03-104860 • 0 -
�i r_ir'ol Fedi:a,Way
' Community Development Services Building - Single Family Permit #:03 - 104860 - 00 - SF
33530 1st Way S .
Federal Way,WA 98003-6210
Ph:253.661.4000 Fax:253.661.4129 Inspection request line: 253.835.3050
Project Name: MARTIN
Project Address: 36502 6TH AVE SW Parcel Number:302104 9052
Project Description: NEW-Construct new single family residence with attached garage,including plumbing&mechanical.
Project includes approx. 100 cu yds of grade/fill work in front yard/septic area. **Bedrooms:4;
Estimated Selling Price: $320,000**
Owner Applicant Contractor Lender
Michael D&Kristine S Martin Michael D&Kristine S Martin REALITY HOMES,INC. CTX MORTGAGE CO
338 SW 314TH PL 338 SW 314TH PL REALIH1984CN(2/15/04) 33801 1ST WY S#391
FEDERAL WAY WA 98003 FEDERAL WAY WA 98003 1308 ALEXANDER AVE E FEDERAL WAY,WA
\ \ FIFE WA 98424 98003
Includes:
Census category: 101 -New si I #1 #2 #3 #4 i
Occupancy Group: R-3 1 U-1 �
Construction Type: Type V-N Type V-Na -
Occupancy Load s�—
__..4.
Floor Area(Sq Ft.): �._�� Ir
1_..
1st Floor Proposed Sq.Feet 2669 Basic Plan No
Census Category 101 -New single family houst Construction Type#2 Type V-N
Deck Proposed Sq.Feet 370 Garage Proposed Sq.Feet 1600
Height of Structure 14.5 Mechanical Yes
Occupancy Group 41 R-3 Occupancy Group#2 U-1
Plumbing Yes Total Proposed Sq.Feet 2669
Zoning Designation RS 15.0
Plumbing Fixtures
-- -
!Dej Quantltyl L Description Quantity] Description JQuantity
- --- --- __- _- _. _
Bathtubs I' 3 1 Dishwashers I Gas Pipe Outlets 1
L _,IL L— -- —
_L. _I
Laundry W asher Outlets —1I 1 iLavatories 5 I[Other Plumbing Fixtures — !I 2 1
11
Showers L 1 Sinks1 2 Water Closets t 4 i
Water Heaters I1--- 2
__L___ —--
Mechanical Fixtures
Description VQuarttity Description Quantity ' Description lQuantityl
Air Handling Units jr1 Ducts ry 1 , Fans 'i 5
Fireplace Inserts I Furnaces 1, I Gas Logs 1--I
Ranges j— 1
I
CONDITIONS:
1.Existing house& shed to be demolished PRIOR to footing/setback inspection. A separate permit is to be applied for and
issued to do with work.
2.No building shall encroach onto any building setback line or easement shown or not shown.
3.Prior to any clearing or grading on a lot,the owner/builder shall install temporary erosion/sedimentation control
facilities approved by the City.These facilities must ensure that dirt or sediment laden water does not enter the public
drainage system,adjacent lots or public streets.The owner/builder bears the responsibility to maintain the facilities in
proper working order,replacing as necessary.The facilities may be removed only after such time as construction is
complete&landscaping is installed.See attached for standards and site plan for location of silt fencing.
4.Per FWCC,Sec.22-1133(4),eaves,chimneys or awnings,&similar elements of a structure that customarily extend
111111111111111111 . Flab -
n:c,un the exterior watts of a structurey extenn up to its incnes 1VIAAIIVIU1Vi 154 requtren yarn setoacx.
Additionally,the total horizontal dimensions of the elements that extend into a required yard,excluding eaves,may no:
exceed 25% of the structure's facade length from which the elements extend.
5.This decision shall not waive compliance with future City of Federal Way codes,policies,or standards relating to the
subject proposal.
PERMIT EXPIRES February 8,2005.
Permit issued on December 22,2003
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy and the use will be in accordance with the laws,rules and regulations of the State of Washington and
the City of Federal Way.
