HomeMy WebLinkAboutMobile Home Park Use - PLN General - 4/2/1973 APPLICATION TO OPERATE TRAILER, TOURIST OR RESORT CAMP
IN THE STATE OF WASHINGTON
In accordance with the Rules and Regulations of the State Board of Health, Book V; Part 11 and/or Part 17: It
shall be unlawful for any person, firm or corporation to operate a trailer, tourist, or resort camp in the State of Wash-
ington who does not possess an unrevoked permit from the State Director of Health or the local Health Officer hav-
ing jurisdiction. Only persons who comply with requirements of these rules and regulations shall be entitled to re-
ceive and retain such a permit.
County V ..............-...........Town / � w...............5.�!...e. . ..... ..........Date .....�, .. .. 2 _. �7J7
Name and location of camp...................... ...........1[ .e. .. .. 1� 4...................
`�..1...... -........ X...f2 o..
....................................................................................................................................... ...............-.........._.................Type............�..d.1.1....... .................
Owner of property J.?.......��.._�......C�'........................Address........Sf-...:,� ..&1..<......Y ... •....
.....
Operatorof camp..---..s .0..5 C P --------ITS------.k;4...... �.........................•---....._................-----......._..............--------....-------•------......----------......--------
Legal description of property (including dimensions) C.°.:+.Nl/_ (-S bdN — NF NW2
.-.......... ..... ........... .l�ff.:.i _Q...... ._......L9-)----(G.)....P.-f.7s �'�.....�(...�� _Sr'j c� uN/��
No. of cabins.... - _......... No. of trailer spaces..........- _........ ...... ... .•-- •••••---••.............
Methodof sewage disposal . --.C......--Tyr-•�.� --••.......................................•-•--------........._......-•------•--•------...._.----................--•-----•--•--
Methodof water supply.................... e.l<.5..........-..................................................................-•--•----------------•-----.
No. of units having running water: Hot..............•........... .........------.................cola....................
�..........................................................
No. of outside faucets................................................................... ..........
_ .................•--....------.....---......--••---•---•-----•---------------....-----......
No. of units having private toilet facilities........................ ..............................---...............---•--...------....•-----......-......--•------•........--------•-•-......----.......
No. of units having private bath facilities---------------------5---•---••--•--........--------•-••------..................------•----_............................_..................................
No. of units using central facilities..................................
P.zq..�.........................................................................................--..............................
No. of central toilet facilities: Male................._.../ P.N..e.....Urinals....._...IY�.N ............Female.......... ............
No. of central hand washing facilities: Male............. JJ........................Female.........&YY.e.:..............-.........._........
No. of central laundry facilities................./- ......./` /1...l. S'. del...... .A/--......fy /s:...70-*e _ ............
No. of central bathing facilities: ...............Vz. ..........................Male..........A/d..........................Female.......,�Y...��............................
Method of garbage collection.................. ...............
-•-----............
- ---------............--------------..............................
------- ----r-- -----
Method of garbage disposal................. C �.1� .......... %..h .... �!u.f'.......... .2....I........Ca�- ,i ...................................
Remarks:.....-...............................•--•-------.........................•---...................
....-----•---....................._.........._.................................................................................................................................................................................................................................
..............................•--•---•--•------------------•-----------•------.....---........---------------•-----....................._.......--------•---......................---.......-----•------------..............---..................................................
-•--------•-----------....................•----•-----------..............--•-----•--•-•---......----------....-•-----•---•---.....-----.......................................................------.......-.................................................-.................
................._...._....................---...----------......---•-•---••------......-----........................_........................................_....................---........--••---•--•---..........................--------------............---...-•----...
•--------••------------•----•-------........-•--------------•---............_...........------•---._......................................-----...............................................--•--...........---..............._----•------••---•----...------.................
..............................................................•--•-----......................-•------•--------••-----.............--•---------.........--•----•-•----------.............--••--•-•--------..............................---•--........---.......---.................
..--••----•.............................................•-••-----.......-----.....-.........-•----......---.....----...................-.......-----.........---...................................-•-------..................................---................................
----------------------------------------------------------•------.....-----.......................-----•------------•------------------.........-----------------.........................................----------............................---.......----....................
A camp plan containing the information required in Section 6 of Part 17 and/or Section 5 of
Part 11, Book V, Rules and Regulations of the State Board of Health is required.
or
.... . ......................................
(Signature of applicant)
Campplan submitted............................................................Permit No.....................................Issued........................................................................
Approved..........................................................................................._ ..............Approved by...................................................................................................
S.F.No.7491-11-51-10M. 30146.