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HomeMy WebLinkAboutSEP1972-00005Jefferson County Department of Community Development PA A I (-SO 621 Sheridan St., Port Townsend WA 98368 (360) 379 -4450 -z/1 CL 1 p :'? MONITORING INSPECTION CERTIFICATION The system serving q 3 g l\d . on parcel # J31 10 0 ZCFK . permit # 72 —5 was most recently inspected on /-1 *5 -03 by Dg� Vt,&AZbk ,u 6A , as specified in Jefferson County Code 8.15.150. The above referenced system is in compliance with the Monitoring/inspection schedule identified in Table 1 of Jefferson County Code 8.15. F] See report completed for Information on the condition of the onsite sewage system. REQUIRED OR RECOMMENDED REPAIRSIMODIFICATIONS TO THE SYSTEM ARE LISTED ON THE INSPECTION REPORT DATED 1 -t 15-03 . Failure to complete repairs or modifications to the system as listed on the report may result in premature failure of the system. � The next inspection required for this system is in 2-CO(-0 Table 1 requires that this system receive an inspection: Annually Every 3 years Every 6 years Other as specified in the sewage disposal permit conditions- An inspection will be required at the time of sale if the system does not comply with the schedule set by Table 1 as described above. The above information is based on review of the file and does not imply or grant a guarantee of current or future system performance. Signature of 44:t� County Employee II: cm-_ hca1t11x1inda \6D \PORMS\MONITORING INSPECTION CERTIFICATION.doc Date �Q .._ CEP7a 006 Q Aftst Caro? 1me OMeIC HEALTH DISTRICT Permit No. Fee Peid - SZWA4E DISPOSAL PERMIT APPLICATION ,wt�r Submit -in Duplicate _ ADDRESS DAT 3 71 _ . _ _,._ ___ _. -s..._ LFAAL .DESCRIPTION �' ��� ��� PHONE DIRECTIONS -FOR LOCATING SITE APPLICATION IS HEREBY MADE TO: INSTALL NEW SYSTENIREPAIR E7CISTZG SYSTEM E OF BUILDING NO. OF BFADROOMS BASEMENT TE SI am NAME OF INST7A�L1;ER;_. AAT fif'[?4' nT1 \TTTnT! a 4r rr T4I1T Tt s AT nTfTAT'[ fl'1'L!'G'! L+r1T.T.(161TN(� �i ORi "iKi 1� ,ueptn ITIme required tol Fercolatlon rate of hole seep last 6 in. I (divide time by 6) Pere. No. 1 Psrc.. No. 2 Pere. No. 37 III, Type of so 1 1 DRAINFIELD LENGTH- -- \&Z WIDTH DEPTH " ��N0. OF LINES IT -.IS HEREBY AGREED THAT THE PROPOSED INSTALLATION WILL'BE MADE IN THE MANNER AS- .RESIGNED AND APPROVED ON THIS APPLICATION. �Nignature of pplicant —APPROX.- -DATE OF INSTALLATION .O-A ARIAN tS COMMENTS: , PiA1T. APPROVED _ DISAPPROVED DATE d� a �- REMARKS: I CERTIFY THAT THIS SYST21 WAS INSTALLED IN THE WNER APkROFED BY THE RE41T- DEPJ.RTPTr]NT r I.VSTALL4R IS NAME ��� �i+-,i D« T Z �. O F0 _- 3. °proge�ctg lines 7. Driveways, patios, carport4 etc. z Location of building 8o Streams or .bodies of water nearby 3-- la0cation. of septic tank 9. Location of percolation test holZe0 of drainfield 10. Septic tank size !0 �� rrw.rrr _gallozk r..r.rmr+ '.Location - -- 11. L ength of -proposed drainfield m "a-ter lines & well(if applicable) 12. Depth to water if encountered. PERCOLATION TEST RESULTS ,ueptn ITIme required tol Fercolatlon rate of hole seep last 6 in. I (divide time by 6) Pere. No. 1 Psrc.. No. 2 Pere. No. 37 III, Type of so 1 1 DRAINFIELD LENGTH- -- \&Z WIDTH DEPTH " ��N0. OF LINES IT -.IS HEREBY AGREED THAT THE PROPOSED INSTALLATION WILL'BE MADE IN THE MANNER AS- .RESIGNED AND APPROVED ON THIS APPLICATION. �Nignature of pplicant —APPROX.