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1959, 10-02 Permit App: 16122 SewageSPOKANE COUNTY HEALTH DEPAR 1 MEN 1 PERMIT NO I (1.1. 1 E. O. PLOEGEf, M.D., Director of Health Dlvisloa of Sanitation N. 819 Jefferson Spokane 1, Washington DATE - L/7 N9 16169 APPI. AT ON ICOR PERMIT TO INSTALL GR RECONST CT SEWAGE SPOSAL FACILITIES dre c7c O .Phone No Name... Address of Type of Use ..12r$7..../ - ....1s basement for building planned?....:-...—.,. ....w. ..8 lid ape ty Camp Capacity Other ,.... ell, Sp�fitg.,.....,Del• Septic tank capacity.,,_ .... _.,.~_:��.... ............... _..gals. Style of tank h of disposal field....._.. ..... . ...._Size of Property act/....3 Number of Bed Water Supply. (1) Draw In property area to scale. Leaching Bed Dist. Box (2) Show relative location of: Proposed house, septic tank, disposal field, well, garage, and other out buildings. (3) Make note of any heavy elope or swampy area or any other important topographic details. 0 WIN Final Inspection Remarks - CONTRACTOR L{Al (Form 316 - Rev. Health - 5M - 0155) Tod ZOO# RECOMMENDED PERMIT BE By ,r Sanitarian OAS Hr1d3H:QI LT:TT M. -TO -EGA