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Home My WebLink AboutSEP1970-00031' 03 East Caroline OLYMPIC HEALTR DISTRICT Permit No, Port Angeles Fee Paid $ .r's—Z! SEWAGE DISPOSAL PLS XlT APPLICAT �T�.•. Submit in Liu 1=cats_: �.�L KAMEQ _/ 6 ...�=ATE LEGAL DESCRIPTION � rv: �S L d 7, cyfZ'O=W K'-t�j PHONE .rr.r�....��..r�a�.r r DIRECTIONS FOR LOCATING SITE AL _Z40F .APPLICATION IS HEREBY MADE TO: INSTALL NEW SYSTEM r REPAIR EXI,S'PffiG SYSTEM YPE OF BUILDING X10. OF BEDROOMS BASEEMEaNT SITE .SIZE. NAME OF INSTALLER." N T RS S A DETAILED PLOT PLAN GIVING THE FOLLOWING INFORMATION �.. Property lines 7. Driveways, patios, carports etc. Location of building Location 8. Streams or bodies of water nearby 3. of septic tank g. Location of percolation test holes 4. Location of drainfield 10. Septic tank size`9� l� gallons g. Slope of land- 11. Length of proposed drainfield 6. Water lines & well(if applicable) 12. Depth to water if encountered. PERCOLATION TEST RESULTS. Depth Time;requ re to Percolation rate ype of so 1 of hole seep last 6 in. (divide time by (9 Perc. No. 1 Pero: No. 2 Perc. No. 3. LRAINFIELD LENGTH WIDTH .2–° DEPTH. 2'0 NO. OF LINES AS DESIGNED AND APPROVED ON THIS AR'PLICATION. (n APPROX. DATE OF INSTALLATIONSignature of Applicant --.SANITARIAN'S COMMENTS aZvi/' -iw ew 75o WA -If r� Fl o 7 W THIS CONSTITUTES A PERMIT WHEN HEALTH OFFICERS SIGNATURE APPEARS AS APPROVED PLAN APPROVED 76 DISAPPROVED DATE ,p 7D 0 1 DATE INSPECTED �. SANITARIAN � REMARKS • A0, w�A-68 �' �ojtrie014<®/i3AP3 6a.`' l'_I'a9®I /�I� i SYMCH PLAN ON ^ GRID BELOW J S ALEQ FEE BETWEEN LINES C � INDIC TE.NORTH - I I� i II J' I u R I it I ➢ � I I I I 'I �I re I i I' If I s �i I 903 East Caroline Port Angeles OLYMPIC HEALTH DISTRICT BUILDING SITE INSPECTION APPLICATION Submit in Duplicate Court House Port Townsend. 107 DATE7�%� AN.APPLfC'ATION f HEREBY MADE FOR APPROVAL OF THE ABOVE LOCATION FOR A STRUCTURE WHICH WILL BE SERVED BY AN INDIVIDUAL SEWAGE DISPOSAL SYSTEM. RESIDENCE _,<_COMMERCIAL BUILDING OTHER` ATO. BEDROOMS. BASEMENT.Lfin— SITE SIZE �"OURCE OF WATER', TYPE OF SOIL DEPTH TO WATER TABLE . IRAW A SKETCH in the space below$ indicating location of building in relation to other btt3ldings, property lines, well, streams or other bodies of water. Indicate proposed location of sewage disposal system. Date of Site Inspe Disapproved * See reverse side for remarks. THIS IS NOT AN APPLICATION FOR A SEWAGE DISPOSAL PERMIT. A SEPARATE PERMIT IS NECESSARY PRIOR TO THE INSTALLATION OF A SEPTIC TANK AND DRAINFIELD. ROUTING SLIP - MEMO A OLYMPIC HEALTH DISTRICT Port Angeles, Wash. 9836; 6: SUBJECT: Lydia Branohflower Bridgehaven Lot FROM: DATE: Angel Ramos 4-29-70 ..b.r—.,w.�+1■.YdL� �rr.r rr+�r� r r r r. r�rr�rrrrrrr+rrrrrlrr MESSAGE': We are not too sure wheer you meant Division 5 when you put in Sea. 5 in your application form. If this is Div. 5, our records show that; there is no potential problem as far as septic tank and drainfield is concerned. The percolation 22 rate in your lot is 4 jXinutes per inch. This is an average rate and we feel that there will n 4 bei mW problem. We would like to know how you are going to set your tank and drainfield. Enclosed is a septic tank permit form, where you can indicate your pixxx sewer plan. We will investigate and reveiw your sewage plan again when we get an illustration Xzx of your plan. There is a $15.00 permit fee for the septic tank permit. 