HomeMy WebLinkAboutSEP1974-00251903 t. Caroline
Port Angeles
Court House
Port Townsend
OLYMPIC HEALTH DISTRICT
SEWAGE DISPCV,,AL PERMIT APPLICATION
Submit in Duplicate
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ADDRESS' c wftm C\
Permit No.
Builder
Date �5 )2ab y
Puna. - 3 71S - F? Sy��
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DIRECTIONS FOR LOCATING SITE + �� OA>� ni�SS�� L�hxx n �ICri.c
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APPLICATION IS- HT]R YMADE 0: INSTALL P1�' BYSYTEI+F�REPAIR EXISTING SYSTEM`
5
DRAINFIELD LEPdGTH \ate IIIDTH_I_DEPTH 34„ #LINES a,' SEPTIC TANK SIZE \O o
DRA',! _A_ DETAILED PLOT PLAN BELOW. SEE INSTRUCT20NS. SOIL TYPE
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PERMIT UNLESS PRIOR APPROVAL OBTAINED FROM THE HEALTH DEPARTMI".N/T.
DATE OF INSTALLATION SIGNATURE OFAP�APPLICANT >' 1 "-6
APR ID DATE 5/z2 7 INSPECTED BY�� BIZ E7
SANITARI? 1 S COPII�:i,NTS: t DTE / %�
I CERTIFY THAT THIS SYSTEM ':'AS I ST.':LLED IN THE MANNER APPROVED BY THE
HEALTH DEAPRTMENT
aSITE
N1E
YPE OF BUILDING
NO OF BLDROONIS�
BASEMENT SIZ
NN OF INSTALLER
DRAINFIELD LEPdGTH \ate IIIDTH_I_DEPTH 34„ #LINES a,' SEPTIC TANK SIZE \O o
DRA',! _A_ DETAILED PLOT PLAN BELOW. SEE INSTRUCT20NS. SOIL TYPE
-B3
a:
Si-P$A- all for'
pro' S"Q'P
++ l uruvaI JJIIVHi1VL9 VA Ol j 11YYNL11JM 11'� 1I11a
PERMIT UNLESS PRIOR APPROVAL OBTAINED FROM THE HEALTH DEPARTMI".N/T.
DATE OF INSTALLATION SIGNATURE OFAP�APPLICANT >' 1 "-6
APR ID DATE 5/z2 7 INSPECTED BY�� BIZ E7
SANITARI? 1 S COPII�:i,NTS: t DTE / %�
I CERTIFY THAT THIS SYSTEM ':'AS I ST.':LLED IN THE MANNER APPROVED BY THE
HEALTH DEAPRTMENT