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HomeMy WebLinkAboutOlder Shower Facility - SWG Application / As-Built - 6/25/1970 `�c_�-�(-� � e-�,��. Y��1��_�i,� -��• i-�e-�,-nn�v.o�., l)J r;`-� 9-�e�� �'-g x-�. 0 No. - e Thurston-Mason Health District 5th & Birch Court Ho se Annex Shelton, Washington DIVISION OF SANITATION Olympia, VlAshington Phone: 426-4407 fQs(CQ /"'. j.O�� / ;//; J n � Phone�35 485� BSit6 j.3'. Owner , rF� Ln! � Phone 2 22 Mailing Address ,Z2UC- 3 a k, City ��State / Builder Address Sly Sewage Contractor Address Legal Description e C. ' � Parcel No. Field Book No. Directions to Property L J J L L Intended uses of Buildings&-52—r_n Public Sewer Water Suppl �/ No. of Bedrooms No. of Bathrooms_Basement_Septic Tank Type of Soil Lot Size Soil Drainage: Good Moderate Poor None DRAW SKETCH in blank space or on separate sheet indicating the following: 1. Property lines and location of house on lot and indicate minimum and maximum setbacks plus dimensions of lot and all buildings. 2. Location of house and sewage disposal system in relation to streams, lakes, wells, patios, driveways, underground tanks, water supply lines and easements. 3. Proposed fill, including depth, area, porosity and amount plus locatiori of drains. Q '... a &0 it ANLI 1 5 C7 awe, � ill �tj , ye w rCtti1Rtil IS APPLICANT'S SIGNATUR ?� Site inspection fee $10. 00 F eceipt No. By Approved 7 i ^ e2? Not Approved By /L 014fq?T ;r-10 Date 6-2/-7>- iP !� Date/ rloofo. TMHD-S- -3/69 /' `7- y i 4 Ll < 3�+Is © 4 5 ^35