11-67 For: „Inf. Action Approval „ Comment ,_, Reply , n !T /gyp • �, 1f{4.P11 ".. ?. �C:t� TO'w i qTc ■y•��,,��yyy•y� �{ a•y�Y �.: y u3.�' fid-l�ci[J?Ikl � t �"�'�' AM•«�o++rrlM�.r.w�r.�rMtiw.rw .Y1J.J()C)W • 1 tY� _.. _. �'7 Q1 [I 7 '9 s J- A - • .��c. ✓111: ,U �.i �. v�.4 E, {-�s le ro-zgq ITS 1,1* A�rlal. moil `! � r b -y. � _.. _ _._ ,.f .._. ..._. _3,_. ... ._ `_n ,. u. , _Y -•lila _...,...w.. :., 903 East Caroline Port Angeles LEGAL DESCRIPT 0 OLYMPIC HEALTH DISTRICT BUILDING SITE INSPECTION APPLICATION s' ! Court.House Port Townsend DATE..—Y/� JJ AN APPLICATION IS HEREBY MADE FOR APPROVAL OF THE ABOVE LOCATION FOR A STRUCTURE WHICH WILL BE SERVED BY AN INDIVIDUAL SEWAGE DISPOSAL SYSTEM. RESIDENCE X COMMERCIAL BUILDING OTHER NO. BEDROOMS�, BASEMENT I SITE SI � .2 "OURCE OF WATER TYPE OF SOIL DEPTH TO WATER TABLE DRAW A SKETCH in the space belowp indicating location of building in'relation to other buildings, property lines, well, streams or other bodies of water. Indicate proposed location of sewage disposal system.. Date of Site Approved* * See reverse side for remarks. THIS IS NOT AN APPLICATION FOR A SEWAGE DISPOSAL PERMIT. A SEPARATE PERMIT IS NECESSARY PRIOR TO.THE INSTALLATION OF A SEPTIC TANK AND DRAINFIELD. L,UILIJi��U t LI...,11 r i LIL.:•��' '. Jefferson County Building Department • County Courthouse • Port Townsend, Iti3sh. 93368 355 1310 N E FEET 1. LOCATION: geographic name. _---- S W SIDE OF ROAD N EROAD A1ND _ROAD S W FROM INTERSECTION OF other specific locaton or landmark:n 1 4 ` LEGAL ESCRIPTION: Lot — Block A / / Subdivision sPar -- Tnumch.o e Q r If II. TYPE AND COST OF BUILDING - TYPE OF IMPROVEMENT ❑ New building Addition Q Alteration ❑ Repair, replacement 0 Wrecking ❑ Moving (relocation) ❑ Foundation only BUILDING TYPE 9 Single Family Multi -Family number of units ----- Hotel, Motel, Dormitory number of units ❑ Mobile Home Other - Specify MOBILITY - v r ❑ New County 116j0pt COU Is this structure lm��^i�al or commercial needs of those eej. i ojed at either the US. Navy's Trident or Indian Island Facilities? ❑ YES ONO USE ❑ Full-time Residence OWNERSHIP ❑ Private (individual, corporation, ❑Second Home: Recreation Cabin, etc. nonprofit institution, etc.) ❑ Second Horne- Future conversion to ❑ Public (Federal, State or local go,/t.) UBC OCCUPANCY GROUP:-- permanent residence COST (Omit cents) Nonresidential - Describe In detail Proposed use of buildings, a g., food processing Plant, machine shpp, laundry building at hospital, elementary • Cost of improvement............ $ Tschool, secondary school, col 109e, parochial school, parking garage or To be installed but not included the above cost department store, riintal office building, office building at industrial plant. in If use of existing building is being changed, enter proposed use. a. Electrical....... ........... I* A S 2p� b. Plumbing .................. X Z�\ — �"Z O X c. Heating, air conditioning ...... d. Other (elevator, etc.)