HomeMy WebLinkAbout03372 INDIVIDUAL SEWAGE DISPOSAL SYSTEM APPLICATION
OWNER QJEt.n (`) 3 T1 FA ►J`/ boNVZ.PAES
ADDRESS el lo t' ST G�►w � 3 r�
laO PHONE 19` 34 64
CONTRACTOR P hilt Coo.
ADDRESS & 1 \ yq PP L..MP a At PHONE 1M 5 • a 3'•1 c i
PERMIT REQUEST FOR (Mel NEW INSTALLATION ( ) ALTERATION ( ) REPAIR
Attach separate sheets or report showing entire area with respect to surrounding areas, topography of area, habitable
building, location of potable water wells, soil percolation test holes, soil profiles in test holes (See page 4).
LOCATION OF PROPOSED FACILITY:
Near what City of Town N Nd C. & S 1' LC co. Size of Lot i� • E 14C ERS
Legal Description or Address (>S It T\Q.EE V -'3.. uN 8) 6 Li 1
WASTES TYPE: (fit) DWELLING ( ) TRANSIENT USE
( ) COMMERCIAL OR INDUSTRIAL ( ) NON - DOMESTIC WASTES
( ) OTHER - DESCRIBE
BUILDING OR SERVICE TYPE: 5 /FotWLG{n-R
Number of Bedrooms 'F ' sj e (� ) J Number of Persons a
(K) Garbage Grinder (X) Automatic Washer Q) Dishwasher
SOURCE AND TYPE OF WATER SUPPLY: ( ) WELL ( ) SPRING ( ) STREAM OR CREEK
If supplied by Community Water, give name of supplier: C 17 0 New Cos - Ve
DISTANCE TO NEAREST COMMUNITY SEWER SYSTEM:
Was an effort made to connect to the Community System? Nn
A site plan is reuuired to be submitted that indicates the following MINIMUM distances:
Leach Field to Well: 100 feet None
Septic Tank to Well: 50 feet N or\ e.
Leach Field to Irrigation Ditches, Stream or Water Course: 50 feet N o.\
Septic System to Property Lines: 10 feet 3D f"
YOUR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT WILL NOT BE ISSUED WITHOUT
A SITE PLAN,
GROUND CONDITIONS:
Depth to first Ground Water Table
Percent Ground Slope
2
770
• \
1 I
780
1
1 I 780
1 1 / 770
1 1 ./ /
I \ is / 760
1 PIU 1 / / 750
1 ■ \`,/ /
1 PROPOSES /
760 1 RESIgENCE / 740
--.
S PIT 2 / /
APPROXIMATE SCALE " / / /
1" = 80' P -12S4e 3 / / /
A / ,... i
P -2 / (....
/
750 \
\\
\-�/
740 ••..
\ \ / / I/
\ LOT 13 / / I/
1 \ / /
I \\ // / /
730.\ \4-i'/
\ / /
\ / /
\ / /
\ / /
\ / /
\\\` // /
720 \ ce
\ w
\
\\.4 1 /
100 362 I GEOTECHN— APIA INC I LOCATION OF EXPLORATORY BORINGS ( Fig. 1
C p r`( 2. 55 S C P et i C- c (3.0n fgt. 4 6, 9
c
0 (lac K - (.--E r- r Cc 9 2o)( __ -- -- 7 f 9 S 2
27 ( - - TAc14 - cg aMi .6 _ = GQ, por EcES ((7I tiP
3r) (2E -�� r q 6 e 17
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