Owner or agent: �l_;►1 �_ t J Date: q -c-/
City unity evel Way
en Building - Single Family Permit #: 03 - 104860 - 00 - SF
Community 4000 Fent Services
33530 1st Way S
Federal Way,WA 98003-6210
Ph:253.661.4000 Fax:253.661.4129 Inspection request line: 253.835.3050
Project Name: MARTIN
Project Address: 36502 6TH AVE SW Parcel Number:302104 9052
Project Description: NEW-Construct new single family residence with attached garage,including plumbing& mechanical.
Project includes approx. 100 cu yds of grade/fill work in front yard/septic area. **Bedrooms: 4;
Estimated Selling Price: $320,000**
Owner Applicant Contractor Lender
Michael D&Kristine S Martin Michael D&Kristine S Martin REALITY HOMES,INC. CTX MORTGAGE CO
338 SW 314TH PL 338 SW 314TH PL REALIHI984CN(2/15/04) 33801 1ST WY S#391
FEDERAL WAY WA 98003 FEDERAL WAY WA 98003 1308 ALEXANDER AVE E FEDERAL WAY,WA
\ \ FIFE WA 98424 98003
Includes:
Census category: 101-New si r #1 #2 #3 1 #4
Occupancy G__roup: R-3 U-1
_Construction Type: _ Type V -±- - - - --
_____N Type V_N ]F
Occupancy Load: �—
a
Floor Area(Sq.Ft.): - - - - - - �
1st Floor Proposed Sq.Feet 2669 Basic Plan No
Census Category 101 -New single family house Construction Type#2 Type V-N
Deck Proposed Sq.Feet 370 Garage Proposed Sq.Feet 1600
Height of Structure 14.5 Mechanical Yes
Occupancy Group#1 R-3 Occupancy Group#2 U-1
Plumbing Yes Total Proposed Sq.Feet 2669
Zoning Designation RS 15.0
Plumbing Fixtures
Description TQuantity Description Quantity Description !Quantity;
Bathtubs 3 Dishwashers L 1 Gas Pipe Outlets 1 1
1
Laundry Washer Outlets 1 Lavatories 5 Other Plumbing Fixtures 2
Showers 1 I Sinks 2 Water Closets 4 I
Water Heaters 2
Mechanical Fixtures
r Description ;Quantity [ - Description JQuantity Description Quantity
Air Handling Units 1 Ducts 1 Fans 5
i
Furnaces 1 Ranges I 1 j
CONDITIONS:
1.Existing house&shed to be demolished PRIOR to footing/setback inspection. A separate permit is to be applied for and
issued to do with work.
2.No building shall encroach onto any building setback line or easement shown or not shown.
3.Prior to any clearing or grading on a lot,the owner/builder shall install temporary erosion/sedimentation control
facilities approved by the City.These facilities must ensure that dirt or sediment laden water does not enter the public
drainage system,adjacent lots or public streets.The owner/builder bears the responsibility to maintain the facilities in
proper working order,replacing as necessary.The facilities may be removed only after such time as construction is
complete&landscaping is installed.See attached for standards and site plan for location of silt fencing.
4.Per FWCC,Sec.22-1133(4),eaves,chimneys or awnings,&similar elements of a structure that customarily extend
beyond the exterior walls of a structure may extend up to 18 inches MAXIMUM into the required yard setback.
Additionally.the total horizontal dimensions of the elements that extend into a required yard.excluding eaves.may not
SP . ` y �'r •
•
AM
•
exceed 25%of the structure's facade' ngth from which the elements extend.
5.This decision shall not waive compliance with future City of Federal Way codes,policies,or standards relating to the
subject proposal.
PERMIT EXPIRES June 19,2004.
Permit issued on December 22,2003
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy and the use will be in accordance with the laws,rules and regulations of the State of Washington and
the City of Federal Way.
