HomeMy WebLinkAboutSEP1975-00094S '
ter, , ,
903 E. Caroline OLYMPIC HEALTH DISTRICT Permit No.
Port Angelest Wash. SEWAGE DISPOSAL PERMIT APPLICATION �
Submit in Duplicate Builder
r s rr
Courthouse Date. / 7
Pont Townsend, Wash.
ANY CHANGE IN BUILDING OR SEWAGE DISPOSAL PLANS, LOCATION OR SITE, INVALIDATES THIS
PERMIT UNLESS PRIOR APPROVAL OBTAINED FROM THE HEALTH DEPARTMENT.
DATE OF INSTALLATION SIGNATURE OF APPLICANT
A�PIZOVED ✓ DATE t- INSPECTED BY �_i�C DATE
SANITARIAN' S COMMENTS: �
A
P
I CERTIFY THA EM, ST MANNER APPROVED BY THE HEALTH
DEPARTMENT �` DATE
INSTAUERS NAME
OHD 6-75
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SITE EVALUATION REPORT
JEFFERSON COUNTY HEALTH DEPT.
Multi -Service Building
802 Sheridan Avenue
Port Townsend, Washington 98368
(206) 385 - 0722
Applicant Dean Sanders
Address P.O. Box 234
Nordland, WA 98358
Telephone 385-0234
THIS REPORT DOES NOT CONSTITUTE APPROVAL OF A
BUILDING OR SEWAGE DISPOSAL PERMIT. THOSE PER-
MITS SHALL BE GRANTED ONLY UPON APPLICATION
AND WILL BE REVIEWED IN ACCORDANCE WITH COW
DITIONS AND REGULATIONS EXISTING ON THE DATE OF
THE PERMIT APPLICATION. THIS REPORT IS NOTA PER-
MIT APPLICATION.
1 request this site evaluation for.
❑Number single family residenc e/s
❑ Preliminary evaluation for short subdivision
Receipt No: 2837
Fee; 45.00
Date: 7/24/86
Sec. 4 Twn 29 Rg lE
1560 -E Marrowstone
LOW D-a"M Mk eUL toe)
Dtrectbna for bCaUnq ate (oaw map anbed* and attach a see Wan)
Property size
150' x 425'
Seller --
Buyer --
® Evaluation of existing system for addition
❑ Other
Do not write below this line (For office use only)
A site evaluation of the above property was made on 2 Tnl y 1986 b this department and the property Y P Party has been found:
0 ACCEPTA - Soil and sfte Mons are acceptable for in lation of a sewage disposal
and regu s. 9 Poral tem. as requested under existing conditions
❑ CONDITIONALL ACCEPTABLE - So d site condftions are acce le for insiailatlon of a ge disposal system, as nested above, under
existing conditions nd regulations, pro ed THE CONDITIONS SET UT BELOW ARE MET.
0 UNACCEPTABLE - Sol d site conditions unaccepatable for Installati n of a septic tank a
COMMENTS:
These remarks do not constitute approval or denial
Our records and a recent visit to the site reveal
sewage disposal system was installed in accordance
in effect at the time of installation. As of this
in an approved of manner.
but just our findings of fact.
that the on-site individual
with the applicable ordinance
date the system was functioning
Respectfully,
R.
ohn es,
P4 t
s y S SID. O azt7
t O c N�-
titF%C)&D Anse
S W I ROLA INIt PSI
C710�w+ Df
olio sarcrtt $ara,.on o• ranonairt
_ Ss,h,}p. wsrOaw
LEGAL DESCRIP710N: Lp.,.--t----' Htot►
_ :.h._. itan
pr
1f..oa
^{�%�Or X Set t•on
�
II. TYPE AND COST OF BUILDING MOBILITY
gUtLOING TYPE C Rr►.ltenf
TYPE OF IMPROVEMENT [�N;'++ osrntr
aprj
„nptrFa—IV RECEI ED' .eswot"'.at
lsimi ssrssetwCibws� t1�
t ` T,irw bwlwnvMuttt•F arc»Itr Curnr^�'ttat rtt hu'r rvfnOta/td
Q � t
f Addni[in olimber Of trnr[f eet>s Na D rY"s E..pcnt of
n�Q
as etcher the us
C}Ahr.�s.an C]Hotel. Mate1. Go•rnrtorY AKA• 7 {..o.a^ jtt.,d faf•Hs•es>
number, of un.n
E ' C] Rcpa.t- seClacsmenl
Q Mobile Home w�.
0 Vticrksnq - G YES W, c)
Opher — SpecifyHEWN
....
C) Mowing hrtocas.onE
[
0 Foundtlt•on only r
LuSE
®Futts.me Ffeytpines
r C)wNE RSHIP '
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f Prrvate imd•v.d-AS'. Car Ppratran,.
