1952, 07-21 Permit App 6390 Septic TankOCT-17—'33 14:43 ID:HEALTH SFO
TEL NO: 5G9-45E, 471E
#189 PO1
Division of Sanitation
1127 W. Mallon Avenue
Spokane I I, Washington
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A�PPLIICCATIOjN�FOOR�PERMIT
'TO_ -INSTALL OR RECONSTRUCT SEWAGE
Dl$ OSAL FACILITIES'
Name. .._.c e...6�"• 424 r`^�� 00�; AAdrees..2 a 1 2 `�•
Address of Proposed e t1 a 0 Y
Type of use_._..__.... . �.. Other
Number of Bedrooms
Building Capacity Camp Capacity tither
Is property below grade of streets or alleys?
Is basement for bu g planned' ._
Water Supply it$fWell, Spring).
Septic tank capacity gals. Style of tank
1 -sixth of disposal field ../-Q.0
(1) Draw inproperty area to scale.
(2) Show relative loeatfoa of: Proposed house, septic tan,
disposal field, well, garage, and other out buildings.
(A,) 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 will be ready for final lnspectlon (that ia,
before backfllling)
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Are streets graded in'
How much excavation or fill proposed?
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'SANITARIAN'S REPORT AND RECOMMENDATIONS:
Date. of Iaspec
Cur
on
Topography
Ground Water
Soil Condition Percolation testa: Minutes_ -_.....I
Special Recommendations
Final lnspectlon Date /..-� ,atid Y {!�',( /( ""'
Remarks:
RECOMMENDED PERMIT B
4
Sanitarfrn
By
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