEB
-RAW A SKETCH in the space below# indicating location of building in relat-. o.n.
to other b dings, property lines, well, streams or other bodies of water.
Indicate proposed location of sewage disposal system.
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� H a 4CI"
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Date of Site
Approved* Disapproved
Sanitarian
* See teverse side for remarks.
6
THIS IS NOT AN APPLICATION FOR A SEWAGE DISPOSAL PE MI� A SEPARATE PERMIT IS
NECESSARY PRIOR TO THE INSTALLATION OF A SEPTIC TAN AND DRAINFIELD.