HomeMy WebLinkAboutSWG Application - 9/4/1981 SITE NO.
MASON COUNTY-HEALTH DEPARTMENT FOR DEPARTMENT USE ONLY
ENVIRONMENTAL HEALTH SECTION DATE BASIS FOR FEE AMOUNT RECEIPT
NUMBER
428 WEST BIRCH STREET • SHELTON, WA. 98584
PHONE (206)A26-5561
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APPROVED
PRCFfRtt OWNFY _ SEP 04 1981 .
^OORFu _ PHONE DESIGNED SYSTEM REQUIRED
SLV/AGE _ RE OJII,McEPI-�'l"marED Nor
CONTRACTOR DESIGNER APPROVED
IEYRIPTION BY;GpT DE
.. SOIL TYPE
TYPE OF NO.OF LOT
BUILDING ._ BEDROOMS SIZE X - DEPTH TO WATER TABLE-
SINGLE RATE
SINGLE RESIDENCE o PUBLIC WATER Q._ NAME_ SEPTIC TANK(S) GAL PUMP REQ.
WATER SYSTEM SYSTEM
COMMERCIAL ONLY DISTRIBUTION TILE TOTAL FEET
LIQUID WA5TE G.P.D.
DIRECTIONS TO SITE: FILTRATION AREA SQ. FEET
QUANTITY OF
APPROVED STONE-CU. YD. SAND-CU. YD.
FILL REQUIRED CU. YDS.
FINAL INSPECTION REQUIRED BEFORE BACKFILLING
E 0
MR SIZE
DEFTH OF BACKHLL
� 2"STRAW OR PAPER
F�STONE
V OVERTILE
/ EO
STONE
O 3 SITE PLAN AND SPECIAL STIPULATIONS UNDER TILE
(INDICATE DIRECTION OF DRAINAGE) CROSS SECTION OF TRENCH
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COMMENTS:
THIS SITE PERMIT EXPIRES