1954, 08-12 Permit: 6467 Sewage Disposal._ s _ L wir - �•w
SPOKANE COUNTY NEALTH DEPARTMENT
-- i Y
Division of Sanitation DATE
PERMIT NO
N. 819 Jefferson
Spokane 1, Washington
N° 8824
APPLICATION FOR PERMIT TO INSTALL OR RECONSTRUCT SEWAGE DISPOSAL FACILITIES
Name
J
Address of Proposed$ile•
Type of Use
,Number of Bedrooms Building Capacity Camp Capacity Other
Is property below grade of streets or alleys? Are streets graded in?
.Address ''6 / ��' w h e Nd0 4..1 --CI V o
Size of Property. rCl O X V1.-4••
Other
Is basement for buil planned How much
Water Supply y, Well, Spring). Drywell 1
gals. Style of tank 1
Leaching Bed
ation or filyproposed?........ _._..... _..._.....
Septic tank capacity
Length of disposal field
A>0
(1) Draw in property area to scale.
(2) Show relative location of: Proposed house, septic tank,
disposal field, well, garage, and other out buildings.
(3) Haire note of any heavy, slope or swampy area o� any
other important topographic details. X,,.�yJ--
A--AA�'
Date when test hole will be ready for
inspection.:. ,
Date installation W1U bt, ready for final inspection (that is,
before backfilting? `
SANITARIAN'S REPORT AND, RECOMMENDATIONS;
Topography. r .»..
Date of Inspection
Ground Water
Soil Condition. ...•__..: Percolation tests: Minutes
Special Recommendations,
Final Inspection Date.
Remarks •. X '
t
CONTRACTOR.... ci�'i RECOMMENDED PERMIT BE.
(corm 346-11ealth-2
0
By
Sanitarian
1