1955, 01-04 Permit 9495 Sewage Disposal_SPOKANE COUNTY HEALTH DEPARTMENT
Division of Sanitation - DATE '/ V ` \ '
N. 819 Jefferson
Spokane 1, Washington
4LPPLICATION FOR PERMIT • INSTALL 0 R • ONSTRUCT SEWA DISPOSAL FACILITIES
Address V 71/O
Addressof Proposed Site
Type of Use^
Number of Bedroom wading Capacity VCamp Capacity . Other
Is property below grade of streets or alleyeys?r Art streets graded in' - Is basement for buil g planned — How much excavation or fill proposed'
Water Supply (__ .._ / City, Well, Spring)... Drywell
j
Septic tank capacity �lgals. Style of .�
Length of disposal field___9( 49 d .I-R�+.Q' '-— Leaching sad--
(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 detailc
Date when test hole will be ready for
inspection
Date installation will be ready for final inspection (that is,
before backfilt;ng)..
SANITARIAN'S REPORT AND RECOMMENDATIONS: Date of Inspection
Topography
Ground Water
Soil Condition - . Percolation tests' Mmutes
Special Recommendations.:., . .:
(berm sae..a'atm- 2341u-7-ss).s.:
1