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HomeMy WebLinkAboutSEP2022-00003 - 01 APPLICATIONJefierson County Environmentat public Healtr 6 1 5 SheriJan St.. Port Townsend WA 9&369. (360) 3BS-9444 SEPTIC SYSTEM PERM|T APPLICATION PROPERTYOWiIER MAILINGADORESS PHONE SYSTET DESGTER LEGAL D€IICRIPTIOil: Sr-bdivisisr lrlarne ( a25 ) 2B/}.56yt EfilL .-- mrkeh@aqcu-cffim-qgIn_-_--. 02't -191 tlviiar-Block-Lot(s) TAx 1 8(s r/2)LEss N 14(} IAX F(S I 12 LF SS N I 40\ Site addrcst t Dirlc0oiltoatb & Ert pb Ness C.ornpr Ultabr SourcePrivate_Public-)( _Nanl€_..- Counte Pt SOURCE OF SEYUAGE/USE Resilentiat Commercial Community Syrtam Typo Conventional xAlternative S|TE SZE r0 S40 acres Pruvioul Eveluation Yes cas* s,rc24fio3 __No_ TYPE OF rcRKNew-- Tanks only_Modificatbn Expansion - Repair_ Tank(s)_ Drainfiekt Replacement_ TanXls)_Drai nfi dd_ DesQnate ReserveArea_ Redesion x Nunberof Gallonslclay 240 .Sorltype_l_(atrach soit a/d ) Apptir=fnn Rate_-Q.4_gat.tsq.fr./day DrairrfieHLengtt--2CI9-ft. Trenclrurk th-l-ft. Trcnctr/BectDepth_Jtr_in SeplicTank size_LQgg_gd punp Chambersize___lJgg__gd. SYSTET DETAILS TYPE OF 2 INS P/PUM P TEsTlqd2e__Monibr'ng Agreement ALLHOLDREQ MET Fu*7 @.:Rec* &0 3102 cn""* # I gl7-S- case#sep 2oAa -OOOo rohht ci6.lclus APPROVED o,," bfSlatu, IL FOR OFHCE USEOi'tY ASBUILTPARTIAL llttlzt & CATHI FtrN qvlr s.TE)trFT qa?06-505A