71-T-3s
· ~ .~ CHF~RFIELD CODNTY HEALTH
~'"'"~ ~.i~% CHESTE~IELD, VIRGINIA
~~~ ~,~rvaluatiOn
~li~ ~ ~-~ ~~~ Address
Exact Location
of Premises
Lot
Block "SeC{ion '"S~'reet
Applicant /7 Desires to have a lot opinion that is subject to re-
j aluation prior to issuance of Building Permit.
/,~/ Is applying for ~ Permit # .
'i~fpe ~ Constru. ction
1~ Dwelling /7 Other 17 House plan not final
/--~to./- Washer /?7 Garbage Disposal /_7 Public Water /~nd~.~ well
Actual or potential bedroom~, Estimated water consumption ~i~bd.
~ecommendations~ Sa~ed on present standards it is our opinion that
th>/k6t has
1_~7 ~voP~n~. . /.,7 ~s~o~ ~.7 NO~ su~
Soil for s~~an], and draihfield installation.
Remarks."
z:c~'/,¢: ,~, ,/./,~t,.,'&,'",- z'O
This is not a permit to install