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12006131
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Last modified
1/9/2024 8:00:18 PM
Creation date
1/9/2024 9:47:35 AM
Metadata
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Template:
Permits
Permit Address
28681 NORTH FORK RD SE
Permit City
Lyons
Permit Number
555-21-007754-PRMT-01
Parcel Number
093E18BA01200
Permit Type
Septic
Permit Doc Type
Permit Document
Status
Ready to Film
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INDIVIDUAL ON-SITE SEWAGE SYSTEM RECORD <br /> 22 ; W/ (to 'x "ompQilt�e4�/by sy�:tel i :a:!e ,Q(f <br /> BITE ADORUS: 11/t� 1-Vte d�} PERMIT M —2 12 O <br /> AS-WILT YLNI OF q1181717CIUD STRO : <br /> 5 4 11 ti_l.••. <br /> /'v SP 1 O Mort <br /> k �O l4 <br /> , <br /> P <br /> IrS <br /> a <br /> A 13 <br /> S� covey 'nog,,, . , <br /> S <br /> s 1-0,tart R0410 r't Yo et mvu <br /> r fJ it, C .:. /AP, <br /> a - /GI <br /> Di, 3 - 5.; <br /> D <br /> ft frobs -I-0C = ! <br /> labor all details and dimension. necessary to locate all components of the system in the future <br /> melt I/t ?Will111"Tr1 a-STTt Maas <br /> r7at.a ttoeipa Serape N:a.- .^a:lo,.a, NY$TSM nurraL1tto at Tim SIOVI amCallae MU QAI <br /> �y� <br /> YlMOCTin Ia AC-CQtMMCI ETU r aaDD12 DTP <br /> .mo! th Taal, Slut: fQ?[� n atic l27d , L a f.1.-C TS,O MINI TIN MIS 01 11R ON![1 TMIorrit. <br /> Deets,nab, sits, �Q �Nat'l, �14lf' wig "ALAI JL-$ I awes teeme <br /> d <br /> the peptic tarn one oertity <br /> ,/ it to be .at.rtipst <br /> eerl. rsat se.. , Sloe. 4 teat'': cell, 140 <br /> �/� The wee.. mutaec.11d by: <br /> 'melee), i 1 Dlatributim: awe' / t I Concr.ts. (,I�lttttc 1 1 Property Omar ,pearlt.. <br /> JI ( t 1 /t I.F'Steuwd t.+q. DI.poeal servicetMtt ta .,d biros Ilse, i!- r �1M6a1. lamar, V : Pert 14 <br /> DUO LicenseTotal ar M To atarl.la Peeeea I smelt%pod', tal. ,; taller saps If 7at�9� <br /> i N <br /> Trasea pwpt/+ Nttnitua.yd r ftisimbo riwd Curtail* Dntn Depth _ signed, G <br /> attlw.t Pam. Nap aedel.iekil.. Static Seed to tyetw, LEI It, <br /> �N(Q nor <br /> Peep C./CIO Tint: Oalls,. per '>cie iplrat prise. <br /> .etas► r MMlabatl .base fr..grams. sea eatriela awe listed .memo / <br /> .lace / ; Z02,j <br /> e <br /> (tor Isrtoa Comty ass only) <br /> Me /bows .epos system his beer. Invented by Nation Cbunty. The aatoraet:on nes Wean datitaiaed to be accurate and <br /> the .yetee la <br /> i ; 1IDProv.d <br /> I 1 approved lath corrections wee Inspection report <br /> I i Denied <br /> Signed. Title Date. <br />
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