HomeMy WebLinkAboutSEP1973-00070903 E. Caroline
ort Angeles
Court House
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LOCATING S
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OLYMPIC HEALTH DISTRICT
SLUAGE DISPOSAL PERMIT APPLICATION
Submit in Duplicate
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APPLICATION IS HEREBY MADE TO: INSTALL NELt SYSTEM
BUILDING NO. OF B
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SITE SIZE
SEP7 3 - 60x76
Permit No.175 f l
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Date i`OAsh
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EXISTING SYSTEM
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DRAINFIELD LENGTH 00 IIIDTH140 DEP AV LINF-0S sr SEPTIC 'SANK SIZE x ill4
PERMIT UNLESS PRIOR APPROVAL OBTAINED FROM THE HEALTH DEPARTMEN .
'�GN�ITURF i -
DATE OF,INST�ALLATION OF AP CANT
PLAN APAPPROVt, 'DATE INSPECTED BY DATE IILL17 j
SANITARIAN'S COMMENTS:
I CERTIFY THAT
HEALTH DEAPRTM
01
':SAS UTSTALIN AMANNER APPROVED BY THE
DATE 73
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