1974, 04-02 Permit App: A13358 Sewage Disposal PermitSPOKANE COUNTY HEALTH DISTRICT
E. O. PLOEGER, M. D., M.P.H., HEALTH OFFICER
N. 819 Jefferson Street
Spokane, Washington 99201
PERMIT NO _..57 /33S e
DATE W% /"/ 'S/
No. A 13696
APPLICATION FOR PERMIT TO INSTALL OR RECONSTRUCT SEWAGE DISPOSAL FACILITIES
Name N/.4.-C.t?.X-e- 1 - Address I .?.69-‘,79-4 Phone No 9-1— )2
Address of Proposed Site
Type of Use
Number of Bedrooms Budding Capacdy
Water Supply /" v (City, Well. Spring).
Septic tank capacity "/C'.-r's—a
Length of disposal field Absorption Pits
Is basement for building planned?
Camp Capacity
Drywell
gals Style of tank
Other
(I) Show relative location of Proposed house peptic tank,
disposal held, well, garage and oll(tr pMibuildi ngs
(2) Make note of any heavy sl. ' iwanjpy area or any
other Important topograph
/ �
Installer �J
R nal Inspection Date (� Pi /77 L6�NtyAAJ2) aA11,2
Remarks
0,
for Spokane County Health District