13 See
HDrr'te'. F,rtwt tOn••trHtrw to
f :'�JeifnaMni rlSrLilrttT
nonprattt .nftnut•an, CiL,t 1UBC OCCUPANCY GROUP- ^---^'- _
0Pubhc IFrd[rat_Stole or_laot gD✓t.)
srse of buitdwsyjs, c g .food
{ - - /Qlnn [tori) Nonresidential — E�escttbe yw detail p.oao+a� at hasLltal- etemt-Mary
COST ma shop. tavnaFv bu•►dNsQ
s { pracrss•n9 p%ant• rpth.at SChbOl,.ON, tt I- ga•tt, far
s. 1' '% t seCOnda•♦ sCrwOOt. C011!'Or, as rrat�l7Sa t+a p:ant
+ Coss of r,vD•rrnenl- - - - • - •--- s:noa _ tt.cc au•to•n9 ott,erbu•td• 5
nai rpriurled ar p,rt me n' St Orr_ ern:at a riaC•
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4y
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C �r'+.r• ir,r.sto• rte 7. -
.. Tv.'!•l CDS3 0r 1-ArR>�VE►''`_ hT
jF BUILDING -
I1!. SELECT ED
r-HARACTERtSTtGS O psrtsEstiSsOstS
TYPE OF SEY.'-GE;DISPJS• 1- • r..r"D•• a' Storrs
pRlntCtP4LTYPE OF,vRAME ' r tecta of t.00r atca-
Fr..ratt • TDtaa st9ua•
1 Ptxbi.c o ease•ro•
f ° Nason.s t..ati bear.ngalt 1roDt s. Lased M'
can., tl C.t r; yrnfrbnl _ - - _ . .
c.
f 5 1.�od Frame
C51 6sn ura' s%eti c s-:-'E F. SUPPLY
T• To.at tanG a ta_sil
YPE O-
nrmio,txd c'
ric•cTe (J— Fubl,c D p...?wr m eny NUNSEfi OF OF .5-.' cET a
oAC:S
t iwLh_c•sserni FpFs'KIr.'G S-,
j' co,e[ — $iTrcify fJ" �r+O,.nO.+e _ ._
, ❑ �10,! EnC�aSeO.
f _..
— :YPE OF FIREP*SCE avtoaars
FRIG+CtFAL TYPE OF HEATING FUEL tRuS Oi;LY
�C RESIC)ENTIAL RUIt;D
N, JrrDe, dt bt,W"ffu ----..-c...
CDs TIC
A:-wo-nTY TYPE OF r.�ECH.ct.l'CAL NrrIDr, Of
Futt
[�'. IDENTIFICATION ---.�-
ATION- n•[t.CITY
ess — N,..rs,::.r<. srr_ --T-
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WATER D2STRICT
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f Apr RDvE ID By: t�
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_
JEFFERSON COUNTY BUILDING APPLICATION
Jefferson County Permit Center
Castle Hill Mall
621 Sheridan St.
Port Townsend, WA 98368
206-379-4450
PERMIT #....:BLD94-0742 DATE RECEIVED.:10/24/94
SITE ADDRESS:1510 EAST MARROWSTONE RD
:NORDLAND, WA :!9835
OWNER ....... :DEAN SANDERS PHONE:385-1124
MAILING ADDR:PO BOX 234
:NORDLAND WA 98358
-------------------------------------------------------------------------------
CONTRACTOR..:OLAY W PHONE:
MAILING ADDR:
CONTR. LIC #: EXPIRATION DATE:
-------------------------------------------------------------------------------
ARCHITECT/..: PHONE:
DESIGNER....:
MAILING ADDR:
-------------------------------------------------------------------------------
PARCEL NO ... :977700067 ?
ALT: CON: NA:_
LEGAL DESC..:STR 03-29-01 .
EWM, TAX #
WATER: DATE:
LOT , BLOCK
HORELINES:
,
: DATE:/O- tD ` Y
p� .� c( --y
.
DESCRIPTION OF IMPROVEMENT.
Pole Building,,, -,BY
----------------------------------------
BUILDING TYPE ...... :GAR
BEDROOMS---
----------------------------------
BATHROOMS-- MAIN FL...:
0 sf
TYPE OF IMPROVEMENT:NEW
EXIST.: 0
EXIST.:
0 ADD'L FL..:
0 sf
GARAGE/CARPORT.....:
PROP..: 0
PROP..:
0 HTED BSMT.:
0 sf
WOODSTOVE..........:
TOTAL.: 0
TOTAL.:
0 UNHT BSMT.:
0 sf
UBC OCCUPANCY GROUP:
SEWAGE DISP..:
OTHER.....:
0 sf
TYPE OF CONST......:
WATER SUPPLY.:
CRPT/GAR..:
1140 sf
UNITS.: 0 STORIES:O
HEAT TYPES.:
DECKS.....:
0 sf
DIMENSIONS:
-------MOBILE HOME------
COMMERCIAL:
0 sf
FRAME TYPE:
MAKE:
YR:
INDUSTRIAL:
0 sf
EST COST.$: 11400
SIZE:
BANK HT... :0
ft
PROJ GRP..: 6189
SH SETBACK:O
ft
-------------------------------------------------------------------------------
Owner/agent
----------------
FEES --------------
Signature:
type
amount by date
recpt
PRMT $
135.00 MTM 10/21/94
99085
Date:
PLCK $
40.50 MTM 10/21/94
99085
B.C. $
4.50 MTM 10/21/94
99085
Issued By:
Date:
e
------------------------------------
$ 180.00 TOTAL
Parcel # 000921042016
Geo Cd 292104203210
54 T29 ME
TAX 24(E OF CO RD)
Mode INQUIRI
Nbad Cd 3210
* Taxpayer Cd SAND 2600 SANDERS, DEAN L T/P Chg Dt
* Title Owner T/P Chg Usr
Tax Code 0211 Status TX TAXABLE Land Use 1100 RES -SINGLE
Affidavit Vol/Page / C/U Code S/C Cd
1 1 r% A I 1A I,n A• /1-A 1 A j% r, /A -9 r% A 1