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505 49TH ST SW 2016-01-01 MF Import
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505 49TH ST SW 2016-01-01 MF Import
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Last modified
4/24/2017 1:47:28 PM
Creation date
3/31/2017 3:04:17 PM
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Template:
Address Document
Street Name
49TH ST SW
Street Number
505
Imported From Microfiche
Yes
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0�/1S/00 11&D ld:Yd FA3 dYS �J9 S4Sd_ ,__'?R'IR�'1 �.TH DIV <br />---�-�—_ ._,;,— _—_ _ .- <br />SNOHOMISH HEALTN <br />inrironm�rR7�1 N�altli <br />Co�rehou��, Ever�tt, W�sl <br />APPLICATION FOR A SEWAGE DI <br />�Submit 3 cop%�+'I <br />�ooi <br />� _., �c�,t�- t/-c"J� % <br />N2l7 "'� r_+ � % � <br />� n 7 '7� ? <br />5r4•LSYSTEM PERI�LT�' <br />f'crmil lo t+e isaued t� LA�.�R�%nrVaLD . _ - - � -- <br />Fur inatyllution at (�lttet ucldnss) �L�NT TQ ¢9t� <br />EvC-RE <br />Sca_I'wp.—Rg._ShunPlatNo._t.ot-ir�ac��.===.T�-... -7— <br />'fype of IIuilAing: New V. Existing. —Single fnmily residence---Nu• bed^wms-`� <br />Water Supply: Public V. _— F�ivate—_. Other: (spaify iype or u►c>. <br />i. RuilAcrp2:��.�A���AQdrexs <br />��n. aox ��� „�A U K 1 LTE ,��Tclephonc �5s l�`3� <br />� � � /lL�o�/A/D �.�fL�RET.t---ticcnse No. �.76 <br />y� UslRncr b • �-'.-�.t'�TJ�d�reca.L <br />�. ' _ . ... '" _'". nw.. <br />� <br />o� <br />M <br />N <br />$pp l.og [iole Nv. 1 � .. <br />V �� I/ <br />Soil Log Holc No. 2 8 y ��. �1 B^ Z4' �� ,. �� ._. _. <br />Uevation of Woter'1'ablc. if cncountbroA. Wlstanw from gronnd surGmcl_.KOr <br />2�t - 4 i�' " �/ <br />�vKT�KE1� � <br />CorcccAons to control surfuct watcr iC neecicd %�Ol� �i�c�l[= •+`- —"--l— � <br />C•ill n�rded: lAtnountl MON� K�EOE/Z—..-- • " <br />percolalion� <br />T��sl Nolc No. l Averagc Ratc_..,`3 _(�'all in min����h-bottam 6" tcsl hole) Oepth tcst takcn <br />T�yl H�le Na 2 Averagc Rafc_._r�.--lFall �n min/inch-buttom 6" fe:xl hole) Depth tCst takcn <br />Tc�l llole No. 3 Average: Rate 3 ._(Fal! in mit�/inch•bottom 6"'=%�; ole) Da 4'h t�Kl tak, n <br />,r 4 y 9 " / �,, -�� .^ns�e tak�m <br />Avcr:,g•_ p�-rcvlatioa rate on whicl� lo hax drninlicld Ac+ign��_��f1- <br />Scptic tank requircmmt� basal on prounl rules und [eb�ulations: • <br />Sepcic Tank Size��. —.,-8?��ons. <br />Amuunt of Squarc <br />3G' <br />�� - <br />36 y. <br />1 �zt/7� <br />'Cr. WWth�._Tt. Depth�� N �' � K <br />iignaturc of Llesigncr_1� ` - `"� <br />DU NOl' WRITE BFLOW TH1S I.INL• lt� bo rnmpkted b� :ssuing agency) <br />Nu Permit_��«---Sanituriun.�----�endin��x�'L�' <br />Permil to bc ixsucd= —Autc— _Sonitarian <br />RccLeckcd. —.---5ssnilutian <br />Wet Wintcr M�nths—.--- <br />r...:.-• '-- <br />Clieck Receivcd--.— Cash Rcceivcd__—.— � / <br />-•:'�� �� %J L��.�-��- as..�----'—. <br />('Alled t'oc Inxpec�iou�.----lnstallcr —__��` <br />' •—�?1 J _ Pcrmit Numbec <br />Pcrmil 'Issual (d+tc) ---; =- <br />�J <br />
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