HomeMy WebLinkAboutEAGLE RIVER HEIGHTS BLK 5 LT 14
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gev. July t958 ~ FEDERAL HOUSING ADMINISTRATION ~ Budget Bureau No. 63-R29&8
HEALTH AUTHORITY APPROVAL
INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM
PART I.--TO BE COMPLETED BY FHA
INSURING OFFICE MORTGAGEE SERIAL NO.
MORmAGOR OR S~ONSOR ~RO~ERTY ADDRESS
BLOCK NO5 -- lOT NO.
?O?AL
Can attic or other area be made into
BASEMENT
~--~ New installation additional bedrooms?
(If Yes, how mony~)
WATER SUPPLY BY:
SYSTEM DESIGNED FOR
[JPublic system ~[] Community system l~] Individual NO. OF BDRMS. O^RB^O~ D,SPOS^t
SEWAGE DISPOSAL BY:
['~ Public system [] Community system ][~] Individual :~ [] Yes ~-] No
PART II.--lO BE COMPLETED BY HEALTH DEPARTMENT
HEALTH DEPARTMENT INSPECTOR'S SKETCH
........... ~: _:;; _- _- _- _- _- _- _- __- __- _- __- __- __- __- _- _- _- _- _-
It is the opinion of the N State [--] County ~'1 Local Department of Health that this individual
water-supply
system
[X'] is M is not satisfactory as a domestic water supply for the subject property.
It is the opinion of the [] State [] County [] Local Department of Health that this individual
sewage-disposal
tern with proper maintenance:
[]['] Can be expected to function satisfactorily, and ~] Cannot be expected to function satisfactorily
is not likely to create an insanitary condition
DATE SIGNATURE / TITLE
spaces provided. /
PART Ill.--FOR USE OF FHA OFFICE
TO THE CHIEF UNDERWRITER:
I have reviewed the foregoing and the pertinent FHA Compliance Inspection Report, and recommend that'the
Individual water-supply system be considered [] Acceptable [] Not Acceptable
Sewage disposal be considered [---] Acceptable [~] Not Acceptable.
DATE
SIGNATURE
[] CHIEF ARCHITECT
J ---] DEPUTY FOR CHIEF ARCHITECT
HEALTH AUTHORITY APPROVAL
INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM
FHA Form 2573
Rev. July 1958