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5-11-72 <br /> <br />MARION COUNTY HEALTN DEPT.-Sanitation Specificatio <br /> <br />Permil Issued To:__.Oack H. er~-~,man 61_8_-__5_4~ Property Address -~%-~-, <br /> <br />Septic tank:: Mi,~imudr, liquM capacity with distribution box ./~ Gals <br />Sub~uJace Dbposal Field required_. _ Lin fl Wd h oflrencl~____ sq. ft__ <br />Lot <br />Other requireme~(~ <br /> <br />'Record Of Individual Sewage Disposal System <br /> <br />To Be Completed by Installer <br />INSTALLERS NAME._~-/h. f¢ t~f//f'(2~ Phone No''~'~'~* 3 ~/ 7 /Addres~ /~ /I ~g<~ ~/ C~.' 6~W'FS~ <br />]0'01 r,ur,,ber:: Li¢in9 ur, il, / 8ed,eom, ~ Baths~ Bo,emerfl:: Yes m NO~ <br />Water supply Pubhc system Individual well ........ ~ ......... Commun(ty system <br /> 5epf,c tank: Distance from well ¢0 feet Materi¢[.~¢)~( ¢¢' ¢(~' No of compgrtm.ents, ~ <br />Total hqu,d copac,t¢_ _/~&Z___~ gal Inside length .~0 :.~.~ fl inside widtb 4';'-~ ~, '~ft <br /> Diameter ~ ;~¢~¢,~ f~. Lqud deph ~ '4 /~ ft ~ <br />Ida d,sposol field D,sfr,bution ~ox?' ' '¢~;s ~ HQ ~ ¢Ofh;r~ ........ <br /> <br />Iota~ length of all lines ~ ~ ~ ft Dis~nce from: , <br /> <br />Distance between lines ....... <br /> <br />Iype al fihel ma~er~ol Grab, el <br />Depdl of ffher mafcr~cl~-over tile <br /> <br />Sketch of instatJahon <br /> <br />ft Nearest <br />___ft Lot line:: Front 17 qide ~ Rear <br /> Foundation7 ~ ? ft <br /> Other. Depth beneath tile (.~ <br /> __inches Deptb of tde below original grottnd <br /> <br />I~Jlcafe NortheHy d*rechon <br /> lt~speCflo~n wdl net be made until completed form is returned to the Health Dept <br /> <br />br~tem apparently will [~ will hal <br /> <br />rFOR HEALTH DEPT USE~ <br /> <br />function satisfactorily, and is tberefore appro~,ed ~ Disapproved [~ <br /> <br />Coples~ (II Orig. HD Files <br /> <br /> <br />