- -DATE OF INSTALLATION .O-A ARIAN tS COMMENTS: , PiA1T. APPROVED _ DISAPPROVED DATE d� a �- REMARKS: I CERTIFY THAT THIS SYST21 WAS INSTALLED IN THE WNER APkROFED BY THE RE41T- DEPJ.RTPTr]NT r I.VSTALL4R IS NAME ��� �i+-,i D« T Z �. O F0 V � / ON-SITE SEWAGE DISPOSAL SURVEY OF Street Or Division Block Lot Landmark Lot Size I. Location, Lot Size ( II. System,Owner kud o Address Tel ephone' Number > 92 IS a Permit ( ?) (Previous Owner) Date Issued III. Installer Average Number of People Served_ N mb f Qedrooms 1 Date Installed _ 7 u er o Time In- Service (years) UA Clothes Washer -- NO Septic Tank Pumped YE—°S YES NO 0W Dishwasher YES NO .OFTEN # of= Months /Years Residence Occupied? Garbage Disposal r NO m CJ�GrI YES Y. Type of cover over drainfield. (i.e. grass, X11 landscaping, etc.) ' V. Repairs (when, what, who) Cause of ,Failure VI Comments (Over for Sketch)_ VII. Action 'Taken • l3UILDING`il ERMIT APPLICATION 'Jefferson County Building DepartmentlP.O. Box 12209Port Townsend.,WA 98368' 1 *. SPECIFIC LOCATION SITE ADDRESS POSTAL D I STR I CTS -�/SUBDIVISION - DIVISION TAX NUMBS LEGAL. DESCRIPTION LOT,BL ®CK�,e ---,- 1 / a g�C,T, I OM„- „�, PARCEL NUMBS -11- SECTION TOWNSHIPS NORTH RANGE,,__ PLANNING AREA_,,,,,_, - .- ---- -- BUILDING INFORMATION TYPE TYPE OF IMPROVEMENT SQUARE FOOTAGE `B,VILDING FAMILY ❑ NEW BUILDING MAIN FLOOR ?SINGLE 5 ❑` MOBILE HOME ADDITION �0< 2ND FLOOR ❑ MODULAR HOME ALTERATION BASEMENT ❑ DETACHED /ATTACHED ❑ REPAIR CARPORT GARAGE ❑ REPLACEMENT GARAGE ❑ WRECKING /DEMOLITION COMMERCIAL ❑ WOODSTOVE ❑ RELOCATION /MOVING INDUSTRIAL ❑ MULTI- FAMILY NUMBER OF UNITS MOBILE HOMES @. $35 ❑ COMMERCIAL S 1 zE ❑ INDUSTRIAL YEAR @ $18 ❑ HOTEL /MOTEL /DORMITORY MAKE @ $a NUMBER OF UNITS_ OTHER,*- - SP E 1 �$ ESTIMATED COST OF �` I MPROVEMENTS TOTAL FAIR R MARKET VALUE UBC OCCUPANCY GROUP $ SELECTED CHARACTERISTICS OF BUILDING PRINCIPLE TYPE OF FRAME ❑ WOOD FRAME ❑ MANUFACTURED ❑ STRUCTURAL STEEL ❑ REINFORCED CONCRETE ❑ MASONRY-(WALL BEARING) ❑ OTHER - PRINCIPLE TYPE OF HEATING FUEL ❑ ELECTRICITY ❑ COLLECTIVE SOLAR ❑ WOODSTOVE ❑ PASSIVE SOLAR ❑ GAS ❑ COAL ❑ OIL ❑ OTHER - SPECIFY D i MENS I Oris NUMBER OF STORIES TOTAL LAND AR DEP EVIEW k1EALTH DEPARTMENT OD F SEWAGE DISPOSAL NUMBER OF PROPOSED 1 C OR PR 1 VATE MR4BER OF EXI ST 1 to i f} m is-w.... �mr e� a V I DUAL ( SEPTIC ) NUMBER OF PROPOSED ROVED D TE V I DUAL WELL NlR.7BF -R OF EXISTING PUD TYPE OF WATER SUPPLY ❑ PUBLIC (NAME OF WATER SUPPLY APPROVED DATE ❑ PRIVATE (NAME OF WATER SUPPLYµ V PLANNING DEPT. WITHIN SHORELIPIE JURISDICTION ❑ YES fi.