HomeMy WebLinkAboutSEP1975-00082RT TAX /-//-v
SEP 7_5 - � �; O 8�
Now filed to
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60sa
9013 E. Caroline OLYMPIC HEALTH DISTRICT Permit No,
Port Angeles Wagh. SEWAGE DISPOSAL PERMIT APPLICATION
Submit in Duplicate Builder
Courthouse
Port flown end, Wash. Date
-PHONE
DIRECTIONS FOR LOCATING 3IT
RL1141 ��Iiz2t
APPLICATION IS HEREBY MADE TO;, INSTALL NEW SY$TEM SYSTEN
TYPE BU IIVG NO. BEDRO", BASEMENT I - SITE . -SIZE ��&&STAIZER
LD V6TH DEPTH 3�,
bRAINFIE SIZE=
DRAW A DETAILED PLOT, PLAN BETj I OW. SEE iNSTRUCTICNS6 SOIL
V1
S \AL
ANY CHANGE IN BUILDING OR SEWAGE DISPOSAL PLANS, LOCATION OR SITE, INVALIDATES THIS
PERMIT UNLESS PRIOR APPROVAL -OBTAINED FROM THE HEALTH DEPARTMENT.
STALLATION SIGNATURE OF APPLICANT
ZOXVED PATEINSPECTED BY
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SANITARIAN'S COMMENTS: ,
I CERTIFY
OHD 6-75
IN MANNER APPROVED BY THE HEALTH
DATE
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