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HomeMy WebLinkAboutSEP1975-00471903 E. Caroline .Port Angeles Court House rt OLYMPIC HEALTH DISTRICT SEWAGE DISPOSAL PERMIT APPLICATION Submit in Duplicate 5 7 Permit No. Builder Port. Townsend 7 /1 1 PHONE DIRECTIONS FOR LOCATING S APPLICATION IS HMEBY MADE TO: INSTALL NEW' SYSTEM EXISTING. SYSTEM A_1= [0a VYPE OF BUILDING NO. OF BEDROOMS BASEMENT_ NAME OF TALLER i ce DRAINFIETD LENGTH M2 A IIDTHJDEPTH.Jb #LINES 2 SEPTIC TANK SIZE zl� DRAW A DETAILED PLOT PLAN BELOW. SEE INSTRUCTIONS.. SOIL TYPE A�T� CHANGE IN BUILDING OR S_L_'_AGE DISPOSAL PLANS LOCATION OR SITE INVALIDATES THIS PERMIT UNTF.q.ct PPTr)'D ADD13MAT DATE OF INSTALLATION SIGNATURE OF APPLICANT,,tj_)e�_ DATE 75INSPECTED BY IZ§.,DATES SANITARLOS COMMENTS - � 'i" `Z3 1Z - 7 �z 3 S I CERTIFY THAT THIS LED IN THE MANNER APPROVED BY THE HEALTH DEAPRTMMI tr! v__M&,' 7,_, -14-1 " I - DATE Parcel Print Parcel Number: 986401401 Owner Mailing Address: DARLENE LOLSEN 20 MASON ST PORT HADLOCK WA 983399584 Site Address: 20 MASON ST PORT HADLOCK 98339 05/14/2007 Section: 2 School District: Chimacum (49) Qtr Section: NW1/4 Fre Dist: Chimacum (1) Township: 29N Tax Status: Taxable Range: 1W Tax Code: 211 Fanning area: Tri -Area (4) Sub Division: PHILLIPS TO IRONDALE Land Use Code: 1101 - MOBILE HOMES (owns mobile & land) Property Description: PHILLIPS TO IRONDALE I BLK 14 1 1 & 2 Page 1 of 1 http://www.co jefferson.wa.us/assessors/parcellparcelprint.asp?PARCEL NO=986401401+... 2/3/2009