°lM1E OF ADJACENT WATER BODY APPROVED DATE PUBLIC WORKS DEPT APPROVED DATE IDENTIFICATION NAME T MjLy. BANK HEIGHT SETBACK ROAD RIGHT-or-WAY W 1 DTH NAME OF PUBLIC ROAD NAME OF PRIVATE ROAD ROAD ACCESS PERMIT REQUIRED ❑ YES ❑ NO &4A 1 L 1 NG ADDRESS 21P I TEL NO TO ALL APPLICABLE LAWS; HE OWNER OF THIS BUILDING AND THE UNDEnSIGNED AGREE TO CONFORM 1 GNATURE OF APPLICANT ' APPL I CAT I prn DATE 1 "SECE I PT NUMBER I CHECK NUMBER OR CASH APPROVED BY BUILDING OFFICIAL PERMIT FEES BASE FEE 1. DG SURCi -Pxm- ENEERGY SURCHARGE 911 NU14BER REI INSPECTION PLAN CHECK TOTAL ND DATE I DATE ISSUED Y Jefferson County Department of Community Development 621 Sheridan St., Port Townsend WA 98368 (360) 379 -4450 Evaluation of an Existing Onsite Sewage Sysiem (EES) Draw on the back of this sheet a current plot plan showing locatjon_o_f:_ Buildings, Drainfields, Septic Tanks, Wells, etc OR attach a curren#_,plo# plat identifying these items. -- ---rr; ALL SPACES MUST BE FILLED IN. Office Use Only Date Fee Recpt Check Case"* ., m ormadon is not available enter (NV) or not applicable (NA). , 7 qQO3 Type of Evaluation Evaluation of on -site sewage system Evaluation of drinking water (] Evaluation of on -site sewage & drinking water Reas�raorva,uatio� Routine Operation and Monitoring Inspection Real Estate transaction Complete a Permit # Building Permit Review and/or no septic permit on file Other ,explain Tax Parcel # a1390QQQL0 Permitted System yes no Permit/case # SEP' -7 —',rJ Subdivision, Division, Block and Lot(s) �•�- Lot Size Dimensions X Current Owner Site Address 77-A 1 m)m kA e,. e. i % Owner Phone Previous property owner name(s) - (NN if not known) iv A Directions to Site 4H,. Vv-x-- _ v.%R. k-%.. Date System Installed_a --,-J ` ! o � Age of Dwelling Iq -% *3 _# Bedrooms House Occupied X yes no, vacant how long? Who installed system? sy Send completed report to: Owner Name Mailing Address �.a. �o t I ho�n emailffaY 'Zf_^— Z 4ZOZ... /_443 LL , — - Realtor or Other Representative Name Mailing Address Phone/email/fax Wi! Evaluation of an Existing Onsite Sewage System Date of Inspection Inspected by Water Supply (fill in only if water supply is being tested in this evaluation) Sample was taken Yes No Sample Results Well casing 12" above ground Yes No Sanitary Seal in place Yes No Public: offsite onsite Name of System Individual: offsite onsite Is well more than 100' to drainfield /disposal component _yes_ no, if not, distance Is well more than 50' to tanks and effluent transport line _yes_ no, if not, distance ONSITE SEWAGE SYSTEM a\ # Bedrooms/gallons per day indicated in County Health Dept records for this case #1 - Septic Tank Tank size j b� gal, single compartment. two. compartment (�c!&3e.R.MM material Riser to grade on inlet vest_ no. Riser to grade on outlet yes X no Condition of tank X good needs repair, describe 1st comp. Scum (top layer) �_in. sludge (bottom layer) (C`� in. 2nd comp. scum in. sludge in. Was ground water observed leaking into tank ? ves �5, no If yes, where was water Condition of baffles: Inlet — > Outlet _good needs repair Screened Outlet :5:(._,_no _yes, Septic "tank needs to be pumped (per Jefferson- I i clean _ code 8.15.150 (1) (PVC, cre } (PV ncre ) no Effluent level at outlet (mark level on circle) If effluent is below the outlet, indicate when tank was last pumped: ( eg: ) Does system include a pump? yes If yes, complete