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Home My WebLink AboutSEP1975-00009E; Caroline Port Angeles, Wash. Courthouse OLYMPIC HEALTH DISTRICT Permit No. SEWAGE DISPOSAL PERMIT APPLICATION Submit in Du 2licate Builder M d LAI Townsend, Wash.. 181'7t0_0 S , r Date & o 9- - Zr � ®r O 17, RZ 57 ADDRESS' `" ° f_ .� PHONE —10 L DIRECTIONS FOR LOCATING SITE a g: �� a 0 Rip APPLICATION IS HEREBY MADE TO: 7INSTALL NEW SYSTEMREPAIR EXISTING SYSTEM _ ;L Zemlel- rR1fr,4-,F P. /Y-CA1 e jqp;�( 1 M40Y TYPE OF BUILDING I NO. OF BEDROOMS I BASEMENT SITE IZE NAME OF INSTALLER DRAINFIELD LENGTH 9 0 a WIDTH DEPTH LINES SEAMM SIZE DRAW A DETAILED PLOT PLAN BELOW. SEE INSTRUCTIONS. SOIL TYPE cx--v, �e � „3w 11 t 45 SANITARIAN'S COMMENTS: QO- I CERTIFY THAT SYSTEM S INS!,rP,11ED IN THE MANNER APPROVED BY THE HEALTH DEPARTMENT .L.. ,ss, DATE INS NAME OHD 6-75 Q ^C, ANY CHANGE IN BUILDING OR SEWAGE DISPOSAL PLANS, LOCATION OR SITE, INVALIDATES THIS p� PERMIT UNLESS PRIOR APPROVAL OBTAINED FROM THE HEALTW DEPARTMENT. �► "® AT -E OF INSTALLATION SIGNATURE OF APPLICANT AP OVEDI� DATE IO � �INSPEC= /® � BY ��.i`.- DATE SANITARIAN'S COMMENTS: QO- I CERTIFY THAT SYSTEM S INS!,rP,11ED IN THE MANNER APPROVED BY THE HEALTH DEPARTMENT .L.. ,ss, DATE INS NAME OHD 6-75 OLYMPIC HEALTH DISTRICT SITE LVALUATION RECORD TO: 201 1 Cj mg uny . ec. R. Legal Description Site Size 90` t}_�$0o Seller BuyerJ��:�� r A site evaluation of the above property has been made by.this department and your request for =g„VAr'irt�1P. ami y mobile home--2-bedroom. ]. bath maximum. has been Pp 9,�',��Y�; (conditionally approved) ohibo, Comments:ti'on,,,,�tjro soil, loins Oct. 7, 197. Soil consisted of clay soil and n_1_av_t.ri th some strands of sancly clay at 41. Foliage growth wth and previous experience e.f_thi-s of—ine in thA area iUdj&r�tes seasonal high water table. A curtain drain to diV surface water will be required.. A maximum amount of deep trench drain£iold All be re- quired. Prior to approval of a building Very truly yours, permit and sewage disposal permit to site must be staked and a specific plot plan submitted for review. Sanitarian Date: Randall M. Durant, R, S. opt - Q, x.274 OIC :11/73 SITE EVALUATION REPORT JEFFERSON COUNTY HEALTH DEPT. Multi -Service Building 802 Sheridan Avenue Port Townsend, Washington 98368 (206) 385-0722 Applicant Dean D. Meredith Address: 191 Ridge Drive Port Townsend, WA 98368 Telephone: Mess-, 385-6237 THIS REPORT DOES NOT CONSTITUTE APPROVAL OF A BUILDING OR SEWAGE DISPOSAL PERMIT. THOSE PERMITS SHALL BE GRANTED ONLY UPON APPLICATION AND WILL BE REVIEWED IN ACCORDANCE WITH CONDITIONS AND REGULATIONS EXISTING ON THE DATE OF THE PERMIT APPLICATION. THIS REPORT IS NOT A PERMIT APPLICATION. Receipt NO: 5533 Fee: $40.00 Date:. 