HomeMy WebLinkAbout1985-10-08 Federal HUD Septic Design ApprovalFHA FORM NQ 2373 U.S. DEPARTMENT OF MOUSING AND URSAH DEVELOPMENT
Rev, 11/71 FEDERAL MOUSING ADMINISTRATION
HEALTH AUTHORITY APPROVAL
INDIVIDUAL MATER SUPPLY AND 'ERAGE DISPOSAL SYSTEM
PART 1. w =TO Sit COMPI. E NUD FHA
Rwe, Address end Sip Cod.
I North American Mortgage Corporation
Shelard Plaza North #801
300 South County Road #18
St. Louis Park, Mn 55426
Att'n: Sally Pearson 593-1436
L
J
Ferro Awed
soft" owe" Na. 65 -NM
orta.eo.., epon.or:
CARLSTEN, Keith & Deborah
op.rt Ad&...:
1920 Country Club Road
Long Lake, Mn 55356
ddl.ldon: Lot Ne.
Lot 5, Block 2, Long Lake Country
Club Addition
- C.n Attic ,.r „iAu Areeh* mad. lore ./dill
C] New installation beer....' tit ,.., Ao..r.nrr)
Ii{ --�--- -1--�� o Yes C] No I �� Yes I-- I No
( WATER SUPPLY sTt SYSTEM DESIGNED FOR
(-] Public System ❑ Community System [] Individual °'
_ _ _ FN-..dr�•o,n. _ Garbolso Dia al
SEWAGE DISPOSAL syr
❑Public System ❑ Community System [] Individual Yen L ] No.
PART II.—TO BE COMPLETED BY HEALTH DEPARTMENT
HEALTH DEPARTMENT INSPECTOR'S SKETCH
MICHAEL GAFFRON
sF.PTIC SYSTEM INSPECTOR
4».,357
On the Nortb Sbon of
Lake Minnetonka
Post Office Box 66
Crystal Bay, Minnesota 55323
It is the opinion of the❑State [] County Local Department of Nesttft that this individual wster-aupply system
JX is is not satisfactory as o domestic .ter
B�DC. e.eAr/A)(e
supply for the ■u ject props y.
It is the opinion of the, C7 State n County Local Department of lUse4th that this individual sewsje4isposel system
with proper maintenance:
-] Can be expected to function satisfactorily, and
-J Cannot be expected to (unction sat utsetatgy
is not likely to create an insanitary condition
S
TATE
�'=�S
SIGNATURE
TtAAS'r
T-dwif" �w►MSTtE�1f/I
NOTE: The health a•r.hority .honld complete l
pepate "oleo statowAmt above oed Ofix date. alenotwe and title in *0
apocu twaelded.
us. al the abo.e arid Io, Heolth Depertn.ent Inspector's
sketch as well as use of the bock of M a (arm is at the opinion of the
he.lth ..thorny,
PART Ill.— FOR USE OF FIELD OFFICE
TO THE CHIEF UNDERWRITER, OR ASSISTANT DIRECTOR SINGLE FAM;LY MORTGAGE INSURANCE BRANCH:
1 h.:ve reviewed the foregoing and the pertinent Compliance Inspection Report, and recommend that the
Individual water -supply system be considered n Acceptable [_) Not Acceptable
Sewage eisposal be considered Acceptable (-1 Not Acceptable.
SIGMATUR[ I L�Tr
CNlFF ARCHIT£( TUBAL lECOM I,—IDEPC'TV fOR CHIEF ARCNIrECr
N#ALTH AUTHORITY APPROVAL FHA IORM NO. 2571
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