the next section no skip to section 3) #2 - Pump Chamber Tank size gal. Material. Riser to grade? ves no Condition of tank Qood needs repair, describe Solids in Tank (see 8.15.150) yes no scum in. sludge in. Was Ground water observed leaking into tank ? ves no If yes, where was water observed? Screen around pump? ves no Shroud around pump? ves no Electrical Components Pump operating ves no, describe High water alarm functions ves no, if no, describe Elec. Panel condition good needs repair, describe Pump cycle drawdown inches. Time for pump cycle min/sec. Timer Settings min/sec on min/hrs off Floats secured: ves no Permit # or Parcel # Dmffternl 3 of 4 LU)t Evaluation _of an Existing Onsite Sewage System #3 — Drainfield Appropriate Vegetation in area __yes no. Describe vegetation allSS Indications of surfacing sewage (check one) yes , if yes, describe and diagram on plot plan no drainfield area is overgrown and not observable Signs of parkingldriving in area yes no drainfield area unknown Ground settling or erosion yes _no overgrown/not observable Monitoring Port Observations (if present): Residual Head yes, # of inches no Ponding in trench ves, # of inches of ponded effluent no Repair area is? Available as shown on permit _None evaluated or shown on permit Addendum is attached for evaluation of Treatment Unit.or detailed evaluation of drainfield yes__.)§ no COMMENTS (attach additional sheet if necessary): �. 'T'�� e7•s� �,�� ��j. ,F�L.� has '��t",�a',o�.�o Ago N��t�s SEE ATTACHED ADDENDUM Was a System Problem Identified? Yes If yes,. what section #. 1No_ This report on the existing onsite sewage system is valldJor the permitted or historic (if installed prior to permit requirements) use of the system only and does not constitute assurance of future County approvals (such as building permits) on this parcel. Any future application will be judged separately by the rules and laws in effect at that time. I certify that the in ormation provided is based on a review of County records and my direct observations at the time of inspection. 00 Na e/Signature Date No guarantee of future onsite sewage system performance is implied or granted based on the information contained in this report This report constitutes a summary of findings only. Permit # or Parcel # �` S 4 of 4 r ` Include the following items on your plot plan: ❑ Property boundaries ❑ Wells ❑ Names of adjacent streets ❑ Septic tank ❑ Driveways and parking spaces ❑ Drainfield (enter NN if unknown) ❑ Surface water (ponds,creeks, etc) ❑ North Arrow ❑ Buildings(residence, sheds, garages, etc) - -- -1 A .1 Permit # or Parcel # 's Q , �)L t S ����••,a•.