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MARION COUNTY <br />Dale 4-24~72 <br /> <br />Permi~ Issued To:: The_o_dore Peters 362-2395 <br />Ssptic tank Minh~lum liquid copocil¥ with dislribution box <br /> <br />Subsurtoce Disposal Field required ..... ~ ~ Lin ft <br /> <br />DEPT. Specificati 7 7- <br /> <br />__Property Address ~e~.~-~A72 Aumsville <br /> <br /> ~.~ ~"' Width et trench ~sq ft <br /> <br />Other requirements~ <br /> <br />Issued by~ <br /> <br />Total hq,Jid copocJ~y ~' ~',; ~9 <br /> Diameter ....... <br />Tile disposal field, D*stribution box'? <br />Length o[ each line ~7~]) <br />Total ~ength M all }ine~ ~ ~ <br />Width of trench ........ ~_~ <br />~otal square footage <br /> <br /> Record Of Individual Sewage Disposal System <br />To Be Completed by Installer <br />INSTALLERS NAMF_ L/~~-".- .... Phone No.~--~J~7 2~_Address ~ ~ _.~.,'M_,~.~,Y~-,~C/~/~%, <br />Total number:: Living unjtT~ .... ~) '~'~' C Bedrooms,, ~ Baths ~ Bas em"e. nt:: y,.~,~ <br /> '',7' <br /> <br />Water supply Public system _,Jndividual well ,,~__..._.Community ~iystem .... <br />Septic tank:: Distance from welt _~'/) ~ feet. Materigl ~'~-,,~,~"~-..,'.~___ No, of compadmems <br /> gel Inside length __ __fi inside width <br /> .fi Liquid depth ft <br /> No [] Other ........ <br /> <br /> .fi <br /> <br />DisParate between lines / ~ ft <br /> <br />type of filter material Gravel:: ..... /~'~ ~ Other <br />Depth of filter material over tile <br /> <br /> Well / ft <br /> Nearest <br /> Lot line~ Front [] Side [] Rear J~ ft <br /> Foundation ft <br /> Depth beneath tile ~=~ ,.inches <br />inches, Depth of tile below original ground surface / ~ inches <br /> <br />~ketch of installation, <br /> <br />Note indicate Northerly direction <br /> Inspection will not be made until completed form is returned to the Health Dept <br /> <br />System apparently ~vill ~-will not [] func[ion satisfactorily, and is therefore approved ~ DJsapprovod ~ <br />Remarks- <br /> <br />Copies: I1) OHg,, HD Files <br /> <br /> <br />