HomeMy WebLinkAboutSWG Application - 2/1/1979 SITE NGO.y 3 CI p o
,MASON COUNTY HEALTH DEPARTMENT FOR DEPARTMENT USE ONLY
ENVIRONMENTAL HEALTH SECTION DATE BASIS FOR FEE AMOUNT NUMBRECEIER
428 WEST BIRCH STREET • SHELTON, WA. 98584 f
PHONE(, 1426 ,5561 n , / (QJ 1 ,00
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FAPPROVEDAPOPROVED
RTY OWNER T-�W ✓ / lL� Gi. .'Z BY: Cam .
ACORE55 \I RgNF
DESIGNED S STEM REQUIRED
SEWAGE ^ SEWAGE NOT
CONTRACTOR. h C' M I c-'IZ O DESIGNER SEWAGE: ❑ APPROVED. ❑ APPROVED
LEGAL CESCRLPTION �„ / X BY: .
RlswL�b..��s�
soa TYPE
TYPE OF NO.OF L �J /
BURDING 42 BEDROOMS SIZOTP� _ DEPTH TO WATER TABLE `�PERC RATE
SINGLE FAMILY bi PUBLICWATER ❑SYSTEM
WATER SYSTEM NAME SEPTIC TANK(S) I ZOO GAL. PUMP REQ.
AI
COMMERCIAL ONLY FEET
LIQUID WASTE G.P.D. DISTRIBUTION TILE TOTAL
DIRECTIONS TO SITE: Q/f Q C/'f VLS / FILTRATION AREA SQ. FEET
/ QUANTITY OF
APPROVED STONE-CU. YD. SAND-CU. YD.
FILL REQUIRED-CU. YDS.
u FINAL INSPECTION REQUIRED BEFORE BACKFILLING
DEPTH OF
BACKFILI
]"bTRAW OR PAPER
!/• E O STONE
OVER TILE
F�PIPE SIZE
<-O STONE
SITE PLAN AND SPECIAL STIPULATIONS UNDER TILE
(INDICATE DIRECTION OF DRAINAGE) CROSS SECTION OF TRENCH
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FEB 2 1979
EGIONAL PLANNING
COMMENTS:
/a,3e7/ 3 y' 9DO(90 THIS SITE PERMIT EXPIRES Z Z ($y