•� 2 of 4 v DATE �j t 1,303 _3DDE °DL I ADDRESS L}%12b"o s &1o, i �= OWNER �, �►�tea►�. Enyiro Check. L.L.C. Company Disclaimer Based on what we were able to observe and our experience with on -site wastewater technology, we submit this Sewage treatment Inspec:iea°Evaluation Report based on the present condition of the on -site sewage treamtent system. Em iro Check, L L.C, has not been retained to warrant, guarantee, or certify the proper fi.mcdoning of the system for any period of time in the present or future. Because of the numerous factors (usage, soil characteristics, previous failures, etc.) which may affect the proper operation of a septic system, as well as the inability of our company to supervise or monitor the use or none visible areas of the system, this report shall not be construed as a warranty by our company that the system will function properly for any particular buyer or owner. Enviro Checic, L1.C. disclaims anv warranty, either expressed or implied, arising front t' he inspection/evaluation of the septic system or this reportlevaluarion- We are also not ascertaining the impact. the system is having on the goundwater or environmezrt. Comnanv Eaviro Check, L.L.C. 1612 Hastings Ave. W Port Townsend, Wa. 98368 360- 379 -9444 T acknowledge that T have studied the information contained herein and that my assessment is honest, done m accor erson Countv Ordinances, and to the best of my .ability, correct. 1 ame Weather Conditions ell Lakkr R , SMWLING (Septic tank) AffASURE Dam- PH :Result DO Rewit- Term R,esuult Comer Setting Hour Met Water U..%M (Ave.GPD) Meter- Squirt Height (In feet)- ENYIROvICHEU, LLC, 1612 Hastings Ave. w Port Townsend, WA 86368 PH 360 - 379 -9AM Parcel Details Parcel Number: 939900008 SEARCH Parcel Number: 939900008 Owner Mailing Address: REINHOLD BERGSTROM PO BOX 1187 PORT TOWNSEND WA983680987 Site Address: 430 DENNIS BLVD PORT TOWNSEND 98368 Section: 13 School District: Port Townsend (50) Qtr Section: SW1 /4 Fire Dist: Cape George (6) Township: 30N Tax Status: Taxable Range: 2W Tax Code: 161 Planning area: Quimper (2) Sub Division: CAPE GEORGE VILLAGE DIV 1 Assessor's Land Use Code_ 1100 - HOUSES (single units, non -farm) RE- RECORD TO CORRECT LEGAL ]C 10/7/98 Property Description: CAPE GEORGE VILLAGE DIV 1 1 LOT 8 1 1 1 Click on photo for larger image. r. Q 4F Printer Friend ermi or Da ax Histonf LM#p Parcel hats urve s Page 1 of 2 http: / /www.co jefferson.wa.us/ assessors /parcel/parceldetail.asp ?PARCEL NO=939900008 1/14/03 Map Output Page 1 of 1 ArciMS HTML Viewer Ma ill —era Legend selected Featums shorerme news is � * C®om Road 5y,MO,e Pawals QGGOC4GQ1i' 4Q21 � I QGGG�SQ ICI f � f I � J OR INFORMATIONAL PURPOSES ONLY- Jefferson County does not attest to the accuracy of the data contained herein and makes no warranty with respect to its correctness or validity. Data contained in this map is limited by the method and accuracy of its coltection. oning information is based on the 1998 Comprehensive Plan Map and does not include changes made using the 1999 Comprehensive Plan amendment process. Zoning designations must be confirmed with the De rtment of Community Development 1766" 4hNPLATTEO 6s4 /7//O N8B s 986E BO a 3 7 6160 35 B0 e I .,• fsR.