7-31-84 Sec. 13 Twn. 30N Rg. 2W Lot 8, Div. 4, Cape George Village Legal pescrlptwn (Dr.. Ili, Loy Directions for Locating Site (Draw map on back). Site size 90 x 130' Seller - - - -- — Buyer - 1 request this site evaluation for evaluate existing system._____._-- l single family residence or INSTRUCTIONS: A minimum or two soil log holes at least 4 feet deep, 2 feet diameter, and 50 feet apart must be dug in the proposed drainfield area and flagged before the evaluation is made. See attached instruction sheet. A site evaluation of the above property was made on ___ August 1, 19R4 by this department and the property has been found: O A CEPTABLE - Soil an site conditions are a ceptable for instal tion of a sewag disposal system, as requested above, under existing co diiions and regulaiio s. E3 CONDI ONALLY ACCEPTABLE Soil and site condit ns are acceptable or installation of a wage disposal system, as requested ove, under existin conditions and reg lations, provided T CONDITIONS SET OUT BELOW A MET. ❑ UNACCEPTABL - Soil and site conditions re unacceptable r installation of a ptic tank system. COMMENTS: As of this date the system is functioning in an approved of manner. SOIL LOGS: especIfuIIy, John Ha s, R.S. ENVIRON TAL HEALTH St CIALIST a 4 .14 M, H. FF ;x K _11 BUILDING PERMIT APPLICATION 'y ' A A JrtfersonCount)• Build,ng Dupartment • County Courthouse • Purr ro.vnsend, Wash. 95368 •' 3SS 1310 ROAD ET S W SIDE OF r ). LOCATION: prographrc namr ROAD NE ROAD AND �' M [ o S W FROM INTERSECTION OF �� ?oft I CJt/►/, 1.�C q l ISE d e D c, -e 71/ other specific location or landmark: ///�- Z LEGAL DESCRIPTION: J (.-Subdivision 10.1 Lot Block IPI 11. TYPE AND COST OF BUILDING TYPE OF IMPROVEMENT N V U 0 New building ❑ Addition �9 0 Alteration 0 Repair, replacement I 0 Wrecking 0 Moving (relocation) ' (Foundatio/�nn only jUD.j>.t, J&fZ, 14 ""_ OWNERSHIP NPnvate (individual, corporation, nprofit institution, etc.) 0 Public (Federal, State or local got/t.) BUIL�DtNGTYPE IJaSingle Family 0 Multi -Family k number of units---- 0 Hotel, Motel, Dormitory number of units _�--- 0 Mobile Home 0 Other - Specify MOBILITY [(New County Resident Is this structure to serve the residential or commercial needs of those employed at either the U.S. Navy's Trident or Indian Island Facilities? 0 YESO USE 0 Full-time Residence 0 Second Home: Recreation Cabin, etc. 0 Secondconversion to UBC OCCUPANCY GROUP- permanent residence COST (Omit cents) • Cost of improvement............ 5 To be installed but not included in the above coat a. Electrical------------------ b. Plumbing ................. e, Heating, air conditioning ...... d. Other (elevator, etc.)- . - . - . _ . - - • TOTAL COST OF IMPROVEMENTLE III. SELECTED CHARACTERISTICS OF BUILDING - PRINCIPAL TYPE OF FRA161E 0 Masonry (wall bearing) Wood Frame 0 Structural steel 0 Reinforced concrete 0 Other - Specify PRINCIPAL TYPE OF HEATING F 0 Gas 0 Oil 0 Electric; 0 C Other - Specify IV. IDENTIFICATION - Name op Nonresidential - Describe in detail proposed use of buildings, e.g., food processing plant, machine shop, laundry building at hospital, elementary school, secondary school, college, parochial school, parking garage for department store, rental office building, office building at industrial plant. if use of existing building is being changed• enter proposed use. day P74-0 g TYPE OF SEWAGE DISPOSAL 0 Public or Private t4 Individual (septic tank, etc.) TYPEWATER SI , PLYLgtL, Svblic or prov l Public or pnvateyompany Individual (well, cistem) TYPE OF FIR DIMENSIONS • Number of Stories .............. •Total square feet of floor area, all floors, based on exterior dimensions ------------------ *Total land area, sq. ft....... NUMBER OF OFF-STREET PARKING SPACES_ �y Enclosed - - - - Outdoors ----------- ---- •-- RESIDENTIAL BUILDINGS ONLY Number of bedrooms ----------- TYPE-----•-•-- TYPE OF MECHANICA Full........ Number of bathrooms Partial...... /Number, street, city and State ZIP code Mailing Address - AIC- 0- _ 3. Architect The owner of this building and the undersigned agree to conform to all applicable laws. Appl applicant Address / n , �J[�/ $igr><}tyre of a it _ /f Gi /C— 4 P- 4. NA yfr 1 /-3z) 2 Tel. No. date a ISCHOOL DISTRICT WATER DISTRICT — PLANNING AREA FIRE DISTRICT_---�- APPROVED BY C JEt't"ER t=ou\rry HEA LTM OE ISSUE DATE' PERMIT NUMBER n PERMIT FEE I APP OV D BY� b - 1 i BUILDING OFFICIAL ti c: I IILDING OIERMIT APPLICATION o..-1.14 ,. hn+op n_ RnY 122n;iport Townsend., WA 98368 � vii ......� .... ... •.7 --r-. _------- 7 O _u�u � LT fjMCIFIC LOCATION SITE ADDRESS POSTAL D I STR I CT / SUB 1 VISION DIVIS ON TAX NUMBER 6LEGAL DES CRIP ION LOT -BLOCK PARCEL NUMBER dO 1/4 SECTION PLANNING AREA SECTION ZZ TOWNSHIP NORTH RANGE WM BUILDING INFORMATION BU DING TYPE TYPE OF IMPROVEMENT SQUARE FOOTA SINGLE FAMILY ❑ NE BUILDING MAIN FLOOR ❑ MOI.7 I LE HOME DD I T ION 2ND FLOOR ❑ MODULAR HOME ❑ ALTERATION BASEMENT DETACHED/ATTACHED ❑ REPAIR CARPORT GARAGE ❑ REPLACEMENT GARAGE ❑ WOODSTOVE ❑ WRECKING/DEMOLITION COMMERCIAL ❑ MULTI -FAMILY ❑ RELOCATION/MOVING INDUSTRIAL NUMBER OF UNITS l MOBILE HOMES ❑ COMMERCIAL ` 2.$404460 SIZE ❑ INDUSTRIALYEAR 07 $20 E]HOTEL/MOTEL/DORMITORY '_ MAKE: 07 $ 1 0 NUMBER OF UNITS ❑ OTHER - SPECIFY ._,._... o@ $ 1 0 ESTI MAT COST OF I MPR EMENTS TOT A,�� MARKET VALUE UBC OCCUPANCY GROU $ $ SELECTED CHARACTERISTICS OF BUILDING PRINCIPLE TYPE OF HEATING FUEL PRINCIPLE TYPE OF FRAME ❑ WOOD FRAME ❑ ELECTRICITY ❑ COLLECTIVE SOLAR ❑ MANUFACTURED ❑ WOODSTOVE ❑ PASSIVE SOLAR ❑ STRUCTURAL STEEL ❑ GAS ❑ COAL ❑ REINFORCED CONCRETE ❑ OIL ❑ OTHER - SPECIFY ❑ MASONRY (WALL BEARING) DIMENSIONS ❑ OTHER - NUMBER OF STORIES TOTAL LAND AREA DEPARTMENTAL REVIEW %00f't' H,kALTH DEPARTMENT I!a f 1^• TYPE OF SEWAGE DISPOSAL ❑P B L I C OR PRIVATE NUMBER OF PROPOSED BEDROOMS NUMBER OF EXISTING BEDROOMS o1�t`�` I n - ND 1 V 1 DUAL ( SEPTIC ) NUMBER OF PROPOSED BATHROOM APPROVED DATE ❑ INDIVIDUAL WELL NUMBER OF EXISTING BATHROOM PUD TYPE 'OF WATER SUPPLY ❑ PUBLIC (NAME OF WATER SUPPLY) APPROVED DATE ❑ PRIVATE (NAME OF WATER SUPPLY WITHIN SHORELINE JURISDICTION PLANNING DEPT. ❑ YES NAME OF ADJACENT WATER BODY ❑ NO APPROVED DATE BANK HEIGHT SETBACK PUBLIC WORKS DEPT ROAD RIGHT-OF-WAY WIDTH NAME OF PUBLIC ROAD NAME OF PRIVATE ROAD APPROVED DATE ROAD ACCESS PERMIT REQUIRED Cl YES ❑ NO IDENTIFICATION NAME MAILI AlDDR£ S .ZIP TEL NO OWNER I CONT .J ARCH H OWNER OF THIS BUILDING AND7HE VNDERSIGNED AGREE TO CONFORM TO ALL APPLICABLE LAWS; NATURE OF AP t T APP IC ON DATE RM EIPT I BER CHECK+NUMSE OR CASH .�` xr BY ERM T FEES BASE FEE INSPECTION 4APR A P BLDG SURCFGARGE _ _ _ - PLAN CHECK ENERGY SURCHARGE • �LTOTAL y EUNt4' 9 1 1 NUMBER REFUND D DAT 1SSUED PLANg BU �II"OFF 1 C 1 AL i q wmza am