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0ate'~ ~-l-~u ' MA,/4UN LUUN 1 I'. Ill:ALI M Ui:i' I. - ~a~tation ~;pecifications Number__~/,~-'~ <br /> <br /> Permit I,~ued To:. Wil'li~t~l A, Wa:'d 585-7'19~: Prop ty Addre~ ;.._,, - A~.a,t,v Llq~' ........... <br /> <br /> Septic tank= Min~mum liquid capacity with distribution b~~Gols. <br /> Sublurfoce DI,D~eJ F~,eld r~luired ~ ~'~ Lin fl ~ O Width ~tr,nch~. ft. <br /> <br /> R~od ~ In~hd,,a! '~a~ <br /> DN~ <br /> System <br />To Be Completed by lps~lJer ~ <br /> <br />Total number, Living unils / _Bede~m~th$_ .. ~Sement- Yes ~ No ~ <br />Woler supply~ Public system,, , Indlvid~l well ~ Community gystem <br />Septic tank D~s~ance travail / ~ feet, ~terlal - ~ ~o. of com~tment~ / -~ <br />Tolo l hquld capacity . ~ ~ .gal Inside length . ~ m~tde w)dth fl <br /> DMmeler ,~, L~ul~depth~ ,,ft. <br />Tile d~sposol field: Oi*/rib~tion~? Yes ~No ~ Other <br />Length of each line 7~ ~ ~'~ .... h <br /> <br />To,al lenoth of all JZnes <br />Width of trench ~ ~'~ - ft. <br />~ota[ aauore ~ootoge ............. eft. <br />Di~lonce between lines ..... ~/.~._ <br /> <br />Dtston~e from: <br />w.~ //-.~, ._ <br />Nearest <br /> <br />Type et filter moiectel Grovel: <br />Depth of ~llter material over tile <br /> <br />½ketc½ of In~tolletlon. <br /> <br />...... ft. Lot llne: Front I-I SldeJ-~ Reef [] h <br /> Foundation. .ft. <br /> Other ..... Depth beneath tile ~/ Itches <br />inches_ Depth of tile bel~,w original ground surface ~/~'~- ..... inches <br /> <br /> Mote, Indl¢oto Northo(ly direction <br /> Inspection will hal be mede until completed form l~ ~'eturned to the Heelth. De~t <br /> <br /> Z' .......... <br />DATE~_ <br /> <br />Sy:~tem opporenlly will ~llJ not [] <br /> <br /> Signature of Msteller <br /> <br /> (FOR HEAL'rH DEFT, <br /> <br />funcHon ~tisfoctoriiy, end Is theretore <br /> <br />o~ ~ L~. .~_ <br /> <br /> <br />