� SAO ad s tidq e 8� a °! I iRB, 'gh650 21 w s�` b5 � 0 2 N°a•. o m !O 9 0 � o �i \b \ch0 12 �6a5' I F Brij SI°h 13 .i Say, Oyer rrS�'.e 6 UNPL.ATTF© Faaaio NOTE- + hWicafes cant moo w/th brass cap • Post set an line L.R Ae14 r 941 CAPE GEORGE VILLAGE PIy SEC MN 13 - T 30 N - R 2 W - W. bf. 1' o rai AO OA7UM+ W,Slnngton "a•� d',4, L'oardnate Sjvfim W ao 9p a /d 1gOQ qy x 4r SCALE, OESCR /PT /ON This P /at of CAPE GEORGE VILLAGE is located m Governmml Lo/ 3, Section /i, Township 30 North, Raoga 2 Wes /, W0. and embraces the tbOaw/ng described fact of Lend Begi401y a1 the noi/heasl corner of Bald Dort. Lot 3; !hence NBB% WW. a/Ortq the ror/h l/ne ofsa/d Gov.. Lot 3, 200 0.. to the Moe Buhl of Beginning; /hence continuing NBB %3%S'Wdony sold north hire 58372 ft, to a concrde amou• ment with brass caps thence S8'36 30'WJZS34 fi.; thence $34`01116V Zia Is t7.; thence S46 t!%S'E 80.7.; /hence 56POY32 F 200700..; .hence S551TI E343idf.,• !hence H/'46'4S'f 204.37.7.; thence ~19'141W 9645 /X; thence N28W'W*T IWAK.•• thence #67 *205W 5121 fl.; 06e700 NP4645 E 374 So fi! 10 1ha north lineofsa/d fi�Wrnment Lot 3 and the True F&W of Beghmhtg. 4d' ENGINEERS CERTIFICATE /hen certify that this plat of CAPE GEORGE VILLAGE /s based upon an adwl e =-'.•, curved subdivision of Sechao /3, Avp.3o N, RZW..V.Af, that /he &SAWcesand '•;'pj',a., are shown hereon eorrvelly • t the monuments have been set and -he block comers slaked corroc! hat /y upoa the ground, and that / hate Mly tdmp /fed w 1h the proWilans of Me &-,tales and phathiny regubf/ons. ROR � ENB /Ml %R _ •� 4ND L ' rw:ASORERS CERT- FICATE lheasurer of✓efferson County, Washington, hereby certify that all taxes on the above property, loge -her w/lh the payment ofadvanec !axes required before fling of the plat, are fully paid up to and *C /aaa r the year /96,/,, TRlASOReR W JBPiLRSON e00R7y RECORDING CERTIFICATE Filed for record at the ast of H°ward G��?iddahl on this _4th day of 1f/ Jts4__ 1963 al%���!�/finulas post &A4 "lock, aad rocorbad M V°/ume _Q of Plots, Page W', records of Jefferson County, Washiagton. --•-- cauNPr,wor ►oa - --- — o�o'�r uo"a�"'�- Sate ZOne) CAPE GEORGE LAND CO., INC. adh Qsl/jTAI v;eCllfflentRy -TR ACKNOWLEDGMENT 7 ! : ` -• STATE of WAS11IN67-ON .�,4. COUNTY of JEFFERSON} ss 'ea,.,� •, " On M4 _� _ day of July, /963, before Inc. Nre undersigned, a Nak7 Pah/ic in and for the Sale of Washington, du /y commissioned and sworn, persona //y ap- peared Howard G. R/dde// and V Keith Colman, to me known to be the Presidenf and Secret?r - Treasure , respec/ive/y, of CAPE GEORGE MOB /LE V/LLA6f, INC. and of CAPE GEORGE LAND CO., INC, the corporations that executed the foregoing inshamanl, and acknowledgad the said instrument to As !ha free and ya/uniai aet and deed of each of said corporations, for the uses and purposes /herein mentioned, and an oath staled that they were au/donied to execu /e the said ms/rumen/ and #o/ Me seals affixed are /he respective corporate sea /s of said corporahons. WITNESS my hand aad officio/ sea/ here% affrked /he day and year in /his© terti'ca /e above wr/Aen. NOTARY PLOUC AVANO POR sn a OF WASWINSTON, R£& /OAVO AT APPROVAL S 'aa - -7 • Approved • 6, me Ads _ day olAbee _ _, 1963 Approved by the Board of County Commissioners hNs _,.,Adiy of, /963 GrA/R AN- eouvo� carraissawevs Aftst: KAI. - ""a VP Cata"r COAfAN T`vfil" JEFFERSON COUNTY, WASH /NSMN DED /CAT /ON %S'w 76172 IKNOW ALL MEN BY TNESE