1964, 10-07 Permit A00248 Sewage DisposalSPOKANE COUNTY HEALTH DEPARTMENT
E.O.PLOEGER,M.D. ,M.P.H. , Health Officer
Division of Sanitation
N. 810 Jefferson Street
Spokane, Washington 99201 DATE-.-
PERMIT
ATE_ PERMIT N0. /� D N9 A 0 0 2 4 8
APPLICATION FOR PERMIT TO INSTALL OR RECONSTRUCT SEWAGE DISPOSAL FACILITIES
Name '
�c=� Address'one No.xle_ S%�)
Address of Prep sed Site //0,6-
Type
/0,SType of Use-y-'.'d-ate.�a,zQ_
Is basement for building planned?
Number of Bedroom ilding Capacity C
amp Capacity- ether
Water Supply (City, Well, Spring). Dr
ywell
Septic tank capacity_ '-;Z� d11 gals. Style of tank
Length -r A:.,----, - . /�'n
disposal field, well, garage Vand cot'hers oi't;'%;d tan , �=
91, z4�
(2) Make note of any heavy slope or swampy area
other important topographic details.
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Iso'
t
Installer
✓Final Inspection Date
Remarks:_
CONTRACTOR
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906 REY MEAL7 M _ r
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County Department_