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Date 9-15-72 <br /> <br />Permit Issued To: <br /> <br />Septic tank: Minimum liquid capacity with distribution box ,,, <br /> <br />Subsurface Disposal Field required ~" Zb~'~....,Lin, ft. <br />Lot ~urve¥ <br />Other requirements; <br /> <br /> MARION COUNTY HEALTI'L..DEp]'. -Sanitation Specifications Number' <br />-- mobile home ¢%-~% ~.,-~',-~'~=~k_--"~¢_.... <br /> Bobby_ L. Shrep_ard 749-2407 .Property Address. J~b~ ~.:,, .... ~C~ S2~ D~_.~umsville <br /> <br /> Gals, <br /> <br />Widd~ of trench ....... sq, ft <br /> <br />Issued <br /> <br /> Record Of Individual Scwage Disposal System <br /> <br />number: Living units / ....... Bedrooms__ Baths Basement: Yes [] No ~ <br /> <br />Water supply; Public system <br />SepHc tank: Distance from well <br />Total liquid capacity .... .~z:~ <br /> Diameter__ <br />Tile disposal field: Distrlbutki~..,J;,,~x? <br />Length of each line ,,~.,,.7~ <br />Total length of all lines <br /> <br /> __.Individual well ..¢'/ _ ...... Community system <br />/,~¢'~__ feet, Material ..... ~a .... No. of comportments .... <br /> .gal, Inside. length _ft. inside widlh ~.. <br /> ft. LIq u.,,i.d,.~e pth ft, <br /> Ye~2~ No [] ¢_..~._,~Other fi. <br /> fi, Distance from; <br /> <br /> Width of trench .... ~""~ ft, Well ,/"~':~"~ fh <br /> Total square footage ft. Nearest <br /> D}stonce between lines -- ft. Lot llne: Front L~ Side[] Rear L--"] fl, <br /> <br /> ~¢~_ Foundation --.ft. <br />Type of filter materiCd: Graveh . __Other. __Depth beneath tile ~ ..... inches. <br />Depth of filter material over tile ~.~ inches. Depth of tile bel¢w original ground surface '¢~-Z:-%~- inches <br /> <br />Sketch of installation, <br /> <br />System c:pparently ~'iI1/~ will nat [] <br />Remarks. <br /> <br />Indicate Northerly direction, .!-!.-:--i' i <br />inspection will not be made unlil completed form is returned to the De~t, J <br /> Heal~. <br /> <br /> Signature of Installer_ ~/ <br /> <br /> (FOR HEALTH DEPT, USE} <br /> function sollsfoctorily, and is therefore apprc~ved [j~/ Disapproved ~ <br /> <br />Copies: (1) Orig, HD Files <br /> <br /> <br />