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MARION COUNTY
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<br />Dote
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<br />Permit issued To:. Marvin More~
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<br />Subsurface Disposal Field required
<br />Lot survey
<br />Other requirements:
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<br />Septic tank: Mirlimur~q ~iquid capacity with distribution box__.
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<br /> -Sanitation Specifications
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<br />__.Property Addre~ Rte 1~ BOX ~_5,,,~_ Aumsvi~le
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<br /> ~' Width of trench ~ sq, ft ~
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<br /> Issued by: ~~
<br /> Record Of Individual Sewage Disposal System
<br />To Be Completed by Installer
<br />INSTALLERS NAME~,-~-_c /~t .,,,j.,? ,c-/=- /~.,,,,. ~- 9 Phone No. ,3 ¢ R,- - 3' 5" ~ Address / ~' ,,$- 3- ~ .-
<br />Total number: Uvlng units __.Bedrooms ,_ Baths Basement; Yes [] No []
<br />Water supply: Public system. Individual well ~ Community system
<br />Septic tank: O~stonce from well ,,,f ~ ~,~ ~,~ ' ,feet, Material c~. o' ,,v-,~C~= No. of compartments /
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<br />.... Qol, inside length __ .fl, inside width fl.
<br /> ft. Liquid depth __Ct,
<br /> Yes [] No [] Other
<br /> ~ if- '7 ..~' _ft,
<br /> Ct, Distance from:
<br /> Ct, Well ,~ f'r*'- ~¢, ft,
<br /> ~ ft, Nearest ~ c ~ ~ * ~ ~
<br /> ft. Lot line: Front ~ Side~ Rear ~ fb-
<br /> Foundation ....... ft.
<br /> ~ Other ,. Depth beneath tile ~ ......... inches,
<br /> inches. Depth of tile below original grourd sudoce ~ ~
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<br />total liquld capacity__.
<br /> Diar'neter
<br />Tile d~sposol field: Distribution box?
<br />Length o~ each line_ ~_~-
<br />Total length of all lines ..~'-
<br />Width of trench ......... .,~,,.
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<br />Tdol square footage ....
<br />Distance between lines___ ,~.
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<br />inches
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<br />Type of Filter materiah Gravel: ......
<br />Depth of fdter materlat over tile ..........
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<br />ketch al installation, ~ r
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<br /> ~ .-/o'/
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<br />Indicote Northerly direction.
<br />InspecHon will nol be mode until comp e ed for s returned<:~ ...... o . · ~j PH~ / ~-/~'
<br /> z:.'.:!/:..! ..E ,,I, ,,J __
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<br /> (FOR HEALTH DEPT. USE)
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<br />Copies: (1 I
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