1968, 08-06 Permit: A03739 Sewer • ` -
FEB-'10-'89 12: 18 It:':HEALTH SF'0 TEL HO:5 1'9-456-4 715 452 P01
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., E O,PLOECER,M.D. ,M.P.H. , Health Officer
` s ,„ ',..0.''.4i“,-,01i- v t s ,L ` • Division of Sanitation
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�f ' ¢ 4 ' • Vi , ,;:c�` ,, ;,,1i '.. N. 810 Jefferson Street ,
!`' + ,vn1 t, ` .�q }y- ` Spokane, Washington 99201 DAT
•TN� NQ A 03739
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APPLICATION FOR PERMIT TO INSTALL OR RECONSTRUCT SEWAGE DISPOSAL FACILITIES
Name�#z
- 4 Y SXJ. 1 Address one T�Io, el.rrr a' Z,
Address of Proposed Site Q .+ _� e. �� -------- .
Type of Use '......,. - — Is basement for building planned? _ _ --
Number of Bedrooms ) . -wilding Capacity - --Camp Capacity Other - -
Water Supply--__ (City. Well, Spring). Drywell -
Septic tank capacity_..- ala. Style of ten -------
Length of disposal field - Absorption pits ., • -- Leach Bed
--- ------- .,. - ---_ :..—__
(1) Show relative location of: Proposed hour*, septic tank
disposal field. well, garage and other out buildings.
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(2) Make note' of any heavy slope or swampy area or agcy 1 I
other important topographic details.
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1�1 Installer r 3 -
1.''''''I'',"4 ,id .: ,',-.Y.,','' :','": ::."'1",110,!&111r- .. ! /� .. ..
Final Inspection Dae Air
Remarks; �� • yyy///JJJ . --• ----
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CONTRACTOR :A 4 .* .;/ !