HomeMy WebLinkAboutSPENARD ACRES Block A Lot 2-CL'I"
APPLIr " NT FILLS OUT UPPER HA' ONLY
Buyer ~.~ ~/v-, ¢~'
Lending Institution Phone
Address Zip Code
Realty Co. & A~nl Phone
Address Zip Cede
Type of Residence
~ Single Family ~'
-~Multiple Family No. of Bedrooms ~¢;':'
~ Other
Water Supply
~lndividual ATTACH WELL LOG. A well Icg is required for all wells drilled since June 1975.
~ Community For wells drilled prior to that date, give well depth (attach Icg if available).
~ Public Utility
Sewer Disposal , '~¢~4 ' ,
~ Individual Year Individual installed;
~ Public Utility When Connected 1o Public~tility: /¢¢/~ ~.
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH RE~EST BEFORE ~OCESSlNG CAN BE INITIATED.
Time Time Time Time
Date Date Date Date
Inspector inspector Inspector Inspector
Field Notee: ~UNI~I?ALIT~ OF AN~HO~AG~
RECEIVED
( ) APPROVED BEDROOMS 'CONDITIONS OF APPROVAL
( ~.}- DISAPPROVED
( ) CONDITIONAL APPROVAL'
Soils Rating Date Sewer Installed Well To Absorption Area Well Log Received
Well to Tank Septic Tank Size
72 023 (31821
Box 69{{3
Snb'jecL: Lo't .:.C )~,lock .% ",en.;)'~f('! lc.,';,', ' '" ~
otu: :[n~pectior~.
P'L~a:3e. noti:f!V i:,hi;~ ))opartmont ]:o~. .... a 'o:~insl)cction. when the
fh.]rt::he~ <,~("-'.,,t].-'c>n,,~" ~Yle;~se, ..... call th:it;o_:~', ~.<.~,:. at: 2fi4~z~72,9
SincerolV,
.1 ..... o.ldt{. ]-:nvJ. i/orlm<~ntal Sl)ec/Lo. lir~t