HomeMy WebLinkAboutSEP1973-00028��'(o["C`' �.dL�i�% .cl.►t� � + �G� �`' O� . ����liy Ji+ d��Kir
903 E. Caroline 7 7ZA 17,
OLY�LPI HEALTH DISTRICTv4f Pe mit No.
Port Angeles SEWAGE DISPOSAL PERMIT APPLICATION��'��
Court House
CE7® Submit in Duplicate Builder
i '
Port Townsend GEM -poa8 Date 2 7 73
OGINERA 19ADDRESS - „ iN�/t�-JPHONE_46&e �
DIRECTIONS FOR LOCATING SITEpd
/ e
APPLICATION IS HEREBY MADE TO: INSTALL N --7j SYSTEM to AIR EXISTING SYSTEM
gLEI\i�R_A�G N0�0;'�B�IZR06�ms BASEMENT I SITES NAME OF INSTALLER
DRAINFIELD LENGTH Tg may!` DEPTH#LINES SEPTIC TANK SIZE ��-
I� i
DRAG. A DETAILED LOT PLAN BELO11. SEE INSTRUCTIONS,, SIL TYPE �
f AIN.
x
T
® 1 sa
r
ANY CHANGE IN BUILD NG OR SE"AGE DISPOSAL PLANS, LOCATION OR SITE, INVALIDATES THIS
PERMIT UNLESS PRIOR APPROVAL OBTAINED FROM THE HEALTH DEPARTMPqW.
DATE OFF (INSTALLATION SIGNATURE OF APPLICANT
APOVED DATE27/jINSPECTED BY DATE 3
?,
SANITARIAN'S COMMENTS: U1
I CERTIFY THAT THIS SYSTEM GRAS DTSTALLED IN THE MANNER APPROVED BY THE C
HEALTH DEAPRT 1ET DATE 0
INSTALLERS NAME 03
�-
,�'
Ca�.•►.
�, 'tri �:.
� A�
�rl
III
Ili
II
�
IIII
III
ul„
I ujl
i;
I
I•
�
_
I
I I
I=
r
re..a
144
I II
�
d
I
I
.k
•AFI
III
r
�
i I
r
I'
I
I
Vy
a
r
I
I,
II
I j
F
i.
I
f 'III
it
IIL
n
-I
III
lel,,
��'*
I
III II
+�I*i
i
II
I
lu
II
hX
I
6
t
II d.
I
t
I
ll,
.✓`
it u��.
M"lc:.�M.
i
{r
II
'I
II I
�Ihy
y
t
u
LII
I
I e
I
I
V
I
rI
�p
II,
t
I
�
Ili
L
I
II
I
i
iIl.
l
L.
�
I;
II
jl
I
III
I
I
nand asv9,7
,jos oOIoy /JaJsvW
I
_ os
w
i
O
6
V)
U
.1
-YV-
a
,os = 80 f
Z
0
J
U
Yl
:'a-iV74j
771 o
Q
sVvo'> IyUlM-c,-
1,7
£�%'28�tissly ,ALO-,•bl :Z a�
0