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#l #2 #3 #4 <br /> <br />DATE: Z~ IO*~Z~ <br />SECTION: I ~ TOWNSHTP: ~ RANGE: <br /> <br />TAX LOT NO: <br /> <br />~,°ttlin~: ........ <br />Eff. Soil q~"~ <br />.... Depth ...... <br /> <br />SYSTEM MUS INSTALLED AS SHOWN: <br /> <br />SYSTEM DESIGN <br /> <br />Daily Sewag9 Flow: <br /> <br />Drainfield: <br /> <br />~pe of Systam~?~ <br /> <br />Trench Depth:~_Z~ ~" <br />.Rock Depth: .... /g" <br />Minimum B~,9~f, ill: ~" <br /> <br /> I <br /> <br />Tesu Holes: 0 = Acceptable; ~ = Not Acceptable ' ' <br /> <br />To conver~ ~his approval to a permit, have septic installer or contractor show location <br />of house, driveway, welt, septic tank~ and sewer line to the approved draimfield area: <br /> <br /> <br />