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~7 O- <br /> MARION COUNTY HEALTH ~PT.-'-Sanitation Specifications q o ',2,_ <br />O~e .......... 7..:~??~ ................................................. N~ho~ ............................................... <br />p,~,.rn~ I.~e~ T,:,: The~dor.~..~.....ZOgg .............. 2~6~ ............ ~t7 ~d~ ~.~,~,, !.,~,.25~....~9~a <br /> <br />SUbSuf[~Ce disposal field required ............. ~.~.... Lin, it ............. ~. ........... Wx~h Ol ~h <br /> <br /> ~ECORD OF INDIVIDUAL SEWAGE DISPOSAL $YSTEM <br /> <br />TO BE COMPL~D BY IN LL~ ' Z~ / '. ". <br />iNSTALL~S N~ME ......... ~.,L.~'. ......... ~ddre~ ......~ ............. ~, ............................................................................. Phone No..~,..~:.!....( ...... <br /> <br />W~ter supply: Public ~y~to~ ~ Individual well ~ Community ~ystom <br /> <br />- ?,.~..~ ........................................... <br />Distance between lines / ~ ft. <br /> <br />CLEAN NO, 2 ROCK: <br /> <br /> Sketch of installation (show location ot mad, house a~d ~eptI¢ ey~tem) <br /> <br />Lot line: F~r~t [~ Side [] <br /> <br />Foundation ........................................ ft. <br /> <br />Rear [] ............................ <br /> <br />~'OR HEALTH D~PT, tl~) <br /> <br /> ,% <br /> <br />Remarks ....................................................................... . ................................................................................................................................................................................... <br /> <br /> .......... .... - ,- ..... <br /> ix) ¥,,xlo-,,,, -- ~e,l,.,e,,,:,,. ! ........g .................. ~~n'.~ ?'. ~ ............................. <br />is) Pink -- Inst~ller ' (SANITARIAN) <br />~'~.-- 43 11/71 <br /> <br /> <br />