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FHA FORM NQ 2373 U.S. DEPARTMENT OF MOUSING AND URSAH DEVELOPMENT <br />Rev, 11/71 FEDERAL MOUSING ADMINISTRATION <br />HEALTH AUTHORITY APPROVAL <br />INDIVIDUAL MATER SUPPLY AND 'ERAGE DISPOSAL SYSTEM <br />PART 1. w =TO Sit COMPI. E NUD FHA <br />Rwe, Address end Sip Cod. <br />I North American Mortgage Corporation <br />Shelard Plaza North #801 <br />300 South County Road #18 <br />St. Louis Park, Mn 55426 <br />Att'n: Sally Pearson 593-1436 <br />L <br />J <br />Ferro Awed <br />soft" owe" Na. 65 -NM <br />orta.eo.., epon.or: <br />CARLSTEN, Keith & Deborah <br />op.rt Ad&...: <br />1920 Country Club Road <br />Long Lake, Mn 55356 <br />ddl.ldon: Lot Ne. <br />Lot 5, Block 2, Long Lake Country <br />Club Addition <br />- C.n Attic ,.r „iAu Areeh* mad. lore ./dill <br />C] New installation beer....' tit ,.., Ao..r.nrr) <br />Ii{ --�--- -1--�� o Yes C] No I �� Yes I-- I No <br />( WATER SUPPLY sTt SYSTEM DESIGNED FOR <br />(-] Public System ❑ Community System [] Individual °' <br />_ _ _ FN-..dr�•o,n. _ Garbolso Dia al <br />SEWAGE DISPOSAL syr <br />❑Public System ❑ Community System [] Individual Yen L ] No. <br />PART II.—TO BE COMPLETED BY HEALTH DEPARTMENT <br />HEALTH DEPARTMENT INSPECTOR'S SKETCH <br />MICHAEL GAFFRON <br />sF.PTIC SYSTEM INSPECTOR <br />4».,357 <br />On the Nortb Sbon of <br />Lake Minnetonka <br />Post Office Box 66 <br />Crystal Bay, Minnesota 55323 <br />It is the opinion of the❑State [] County Local Department of Nesttft that this individual wster-aupply system <br />JX is is not satisfactory as o domestic .ter <br />B�DC. e.eAr/A)(e <br />supply for the ■u ject props y. <br />It is the opinion of the, C7 State n County Local Department of lUse4th that this individual sewsje4isposel system <br />with proper maintenance: <br />-] Can be expected to function satisfactorily, and <br />-J Cannot be expected to (unction sat utsetatgy <br />is not likely to create an insanitary condition <br />S <br />TATE <br />�'=�S <br />SIGNATURE <br />TtAAS'r <br />T-dwif" �w►MSTtE�1f/I <br />NOTE: The health a•r.hority .honld complete l <br />pepate "oleo statowAmt above oed Ofix date. alenotwe and title in *0 <br />apocu twaelded. <br />us. al the abo.e arid Io, Heolth Depertn.ent Inspector's <br />sketch as well as use of the bock of M a (arm is at the opinion of the <br />he.lth ..thorny, <br />PART Ill.— FOR USE OF FIELD OFFICE <br />TO THE CHIEF UNDERWRITER, OR ASSISTANT DIRECTOR SINGLE FAM;LY MORTGAGE INSURANCE BRANCH: <br />1 h.:ve reviewed the foregoing and the pertinent Compliance Inspection Report, and recommend that the <br />Individual water -supply system be considered n Acceptable [_) Not Acceptable <br />Sewage eisposal be considered Acceptable (-1 Not Acceptable. <br />SIGMATUR[ I L�Tr <br />CNlFF ARCHIT£( TUBAL lECOM I,—IDEPC'TV fOR CHIEF ARCNIrECr <br />N#ALTH AUTHORITY APPROVAL FHA IORM NO. 2571 <br />1"n"1001111.1. wI. ^R supri v ',)/0 f/h"'•t DtiFo' ' ♦YETFM <br />