1957, 08-16 Permit App: 13612 Install SepticSEF -2T—'88 13413 ID:HEALTH 'SFO
TEL NO: 509-456-4716 .
#112 FR1
. OKANE COUNTY HEALTH DEPARTMEN
ARTHUR E. LIEN. M.D.M.P.H., Health Officer
Division of Sanitation p
N. 819 Jefferson DATE._._...Q
Spokane 1, Washington
PERMIT NO
/ C -' �J
IN? 13612
ZA Lo1CATION OR PE MIT TO INSTALL OR RECONSTRUCT
SEWAGE Dl POSAL FACILI lES
Name "� / `� ^�� 7 �•� Address_..[ Q....&.Y o ' Phone No �' f‘ �J
Address of PrJ/9 yr
' -d Site -.../.R a , >7 a'� t -z7 Size of Property.... il_._ /.P....0
Type of C7se�r ti...:�J
Other
Number of Bedrooms -Q----)Building Capacity Camp Capacity Other
Is property below grade of streets or alleys?
Is basement for building
Water SuppIYr"r1.-- �(
Septic tank capacity
U Ca
Are streets graded in?
How much excavation or fill propbsed?
Well, Spring). i)rywell
gals. Style of tank
i
Length of disposal field / O Leaching Bed 4 Dist. Box
(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) Make note of any heavy slope or swampy area or any
other important topographic details.
Date when test hole will be ready for
inspection
Date installation w111 be ready for final inspection (that is,
before backfilling)
SANITARIAN'S REPORT AND RECOMMENDATIONS:
Topography
Ground Water
Soil Condition Percolation tests: Minutes
Special Recommendations
Date of Inspectgion
Final Inspection Date--+ir_..,w1.-.slf;4"''
Rernarks'
CONTRACTOR
(e'orm 548—Health—SM--2-85)
4
RECOMMENDED PERMIT I+
By
Sanitarian