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0�/1S/00 116D 1dcPS F.Aa dYS 7�9 SYSd ENVIRON �.TH DIV _ _ �OOt <br />-- '--'_. �� <br />. . �� �1��� � o � <br />�- y - c <br />..' � SNOHOMISH HEALTN DISTRICT �� �.Gj � `f � � t,� <br />ENVIRONMENTAI NEALTH DIVISION ' � n / / <br />Ceurf Hous�, Evontl. Wmhin9lon 9s201 . <br />SEPTIC TANK INSTALLATION PLAN <br />Su6miL in T'ripluale <br />Owncr DA.V.I¢.....A•_ BRnMfl.N.Q.W _. Addms�.l�O.h...42B�.I!:�t!IKI�TED.._YY27.�Phonc•3$5-lj3' <br />. Ad atu.,F..�.. 4`�.�' ?,.!�...v!s�+x.....�'��.�. t.... Y�e N�..� 2'7y <br />AnUlt�.SS OF PROPElLT'Y....... f... ... . • <br />. . .... .......... .. <br />`(� � -e�n .......__ ........ <br />Lcgnl Dexnptmn......f�.O..T '�1�............lJ�.p..7�•�0..%�X..... .. �i.V.'.l%.C.�. <br />..................... ................. <br />..........3:�s... v :',s7,4 .p...1.,4.�� :.......... .......... . .......... <br />.. ......._ .............. .. <br />........................... _ <br />......... .......... .. <br />............. .......... ............... <br />............._......................... ..... � d <br />�cc_Rc.E.:.S.GA.i.Ml.i2.1 ............. Address5[2/. �Qt?►•iD.......Av�.....r'►wnc��,Jt''.'�•�•7T- <br />�� � A N , �,.T.: �.....�94 �l�...�I,'I.INGTi2Nl Phonc�y'S3�3 <br />ImlTlltr. .....f.e1d/.�R.i li.....!�14%f....b .... Adds�s <br />I hereby certify dte attompu�ying drawing is an ai:curnte rcpresadation of !he sqstan inslalh�d at thc lisled <br />addrcse. T alsu r.ortify all raa��+���`��datiene and a�trittin�ts (rnnrr.ming plucubing xtub elc�n�ions. �uaintr.nnna of <br />gra� [illx� mriaec drai�u, eta) lirted by mr. on my u�•':u;r. di�osal syc[em peru�it applic�tion dltr.d..... <br />��/ jr..,. %Jr ._....havc bci:n Complic it � <br />� .. 3..� ._7..5 <br />r,� ��.....�.���� ��� <br />.... <br />.......... ..Si�nature u/ Dr.ti�ner <br />_,.,,.�,,.....�_:.�..... �.�„r,�.,,R-._..,. <br />..: _,�.��-- <br />�_.-..�.�.�_-�:.,::-- �--._.. <br />TO BB FTi.I.L'D IN Rl' FIEAL'1'I! TJAPAR'1'biCN1' UNLY <br />n�«�ua ..... . ........... .............. <br />........ Da« �3-/�'.7...�'..... <br />rr�c naapced n��a ....... ................ ..... <br />....... .... . <br />. . . . . ....� ......... ........ <br />�� . . ... <br />Sin,natum of Samtan:u� � -•L/�"r � - j � ^ <br />�j� �� . �(i.t{..... <br />Rcmarke: . C'.�G�P/CPC��v-�^/�G:lIS'• C�FL,��i�.�C•�:]!.. /!.:(�....�Q/Y.L��- Q�1*j <br />d.............. ...................... <br />...... . .. . ................ . ...... _. _ . <br />................. .. ... ............... . <br />........ ..........._ • <br />. ...,.�,�_..: , -.�-....: ...�,,...t�_...— <br />...,�_.,,.. �—.�.,,_._. .-.-��.'..... ,_._. <br />AtiENTION HOME OWNER: <br />Your a+p�ic iazJc lias limitatinn�! 1t w:u dcsi�nrd and insulled to �am fer an aver:wrsizrt (a*aily. Uver- <br />loadin� thc veptic tmk or disturbance of the dr.�in fi�id *nny <�rm�s�)' '^�Pyr zati�taciory u�xniion. Pnintx tu <br />runcmber: <br />I. Ha��e v��ur [ank r.hecked pc:ri�xli��.11y to sec if pumpi�i4• i.c nr.�:essary (2%r3 years). <br />2. llo noi clrrnncl ground watcr. aurl:u:c watr.r, tootinS drains or Jm.aupoah into tlic Innk or draintield. <br />:f. I1n not ceca.ate, fill, placc u xlruc[urc, d�i�•c�r.q' ���• pa[io in� nn, or uver thc draiuficld. <br />h. Li���i� toilrt f,xiurc dispesal to r.viiian waetes and tnilr.t tiasuc. <br />5. 11Ncr4tnts and blcachu used iu twnuai liousehold �pi>u�tiucs "ill n<,� I�:�ni� tl�c action of dic septic tank <br />nnd dispos:�l field. <br />�r.a..�.�- <br />