Owner or agent\ u.., �Y• I ' J��!�r Date:
SW • PO HIS CARD ON THE FRONT OF BUILD
CITY OF
ftkre Federal Way BUILDING DIVISION
INSPECTION RECORD
INSPECTION REQUEST PHONE#: 253-835-3050
PERMIT #: 03-104860-00-SF
OWNER'S NAME: Michael D & Kristine S Martin
SITE ADDRESS: 36502 6TH SW
PA
FOOTINGS/SETBACKSl� () FOUNDATION WALL Or 114 /l
DO NOT POUR CONCRETE UNTIL THE ABOVE IS APPROVED
t
( ) DRAINAGE: Line _!/Z V ( ) Connection
DO NOT POUR SLAB UNTIL TUE ABOVE IS AP RO
O UNDERFLOOR FRAMING E , /9A)
O ROUGH PLUMBING: DWV q -"GD" O f/C„_C'i^✓ Water piping q-- i --Q V <,(...j
) ROUGH MECHANICAL g/i / Com• Ga piping / y et, /14L
( ) SHEATHING rI „ '7 I Roof I Floor _
( ) SHEAR WALLS
( ) ELECTRICAL ROUGH-IN Ditch Cover
( ) FIRE/DR.AFTSTOPS
ALL THE ABOVE MUST BE APPROVED PRIOR T RAMING INSPECTION
( ) FRAMING/FIRESTOPPING C3 ( D" o
THE ABOVE MUST BE APPROVED PRIOR TO INSULATING OR
( ) INSULATION: Floors Walls f 73-c G, Attic
THE ABOVE MUST BE APPROVED PRIOR TO APPLYING SHEETROCK
() WALLBOARD NAILINGCi.C 0 1 O SUSPENDED CEILING_
THE ABOVE MUST BE APPROVED PRIOR TO TAPING OR INSTALLING CEILING TILE
( ) ELECTRICAL FINAL
() PLANNING FINAL
( ) PUBLIC WORKS FINAL m6 Z/z y/ec
( ) FIRE FINAL
THE ABOVE MUST BE APPROVED PRIOR TO BUILDING DEPARTMENT FINAL
() BUILDING FINAL
DO NOT OCCUPY THIS BUILDING UNTIL BUILDING FINAL IS APPROVED
. ,' ‘.. THIS CARD IS TOMAIN ON-SITE ' •
CITY OF itommunitYDevelopmentInspection Ins ection Record
-ederal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 03-104860-00-SF
Owner: MICHAEL D & KRISTINE S MARTIN
Address: 36502 6TH AVE SW
FEDERAL WAY, WA 98023-7269
This card is part of your required inspection documents. Scheduled inspections may be failed if this card is not on-site. DO NOT LOSE THIS CARD.
Inspections are listed as close to sequential order as possible(read left to right,top to bottom). Please schedule inspections as appropriate. Work must not
be covered until it is approved. Check with your inspector if you are unsure about any of the inspections or the inspection sequence. On-going inspections
are logged on the back of this card.
❑ Temp.Erosion Control (4365) ❑ Footings/Setback(4110) 0 Foundation Wall (4115)
To be done prior to breaking ground Approved to place concrete Approved to place concrete/14Z./14Z.By Date By / Datef/f 2141 By 44/4 Date 05joy
•❑ Drainage/Downspout(4040) �❑ Plumbing Groundwork(4190) ❑ Slab/Concrete Floor (4255) ,
Approved to backfill Approved to cover Approved to place concrete
By `I i L Date q/2/0/ By Date By Date
•
❑ Underfloor Framing(4285) '❑ Floor Sheathing(4105) • ❑ Shear Walls(4245)
Approved to sheath floor
,/ Approved to install flooring Approved to install siding
BY M L Date S/ 0 y By Date , By _L Date G /v e.,7
���---44Www - '
0Roof Sheathing(4220) 0 Rough Plumbing(4230) 0 Mechanical Rough-in (4165) ,
Approved to install roofing Approved Approved
By jt. Date Ol °• 7 By /14t. Date 1/f/b y By C G4/ Date ///z�G
•
❑ Gas Piping(4125) ❑ Fire/Draft Stops (4095) r NOTE_ Prior to scheduling a Framing(4120)
Approved to release test Approved inspection;Electrical,Plumbing&Mechanical
Rough-in and Fire/Draft Stop inspections must be
A �/ 'signed-off and approveu. IBC 109.3.4/UBC 108.5.4
By /t/t i.- Date 10 V .By Date
i
.❑ Framing(4120) 0 Insulation (4150) ❑Gypsum Wallboard Nailing(4130)
Approved to insulate Approved to install wallboard Approved to install mud&tape
By Date 9 /Q 0 y By Cjq/ Date 11-13-0 dy By e, Date l'-/-1-0/
❑ Final-SWM(4375) ,❑ Final-Mechanical (4065) ❑ Final-Plumbing(4075)
Approved A` Approved Approved
�r Sl' /VI/
t�
Bypt, t at `0( By,, . Date 2 -(f13 13. :1----6 S Date 2,--7-4 -v,----
•
• •
❑ Final-Building(4050) ❑Temp.Erosion Maintenance(4370)
Approved Approved
By ok
Date *I11_,( By Date
•
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® I EKED CONST I PERMIT APPLICATION
Q3 - 1e � 5C
CITY of � APPLICATION NUMBER: � � -
Federal Way OCT 2 4 2003 APPLICATION NUMBER: -
APPLICATION NUMBER: - -
'TY OF FEDERAL W
"The following is 000i011dinforriiation-Please print(in ink)or type" `-77-
Please note: Electrical, Fire Prevention Systems and Engineering permits may require a separate application.
