HomeMy WebLinkAboutALDERWOOD ADDITION #1 BLK 3 TR B1 COMMON AREA
' APPLIC '-' IT FILLS OUT UPPER HAL'-'3NLY
Lending Insti~tion Phone
Address Zip Code
Street Locati. /if
Type of Resi~nce
~ Single Family
~ Multiple Family No. of Bedroo~
~ Other
Water Supply
~ Individual A~ACH ~LL LOG. A w~l log is required for all wells drill~ since June 1975.
~ Community For wells ~illed prior to the date, give well depth (attach log if available).
~ Public Utility
Sewer Disposal
~ Individual Year Indiv~ual Installed:
~ Public ~ility When Connected to Public Utility:
~ Holding Tank
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH RE~EST BEFORE ~OCESSlNG CAN BE INITIATED.
Time
Date
Inspector
Time
Date
Inspector
Field Notes:
~h~.pector / \ ~ Inspector /\ r --- -- /
<'Z.)--APPROVED BEDROOMS
) DISAPPROVED
) CONDITIONAL APPROVAL*
*CONDITIONS OF APPROVAL
Soils Rating Date Sewer Installed Well To Absorption Area
Well to Tank
72-023 (3182) .~.~ -
Well Log Received
Septic Tank Size