........ . • TOTAL COST OF IMPROVEMENT 111. SELECTED CHARACTERISTICS OF BUILDING - DIMENSIONS PRINCIPAL TYPE OF FRAME TYPE OF SEWAGE DISPOSAL • Number of Stories ..... , .. • • • - [] Masonry (wall bearing) ❑ Public or Private •Total square feet of f[oar area, Individual (septic tank, etc.) att floors, based an exterior y 'VWood Frame dimensions .................. tructural steel TYPE OF WATER SUPPLY •Total land area, sq. ft. - [] Reinforced concrete 0 Public or Private company NUMBER OF OFF-STREET ❑Other -Specify Individual (well, cistern) PARKING SPACES Enclosed............... . ---- PRINCIPAL TYPE OF HEATING FUEL TYPE OF FIREPLACE Outdoors ...................... O Gas RESIDENTIAL BUILDINGS ONLY ❑ Oil Number of bedrooms _ ........ • - ❑Electricity C-) Ic- v --- TYPE OF MECHANICAL 0 Full_ ...... . Coal Number of Other — Specify -L \p\ �e�T bathrooms Partial...... SL\- , p�s�.�... IV. IDENTIFICATION - - ZIP code Tel. No. Name Mailing Address — Number, street, city and State c W7751-1 Owner . LU 2. State License No. Contractor 3. Architect The owner of this building and the undersigned agree to conform to all applicable laws. Application date Address1 Si tune of applicant FIRE DISTRICT SCHOOL DISTRICT WATER DISTRICT PLANNING AREA - APP ®V�i�'7 `t�i.��%C� �!/ > Q REAL DEPARTT� ( REGE! PT NUMBER '1EFFERSON PERMIT FEE ISSUE DATE APPROVED BY: � ^� ou �^ Y (o i s) BUILDING OFFICIAL (0 � , -j�p ` ,5f-T��N4/ e Tl:e Pr,ntery — Pcrr To.+nsend 0 ! G ! 111 ✓V `� Jefferson County.Health.Department Environmental Health Section Port Townsend, WA 98368 Application for evaluation of: Receipt No. %� 5 Fee $45.00 Date V Sewage Disposal System Sewage Disposal System and Water System Applicant name Port Ludlow Realty, 7520 Oak Bay Road, Port Ludlow, Wa. 98365 Owner's name (if different) Jack Windh (previously Cecil & DeAnna Nelson) Property Address 50 Finch Lane, Port Ludlow, Wa. 98365 (Bridgehaven) T.Pgatl description Lot 24, Div. 5 Sec._ _ Twn._27N Rge._jBfi_ Direction to property over --- y * If there -is no record of permit at health depar-tment, uncover total top of septic tank. If there is a record, uncover outlet of septic tank only. trail to: Port Ludlow Realty 7520 Oak Bay Road Port Ludlow, Wa. 98365 Do not write below this line su Water Suppl Type of System V. Yes No Well casing 12" above ground Sanitary seal in place Well 100' from drainfield Water sample taken When sampled: Date Time Sample results Sewage Disposal Svstem Yes No Permitted System knsgalled prior to permit requirements � Sewage noted on ground at time of inspection* 41, Comments: g�r„� rsarz�r� �w �«.. Pa®W L . c,6 `tnT f° i0,% Inspected by:�.Date: 11 -fes- Time a;® -o f *This report does not constitute a guarantee, either written or implied, that the system will continue to function properly. This report constitutes a summary of findings only. BUILDING PERMIT APPLICATION_, ' Jefferson County Buiidio.g bepartment • County Courthouse • Port Towitu ld, Wash. 98368 • 385.9 141 li PL NNING AREA