71-T-6s
CHESTER~LD COUNTY HEALTH DEPARTMi
CHESTERFIELD ~ VIRGINIA
Reques't fo~ Lot Evaluation
For:
Applicant ~/~,-~ ~, ,~ 7~M7~. Address
Phone ~ '
Own er Address
Phone
Exact Location
of Premises / F 3 ~ /~./)/(['I,,.',,L...(' ,/?,~, , ,
Lot Blo'c~ Section' Street
Subdivi~'' ~
Applicant /.. ~ Desires to have a lot opinion that J.~'~' .~,~ik,[i,':~,ct to re-
evaluation prior to issuance of Bu:i..i.~.iJ~.~g 3::~armit.
Is applying for Building Permit
Type of Construction
/__--7 Dwelling /~ Other~'~-./.~ ~?~ /7 House plan not final
/__--7 Auto. Washer /-7 Garbage Disposal ?~Public Water /~.~-7 Ind. Well
Actual or potential bedroom ~__Estimated water cnnsumption~d gpd.
Soil Study: .j~) ~,,g ~,/%/~,~) L~~7 ~.,,I ~,~/,~
/
Recommendations: Based on present standards it is our opinion that
~hi]'"l°t has:
/~/ ~%~fL~2~LL~ /-7 QiTES'hqi~?L:!.BLE /7 NOT SUITED
~-~il for septic tank and ~¥ainfi~,~id
Remarks:
~his'
iS not a permit to install '~'~.ep~ic tank..
Sani arian -
Date
Posted Grid