PRESENTS /hat the anoWl" nod owner oh Fee simple of the /and herein p/alted, hereby dec /eras this p /at of CAPE GEORGE V/GLAGE, • Bo 70o b // eel fo the res/ricAons, covenants, and resew he" set rorlh m /hat WIZ, AGRfE6fENT FOR RESTRICTIONS, CM NANTS AND RESERVATIONS AND PROM /O /N6 FOR 3 2 / N.B comer ANNEXAT /ON OFpCAT, d /e �/ta dyaf✓u/y, /96� aLta'recorowe sdtW /hneoas/ydere- 6ovlLot3••"• I milhlnValWne/de[paga�2 IWIIderAadilaKkM&NaL ,rerordsafJe/TersonCamly,FYash. center see /a /NW/TNESS iVNE.QEOF a andersigned have hereunto set Mew hands this Y 4oi,12944 day ofJuQ; 1961 X4 W740 CAPE 6E0R6EM481LE V /[CAGE, AMC 3s6 BL VD 4" -0v-i::'". ZZ a ?9 24 ., 'vex;ps, v t 2 DECLARATION OFANNEXATION f �"•: ^;,��: tt a S ti 0 \ q0 B xiry •f' I The undersigned dons hereby acknowledge Itch the fore";I plat Of CAPE 6EORSE VILLAGE Is hereby annexed th CAPE GEORGE COLONYaid !dep/ais /dereaf mm/Yi \ti ro , 5� sYp egAa that Me same prm!/eges as to the use ofNm reserved pmaerlymdrights ander \�- *6 •0 CAPE GEORGE COLONY and the plats thereof are extended to each and a!! par- chasers and Owners afany lot. had orpareel Within the hints afCAPEGAME b(I V1LL46E as are granted fa the purchasers and owners of / nt /7 hlee smd / mpliians jY and vas /ricl/ons as aro apphcehle to such rise as provided Form Me plats of CAPE r es, xipr P. f1� GEORGE COLONY. /N WITNESS WHEREOF the undersigned has hmounla set his hand this ._day of Ja/t; 196a o rai AO OA7UM+ W,Slnngton "a•� d',4, L'oardnate Sjvfim W ao 9p a /d 1gOQ qy x 4r SCALE, OESCR /PT /ON This P /at of CAPE GEORGE VILLAGE is located m Governmml Lo/ 3, Section /i, Township 30 North, Raoga 2 Wes /, W0. and embraces the tbOaw/ng described fact of Lend Begi401y a1 the noi/heasl corner of Bald Dort. Lot 3; !hence NBB% WW. a/Ortq the ror/h l/ne ofsa/d Gov.. Lot 3, 200 0.. to the Moe Buhl of Beginning; /hence continuing NBB %3%S'Wdony sold north hire 58372 ft, to a concrde amou• ment with brass caps thence S8'36 30'WJZS34 fi.; thence $34`01116V Zia Is t7.; thence S46 t!%S'E 80.7.; /hence 56POY32 F 200700..; .hence S551TI E343idf.,• !hence H/'46'4S'f 204.37.7.; thence ~19'141W 9645 /X; thence N28W'W*T IWAK.•• thence #67 *205W 5121 fl.; 06e700 NP4645 E 374 So fi! 10 1ha north lineofsa/d fi�Wrnment Lot 3 and the True F&W of Beghmhtg. 4d' ENGINEERS CERTIFICATE /hen certify that this plat of CAPE GEORGE VILLAGE /s based upon an adwl e =-'.•, curved subdivision of Sechao /3, Avp.3o N, RZW..V.Af, that /he &SAWcesand '•;'pj',a., are shown hereon eorrvelly • t the monuments have been set and -he block comers slaked corroc! hat /y upoa the ground, and that / hate Mly tdmp /fed w 1h the proWilans of Me &-,tales and phathiny regubf/ons. ROR � ENB /Ml %R _ •� 4ND L ' rw:ASORERS CERT- FICATE lheasurer of✓efferson County, Washington, hereby certify that all taxes on the above property, loge -her w/lh the payment ofadvanec !axes required before fling of the plat, are fully paid up to and *C /aaa r the year /96,/,, TRlASOReR W JBPiLRSON e00R7y RECORDING CERTIFICATE Filed for record at the ast of H°ward G��?iddahl on this _4th day of 1f/ Jts4__ 1963 al%���!