1969, 11-17 Permit: A05411 SewerOKANE COUNTY I-4EALTE; DEPARTMENT
PERMIT NO.
Name
E.O. PLOEGER,M.D.,M.P. H., Health Officer
Division of Sanitation
N. 810 Jefferson Street
Spokane, Washington 99201 DAT
N4 A 05411
APPLICATION FOR PERMIT TO INSTALL OR RECONSTRUCT SEWAGE DISPOSAL FACILITIES
Addres —Ss Z one i
4.
. Site L , R'✓�.i�
I� �! f
Address of Propose
Type of Use
Is basement for building planned)
Number of Be ms /� ilding Capacity Camp Capacity Other
Water Supply .i}-0-Cr7Q (City, Well, Spring). Drywell y�J
Septic tank capacity
Length of disposal field (/ 'O Absorption Pits
gals Style of t
Trach Bed
(1) Show relative location of: Proposed house. septic tank.
disposal field, well. garage and other out buildings.
(2) Make note of any heavy slope or swampy area or any
other important topographic details.
Installer
3s"
Final Inspection Date
Remarks- ;2) 7C