- -= ■ PROPERTY INFORMATION -
SITE ADDRESS: est - V�
) -- (, ASw 3 ASSESSOR'S TAX/PARCEL #: . 0 -7-- t 0` -Glp S- 7--
LEGAL
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY): ,S1Z 302-104. 04-- 67-
t j
j 2-tJ 2--I(oET b4 S '12 be 1.1E 'ly t,4' s ) 14-t cA' SE 1/4 LeSS I-ii Fi
co 1442 4 Pop_,
<1 PROTECT INFORMATION
TYPE OF PROJECT(This application): NiiUILDING o PLUMBING o MECHANICAL 0 DEMOLITION
0 ELECTRICAL - 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT_DESCRIPTION (Provid• detailed description): Cb.3rPL)Cn o CSF Sl- J2�1DeApC-
I- I/ ' ' 1 , 'IMO 4' ieU Gild .S (? orc 2(-6I( (it . ± (i '9 .
•
PROJECT NAME: v 10.If t-vv-1 (4,.,S{Gteivlte .
.. ■ PEOPLE INFORMATION -
PROPERTY OWNER: NAME: ; DAYTIME PHONE
tGVt, + Kris-1/2-in es rnt ..461 ( Z53 )9Lilo - 9231
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP):
338 So(,.St-1. 31Lir"` ?i, -cz Feck ,r A 0-46. ,t,o48cb 3
CONTRACTOR: NAME: DAYTIME PHONE:
R�ht.iry r/omes, TNC. ' (253 )92(,-6330
MAILING ADDRESS(STREET ADDRESS;CITY,STATE.ZIP) i EVENING PHONE*
1308 AL.cxP+NDe.;R f)t ( )
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: FAX NUMBER:
•
-.
► - - I V (253 ) 9a .-85LN
• COUTRACTO' RE:'•'ATION NUMBER: I EXPIRATION DATE:
( of REAL ' H 1 � l C N ; 2. / 1 S /2cx-(
APPLICANT: NAME: DAYTIME PHONE:
S Prvv.� S pWtyFN`_ ( ) -
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): ' EVENING PHONE
� ( `
RELATIONSHIP TO PROJECT: j FAX NUMBER.
❑ ARCHITECT ❑ TENANT 0 OTHER( DESCRIBE): ( ) -
E-MAIL ADDRESS:
I i
CONTACT PERSON FOR THIS PROJECT: ®'PROPERTY OWNER o APPLICANT ❑ CONTRACTOR
..--II DETAILED BUILDING INFORMATION • -
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: SR PROPOSED VALUATION FOR IMPROVEMENTS: $ I Szo I cj Z
SPRINKLERED BUILDING? ❑ YES 3NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:o YES f10
WATER SERVICE PROVIDER: /LAKEHAVEN 0 HIGHLINE 0 TACOMA o PRIVATE(WELL)
SEWER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE [Yft IVATE(SEPTIC)
**NEW RESIDENTIAL CONSTRUCTION 464/411
6 ., `'-
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $ ,32(7)(:)60
f- • ■ PROJECT FLOOR AREAS
FLOOR EXISTING SQ. FT. PROPOSED SQ.FT. TOTAL
BASEMENT /�
FIRST b b y
SECOND / ( )
THIRD "1
FOURTH
OTHER FLOORS(l7�lE, CRIE)
DECK ���//UU�� 370
31 d
GARAGE
HOW MANY FLOORS? I 9' /G Qo
TOTAL: (,3*I /
■ FIXTURES • .