�/finulas post &A4 "lock, aad rocorbad M V°/ume _Q of Plots, Page W', records of Jefferson County, Washiagton. --•-- cauNPr,wor ►oa - --- — o�o'�r uo"a�"'�- Sate ZOne) CAPE GEORGE LAND CO., INC. adh Qsl/jTAI v;eCllfflentRy -TR ACKNOWLEDGMENT 7 ! : ` -• STATE of WAS11IN67-ON .�,4. COUNTY of JEFFERSON} ss 'ea,.,� •, " On M4 _� _ day of July, /963, before Inc. Nre undersigned, a Nak7 Pah/ic in and for the Sale of Washington, du /y commissioned and sworn, persona //y ap- peared Howard G. R/dde// and V Keith Colman, to me known to be the Presidenf and Secret?r - Treasure , respec/ive/y, of CAPE GEORGE MOB /LE V/LLA6f, INC. and of CAPE GEORGE LAND CO., INC, the corporations that executed the foregoing inshamanl, and acknowledgad the said instrument to As !ha free and ya/uniai aet and deed of each of said corporations, for the uses and purposes /herein mentioned, and an oath staled that they were au/donied to execu /e the said ms/rumen/ and #o/ Me seals affixed are /he respective corporate sea /s of said corporahons. WITNESS my hand aad officio/ sea/ here% affrked /he day and year in /his© terti'ca /e above wr/Aen. NOTARY PLOUC AVANO POR sn a OF WASWINSTON, R£& /OAVO AT APPROVAL S 'aa - -7 • Approved • 6, me Ads _ day olAbee _ _, 1963 Approved by the Board of County Commissioners hNs _,.,Adiy of, /963 GrA/R AN- eouvo� carraissawevs Aftst: KAI. - ""a VP Cata"r COAfAN T`vfil" New Page 1 n Page 1 of 1 http: / /maps.co jefferson.wa.us /website /shoreline /shorephotoZoom.asp ?ID=8926 8/13/2004 Map Output Page 1 of 1 939900008 1 e9 L end selacsd f UJIGa I 1J ' —DENNIS eLi+ r T. �•j Road Spftm Panraft-li Landslide Hazard I w,t ,.% •iµ-4 � ■ SW ,� li__ I y TT,{ • lie FOR INFORMATIONAL PURPOSES ONLY - efferson County does not attest to the accuracy of the data contained herein and makes no warranty with respect to its correctness or validity. Data contained in this map is limited by the method and accuracy of its Ilection. Fri Aug 13 07:49:48 2004 http: / /gisserverlservleticom.esri.esri map. Esrimap? ServiceName — ovmap &ClientVersion =4.... 8/13/2004 Map Output Ali � 4 4 �rt 9 Y p. LU M w, j4C 51's Yirt �C ¢� 5.7 -°wdyp .r a DENNIS sLVD Y Oil kll AiSyr+_ *^ �3•� •� y q� Cd*Af swdcazG +lea; k, � 4 4 �rt 9 M Page 1 of 1 Legend 13 Selected Feetums // Reed System Ej pawalsm 2(100 Aera6 Phetes I vr% wyrurwhm i IVIVHL rURI"VOCJ VIVL. T' efferson County does not attest to the accuracy of the data contained herein and makes no warranty with aspect to its correctness or validity. Data contained in this map is limited by the method and accuracy of its collection. Fri Aug 13 07:50:49 2004 http: / /gisserverlservleticom.esri. esrimap. Esrimap?ServiceName= ovmap &ClientV ersion =4.... 8/13/2004 I vr% wyrurwhm i IVIVHL rURI"VOCJ VIVL. T' efferson County does not attest to the accuracy of the data contained herein and makes no warranty with aspect to its correctness or validity. Data contained in this map is limited by the method and accuracy of its collection. Fri Aug 13 07:50:49 2004 http: / /gisserverlservleticom.esri. esrimap. 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