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Da,~,,,, S-~O--~¢ MARION (;UUNIY ttlr. ALl~g..l:~l..~annmmn .specmcmmns <br /> <br />Othe¢ tequlrements~ <br /> <br />Property Address...Rt:' 2t Aurora, <br />~0" W~d~h of trench <br /> <br /> Record Of Individ-.I Sewage Disposal System <br /> ~o ~e Completed by~?all~r ~,'.~ <br /> <br /> Wo~er ~upply: P~bHc system Indivlduol ~ell ~ Comm~nHy ~ys}e~ <br /> Septic tank, Dlslonge ~rom weJl~ o feet. Material ~' ~ No. of compartment~, <br /> <br /> Di0meler fl_ Liquid ~h ........... <br />Tile disposal field: Distribution box? Ye~No ~ Other. <br />~ngth of eoch llne ~_~ ~ ~ ~.ft <br />~ot~l length of o1( line~ ~.~ ~ fl. Distance tram: <br />W~h of trench ...... ~ ft. Weft ~ o <br /> <br />Distance between Dines ~ ' H. Lot line: Front ~ Side ~Reor ~ h. / <br /> Foundation , fl. <br />Type of filler matert~h G~aveh / Other ,De~h beneath t~le~tnch~s~ <br />Depth of f~lle~ material over tile . ~ i~heg. Depth of Nle below original ~round surface ~ inches <br /> <br />Sketch of installation. <br /> <br />Inspection will not be made until completed form is returned to the Health, Dept, <br /> (FOR HF. ALTH I~EPT. USE) <br /> <br />function soHsfoctorily, and is therefore opprev'ed ~ Disapproved [] <br /> <br />Syslem apparenlly will ~iJl not [] <br /> <br /> R. <br />Copies: (1) Orlg, fid Files <br /> <br /> <br />