Indicate number of each type of fixture 4 T/+�
/�
MECHANICAL
I AIR HANDLING UNIT(S) EVAPORATIVE COOLER(S) GAS LOG(S) REFRIG.SYSTEM(S)
BBQ(S) FAN(S) w i t? HOOD(S) WOODSTOVE(S)
BOILER(S) FIREPLACE INSERT(S) RANGE(S) MISC.( )
1 COMPRESSOR(S) I FURNACE(S)
DUCT(S) GAS PIPE OUTLET(S) HEAT SOURCE: q 'LECTRIC o GAS
PLUMBING
BATHTUB(S)_ i LAVATORY(S)
URINAL(S) 2- WATER HEATER(S)
DISHWASHER(S) RAIN WATER SYS. VACUUM BREAKER(S) tLECTRIC i rGAS
DRINKING FOUNTAIN(S) ,., SHOWER(S) WASH MACHINE OUTLET
GAS PIPE OUTLET(S) SINK(S) WATER CLOSET(S)I1I) _ Z- MISC.(1+° f )
INTERCEPTOR(S) SUMP(S)
■ DISCLAIMER/SIGNATURE BLOCK
I certify under penalty of perjury that the Information furnished by me Is true and correct to the best of my knowledge,and
further,that I am authorized by the owner of the above premises to perform the work for which the permit application is made. I
further agree to hold harmless the City of Federal Way as to any claim(including costs,expenses,and attorneys'fees incurred in the
Investigation and defense of such claim),which may be made by any person,including the undersigned,and filed against the City of
Federal Way,but only where such claim arises out of the reliance of the city,including its officers and employees,upon the accuracy
of the information supplied tothe
city as a part of this application. ?
NAME/TITLE: .'�rL.tila,Via Ss) l�J ��c \.L � DATE: CA LA—(7J
PROPERTY OWNER ❑ APPLICANT ❑ CONTRACTOR
FOR OFFICE USE.ONLY:
;NEW M:0ADDITION.,. ❑ALTERATION :'O REPAIR O,TENANT IMPROVEMENT^"
CENSUSCODE: .;= - LOT SIZE:
'ZONING DESIGNATION': BUILDING SHELL ONLY? ❑YES --❑ NO
COMP PLAN DESIGNATION BASIC PLAN? = : I YES ❑ NO'<'"
SECTION- TOWNSHIP RANGE '' NEW ADDRESS REQUIRED? • ❑ YES ❑ NO
PLATTED LOT?. i''❑YES n NO CHANGE OF USE? ❑YES -I NO
COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•PO BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000•FAX:253-661-4129
www,cityoffedera I wav,com
' µ Public Health, Seattle and Alk County 4111 Record LP!. Number
Site Design Application Form for Individual On-Site Sewage System (OSS) ON ' c i
(Submit 5 copies of application with 4 copies of plans) Department Use Only
Approximate r / ATTACH A DETAILED ROUTE/DIRECTION
])C 1 p Cts AMIE 6tJ 6,,,,ri''P--(1)x) MAP FOR LOCATING THE PRQPESite Address: 6 t �
.� P E-C_Al.r AT id
Name and address of property owner 1 MI t N\PsfZTr{?,l '339 60 -314 P t, Vp t3- 2003
Applicant Street Address 33 e 30, -614_ P i_.
