1952, 11-14 Permit: 6664 Sewage Disposal- POKANE COUNTY HEALTH DEPARTMENT
Division of Sanitation I
(moi f
1127 W. Mallon Avenue
4
Spokane 11, Washington - N9 6.66
DATE
— f L
APPLICATION FOR PERMIT TO INSTALL OR RECONSTRUCT -SEWAGE DISPOSAL` FACILITIES
Name P
Address of Proposed 2o (�
Type of Use..._.._
Address.... .... Phone No af)Q / 7
CC—L.-1'4a `—^---5__Size of Property ri fr
Other
Number of Bedrooms Y Building Capacity Camp Capacity Other
Is property below grade of streets or alleys? Are streets graded in?
Is basement for building planneddd'...........
Water Supply . a ` ...g—L�Bii'y, Well, Spring).
Septic tank capacity
�O t7
Length of disposal field ADO
gals. Style of tank..
(1) Draw in property area to scale.
(2) Show relative location o Popo\ed\ouse, sptic tank,
disposal field, well, ggrag other out,bulldi
How much excavation or fill proposed?
?�h
(3) Make
other
Date whe
inspection._', L
Date install
before backfilling)
SANITARIAN'S REPOR ANCOMMENDATIONS:
Date of Inspection
Topography
Ground Water
Soil Condition0_1(.1.1 ? l
Special Recommendations
Percolation tests: Minutes
Final Inspection Date
613 - °.r...ntr.f 0%i5z.tze:
RECOMMENDED PERMIT BE