HomeMy WebLinkAboutSEP1974-00225r
ch n
903 E. Caroline �� �OLNPIC HEALTH, DISTRICT Pe=it No.
Port Angeles 1=�OJ SEWAGE DISPOSAL PERMIT APPLICATION
Submit in Duplicate Bui:lcler" C11
Court House
Port To�rnsan Dated h j
s
ck`c' 026i,n
(]
HiQ aR
DIRECTIONS FOR LOCATING SITE
W-1,
APPLICATION IS HEREBY MADE TO: INSTALL Nat SYSTEM REPAIR EXISTING SYSTEM
. 1/
53OF INSTAIZM
DRAINFIELD LEP1GTIi�uDTH_DEPTH 3� LI NES I- SEPTIC TANK SIZE
DRAIN A DETAILED PLOT PLAN BELOIJ. SEE INSTRUCTIONS. SOIL TYPE
.ANY CHANGE IN BUILDING OR S E'' ;AGE DISPOSAL PLANS, LOCATION OR ITE a 191iALIDAT TIS
�'ERMIT UNLESS PRIOR APPROVAL OBTAINED FROM THE HEALTH DEPARTMENT. _
DATE OF INSTALLATION SIGNATURE OF APPLICANT�'4'
APAft0V DATE 7 INSPECTED BY��.,�,�� DATE_5i
SANITARIAN' S C01-N124TS :
p -(/tip I I* (
I CERTIFY THAT THIS&TJ2MZ.,46II 'i FANNER APPROVED BY THE
HEALTH APRTI�?vm s�
e, ..
Parcel Print
Parcel Number: 952800702 05/14/2007
Owner Mailing Address:
RANDEE LEE SLEHOFER
2884 MONROE RD
PORT ANGELES WA 983629357
Site Address:
41 STEVEN ST
PORT HADLOCK 98339
Section:
2 School District:
Chimacum (49)
Qtr Section:
NW1/4 Fre Dist:
Chimacum (1)
Township:
29N Tax Status:
Taxable
Range:
1W Tax Code:
211
Planning area:
Tri --Area (4)
Sub Division:
GARFIELD'S ADDITION
Land Use Code:
1100 - HOUSES (single units, non-farm)
NAME CHANGE WAS RANDEE L COLLINGS, 10/92 NAME CHNG FRM LEROM
Property Description:
GARFIELD'S ADDITION I BLK 7, 1 LOTS 3(ALL), 4(ALL),14(W50') & 115(E50')
Page 1 of 1
::nclud -following items on your plot planr,-,!---:
roperty boundaries 1�3ells
f adjacent streets .ctank
rDnames
mewof
sand parking spaces wifield (enter NVV if unknown)
[3 urface water (ponds,creeks, etc) Arrow
/Ssuildings(reskience, steds, garages, etc) I
Peffnit # o r Parcel # -go- o -2- page 2 of 5
Evaluation of an Existing Onsite Sewage S
ystem _Q7f3O/G4_pdf