Name 1 M amort► i Mi V-E- I City-Zip Code 1r E L Wki Phone Z53 ( 4C. `1'23 i
Last First `l'E3bo 3
Designer Street Address 2c)2.A9 6E. '344 5T
LMFaR- L V • 61-t•V IDS 1 City-Zip Code AUBURtJ cpe092 Phone zS3 5-2 `J2o3
THIS IS NOT A PERMIT
PROPERTY INFORMATION: Legal Description Attached ❑
Parcel # (APN) F3 101 2_ t1014-1910 15 I Z I Section: 13 ID 1 Township: 12_ I I 1 Range: lo 14-I
Subdivision Name: 1SP 37502ci I Lot: I I 11l Block: 1 1 1 1
Property Size L 13 12,I 1 Ig 14 ISq. ft. Acreage: 1 1 Rural Area ❑.Al Urban Area
Distance from property line to nearest sewer: 1 ZI O 10 0 1L
01
Water Supply 1i" 1 (IP) I = Individual Group A Supply r Group B Supply
Public Water Supply Name: 1 L_Av-.IG-N.A.l-Q on L_cri D1S-T 11D# 1 1 1 1 1 1 1
Sensitive Area: 11.11 (Y?N) If yes, specify 1 1 (L,W,O) L = Landslide W =Wetlands 0 =Other
SYSTEM INFORMATION: �/
New System 1V1 Repair Design 1 1 Correction of OSS Failure? 1 1 Y?N Detailed Plans Attached (4 sets) I 1 1 Y?N
Type of Building 1 1 IS I r I SF = Single Family MF = Multiple Family COMM = Commercial INST = Institutional
Type of System Proposed: I S IFI — I P I D I G = Gravity GP = Gravity with pump M = Mound SF = Sand Filter
PD = Pressure Distribution HT = Holding Tank CT= Composting Toilet E = Experimental 0 = Other
Dates Soils Logged: I 12. 1 II 1013 I Soil Logs Data Attached: (Min.4/lot) IY 1 Y?N
Depth to Watertable or Restrictive Layer: 1 1 IS 1 Inches Maximum Slope in Drainfield/Reserve Area 1_ I k 1 %
CALCULATIONS:
Number of bedrooms: 14 1 Total Gallons/Day (450 minimum): 15 17 to I Gal. Soil Texture Type (1A-5) 1 4 I
Application Rate: I • &I Gal/sq ft/day Total Absorption Area: 1 19 15 10 1 Sq. ft. Trench Width 136 1 inches
Total Drainfield Length: 13 It 17 I Ft. Septic Tank Size: 1 ( lo 10101 Gal. Garbage Grinder 1M 1 Y?N
Pump Chamber Size (if needed) [ ( 10 10 101 Gal. Trench Depth (min/max): 1 1 9] / 1 1 12- I inches _
I understand that failure to comply with the Code of King County Board of Health Title 13 may result in the disapproval of the sewage system being proposed in this application. Non-compliance may
also lead to revocation of my Designee iticate of Compe , cy and/o appropriate legal action by the Health Department.
Designer's Signature: % K.C.j.,,,,j ID# I 1 I I I Date: 7-- ZJ --O.3
FOR HEALTH DEPARTMENT USE ONLY: NOTE:SYSTEM MUST BE INSTALLED BY A KING CO • ' ' I 4,STALLEFOLES
2."-WISE PROVIDED BY CODE C. SE4 L, .!� e
APPROVED (date):? ,d BY: tz,,_ k 6.....4..,____ --- Jv ._04
AT-
Comments ._,,, c- --- /t
. / i�
, ,. r e ' a---- '�/,1-" - 1. `,f ...„ 44,,
dirl ,t,--,.,
. ' i CJS ���'y �'T
'► c,/,,, --fi fid:
I-
AAPre-construction meeting required between designer, installer,builder�prior to er 1 'ECEIVEDY� 4p "C
P�OOVAL OF THIS DESIGN APPLICATION IS BASED SOLELY ON INFORMATIONI v1D t r S AAP ICAYI SN f O�:..•..•., e ; <�
PERMISSION TO BEGIN CONSTRUCTION OF THE PROPOSED SEWAGE DISPOSAI_ISYSTE 'OR ANY OTHEI'1 IMPROVEMENTS ON THE•f " f .• ••••• 1'1y }±
SHALL NOTBE CONSIDERED AN ASSURANCE,EITHER EXPRESSED OR IMPLIED,THAT DEVELOPMENT PERMITS FOR THE SITE WILL:E ISSC •
-
THIS APPLICATION EXPIRES TWO YEARS FROM DATE OF APPROVAL.
DISAPPROVED (date): BY: tEXPIRES 9/ 11 0 3
See attached Site Deficiency Sheet.
Any person aggrieved by any decision or final order of the Health Officer may file a written application for appeal to Health Officer within 60 calendar
days of the date of the above decision. (Title 13,K.C.B.O.H.Chapter 13.12-Sewage Review Committee). CS 13.15.97 Rev.7/21/00