FIRE DISTRICT SCHOOL DISTRICT NE APPROVED B� � _u_� • I. LOCATION: geographic name S W SI DE OF ROAD FEET NE S W FROM INTERSECTION OF ROAD AND )�' d ROAD other specific location or landmark: RECEIPT NUMBER 8� LEGAL ^ 'DESCRIPTION:^I �,CC1 # Lot Block Subdivision 5 60p Zai "13 Tax Number 'h Section Section Township Ranged I1. TYPE AND COST OF BUILDING - aOn TYPE OF IMPROVEMENT BUILDING TYPE MOBILITY ❑ New building Addition �ngle Family /❑ Multi -Family ❑ New County Resident Is this structure to serve the residential /❑ `Alteration 171 Repair, replacement number of units ❑ Hotel, Motel, Dormitory number of units or commercial needs of those employed at either the U.S. Navy's Trident or Indian Island Facilities? ❑ Wrecking ❑ Mobile Home []Moving (relocation) ❑ Other — Specify ❑ YES ❑NO ❑ Foundation only USE OWNERSHIP 0 Full-time Residence Q Private (individuel, corporation, nonprofit institution, etc.) ❑ Public (Federal, State or local govt.) ❑Second Home: Recreation Cabin, etc. ❑Second Home: Future conversion to permanent residence UBC OCCUPANCY GROUP: COST (Omit cents) Nonresidential — Describe in detail proposed use of buildings, e.g., food 0 Cost of improvement............ To be installed but not included in the above cost a. Electrical ................... b. Plumbing .................. $ processing plant, machine shop, laundry building at hospital, elementary school, secondary school, college, parochial school, parking garage for department store, rental office building, office building at industrial plant. If use `of existing building is being changed, enter proposed use. (Q 1'' lD —ci"ngi - c. Heating, air conditioning ..... d. Other (elevator, etc.)........ . $ • TOTAL COST OF IMPROVEMENT Ill. SELECTED CHARACTERISTICS OF BUILDING - PRINCIPAL TYPE OF FRAME M Masonry (wall bearing) /Wood Frame [� Structural steel ❑ Reinforced concrete ❑ Other — Specify TYPE OF SEWAGE DISPOSAL ❑ Public or Private Xindividu (septic tank, tc.) DIMENSIONS • Number a Stories floor area, . •Total square feet of floor area, all floors, based on exterior dimensions......... . •Total land area, sq. ft.......... . TYPE OF WATER SUPPLY Public or private company A ❑ Individual (well, cistern) NUMBER OF OFF-STREET PARKING SPACES Enclosed....................... PRINCIPAL TYPE OF HEATING FUEL ❑ Gas TYPE OF FIREPLACE Outdoors .................... RESIDENTIAL BUILDINGS ONLY ❑ Oil NlS(Electricity Number of bedrooms ............ Coal ❑ Other — Specify TYPE OF MECHANICAL Number of Full....... . bathrooms Partial.... . IV. IDENTIFICATION - ' Name Mailing Address — Number, street, city and State ZIP code Tel. No. ,.4arry.. Owner 9L4 L4 2) 2. Contractor _ -- - - tate License 00. 3. Architect The owner of this building and the undersigned agree to conform to all applicable laws. S1 n re of applicant d Address Application date 03 1 11(o U8 li PL NNING AREA FIRE DISTRICT SCHOOL DISTRICT WATER DISTRICT APPROVED B� � _u_� • JEFFER C Ni'Y HEALTH DEPARTNIENP APPRO BY: PERMIT FEE ISSUE DATE RECEIPT NUMBER 8� 3 50 aOn BUILDING OFFICIAL 8 �I 7 'S� : I The Printery — Port Townsend —' /'a�► �•'' ��a.,��.'� �= jr111}... �w f