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MARION COUNTY HEALTH DEPT.-Sanitation SpecificationSN~mber <br />Da te_8-~Q-69~ ._ .~t Trailer ) <br /> <br />Permit Issued To:.Jim Casselman <br /> <br />...... Property Address13]'2 Piper St. s A~rora <br /> <br />Septic tank: Minimum liquid tape, city wilh dist$.,ibution box <br /> <br />Subsurface Disposal Field..~e.o, uired ,. Lin, ft, ,. <br />Lot survey __ <br />Other requirements: <br /> <br />,~ F~.. ,Gals, <br /> -'~ ~' WJdth of trench <br /> <br />issued by: <br /> <br />__sq. ft ..... <br /> <br /> Record Of Individual Sewage Disposal System <br />To Be Completed by las.taller -- <br />~-h~'S~LL~"/~E...~'~-_ ~ ~,~', .~_.~, Phone No.L'~ ~,~ ~ / Address/~~ <br />Water supply: Public system Individual well __Comm~ity system ~ ~ <br />Septic tank; Distance from woll ~ feet, Mot~rial_.~ ..... No. 0f comportments~ <br />ToloJ iquid capac ly .... ~ ~ ,gui, Ins'ida length, .h. inside width. .ft, <br /> Diameter ff. Hquid depth ..... ft. <br /> <br />file disposal field: Distributiana.~ox? <br />Length of each line ..~ <br />Tolat length of aJJ Ii.eS <br />Width of trench._ <br />Total square footage ~ <br />Distanc~ between lines <br /> <br /> Yes [~ No [] Other <br />._,'/,c. L~ ~o .... <br /> ,ft. Distance from: <br /> ft, Well ~4~~'~2 ? ft, <br /> __ ft. Nearest <br /> ft. Lot Ilea: Front [~ Side[] Rear [] ft <br /> <br /> Foundation _ft. <br />Type of filter material: Gravel: ~__ ~- r?_~_..~._~Other__ Depth beneath tile_ ~/ . <br />Deptt~ of filter material over tile ,~ ,inches, Depth of tile below original ground surfoc~ <br /> <br />fl. <br /> <br />inches, <br />z~'~' inches <br /> <br />ketch of installation. <br /> <br />System apparently will ~//wijl not [] <br /> <br />Indicate Northerly diraction. <br />}nspecHoe will riot be made until completed form is returned to the Heagb. Dept, <br /> <br /> Signature of Installerq7~-_w~_.~ <br /> <br /> function satisfactorily, and is therefore approved [~ Disapproved [~] <br /> <br />Copies: (1) Orig. HD Files <br /> <br /> <br />