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.�-- . <br /> Snohom�sh Health D1etrlct Property. lax Account N���'��-Gb� �-dao <br /> Environmente], Heeith Diviston <br /> Caurthause. everett, Meshin9t� Plen Check No. <br /> 259-9473 <br /> NOTICE: REVIEN AND PROCESSINfi FEE OF $25. 00 !S PAIIABLE UPON ISSUANCE OF THE BUILDING <br /> PEAMIT. <br /> CLEARANCE for Con:trucN on Mtth Ex1�tlnp On S1t� Syatem <br /> Owners Neme:/�J/�7�'�l�C'iFiz"i71�S' Phona s � J .�ate s 7 —7 "� 7 <br /> Si te Address: S'"D S�' /Oa7��J/S C � City':' �//��-�— <br /> Contact Persons.���C' �c+�� Phonesti_� �i'.- 9�6 <br /> Contect Person's Addreas S'�C�� - �/9�`'�t -'C.._' h� L�,C7�2"�s <br /> 51te Leqel OescripN on/Lot No:: <br /> ec onp ega <br /> Expleln Pro�ect end 1ta use: (aoom edditlon, �re e ern� replectnp mobile home� <br /> Temporary Condi one Use) <br /> —_�o k 30 <br /> • Indicate totel nunber of bedrooms before end efter constructlons �J <br /> ATIACN COPY OF PLOT PLRT: 8k" X 11" mlolmun showtng: <br /> l. Dimensions of property 11nac 5. Roads. eesemeats� drlveMays. perking <br /> - area: <br /> 2. Uimensions of exlstlnp structures end <br /> ' 'their dlstance to lot 11nes. 6. Ne11 locetion <br /> 3. Dimenslons of proposed construction 7. North arrow <br /> 4. Locatlon of septic tank end drelnfleld, <br /> 1f known. • <br /> SEWAGE SYSTEM "as-bulit" DRAHINO IIL,FORMATION: � <br /> Non�es Conatructed efter 1917� Pro�rty tex eccount nunber used. <br /> Ilanes Constructed 1955 to 1971: Provldes Name of Bullder: <br /> or Neme of First Owner . end Year of ConstrucNon <br /> Appllcant Signeture:7���"" e�"j. <br /> , DO NOT HRITE BELOH TNIS L1NE <br /> REMARKS,�yis�i..� sf�/S ��»� •.i �eLa' f.�,���,,,� D�ca:icl �� :rcve A�� �-•.���� <br /> �ks i/�' c�i��ut �Fv.i__S�•_1•,,•�'��rc� �. �-.-�d ,Li.� <br /> —�'--�- — - <br /> Denied by __11 Date: <br /> Approved by �..� /`� � n.�e. �1 . 7 � % <br />