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RE <br /> <br />Septic tQnk: MJ~lmum fkluld capacity with dbtrlbutfan bm <br /> <br />Number _ ,,, .~-~ <br /> <br /> .... ReC°rd Of IndiVid l Sewa DislX System <br /> To Be Compleled by Installer <br /> <br /> Total number: LiviN vnlN ... ~ ~ ~dr~ms~Bath~ ~ement: Yes ~ No ~ <br /> Water ~pply: Public ly~m_~ ~ .... IndWell ~ll ~ ~mmuni~ sy,tem ~ <br /> Septic tank~ Ot~e I~ ~11.. ~ / :: ,feet. ~erlal~No, ~m~rtmems ..... <br /> <br /> Diameter. ~ ff. L~u~p~ ..... ft <br />TlIe di,~sa/ field: Dl~t~l~o~b~? Ye( ~ Nb ~ Other <br />To~I length of all lt~*~ ~ ~. Oi~o~e fr~: <br />Widfh ~ ~fench ~ ~ H, Well ~. <br />Total ~uoro f~:.. ~ ~ ,.fl, Neorett <br />Distance be~n ~inee h. Lot liner Front ~ Side ~ eeoc ~ fl ......... <br /> <br />Type ~ fllle~ malerl~i~ Gravel:~Ofhe~... Depth ben~ih tlie~ I~e~ . <br />Depth o~ fll~r moler~l over ttl~ ~ ..... ' I~he*. Depth of Ilia be]~ or~l~J ground surf~e~i~e, <br /> <br /> Indlcale Northerly direction, ~ <br /> Inspection will not be made u.til completed form Is relornnd to the Health. <br /> <br />DATE . S~9~mh.~ O~ Ir~mller <br /> <br /> ~FOR HI[ALYM Bi~Fq-. <br />apparently will ~"~will nde [] functlc, n letidactorlly, and is therefore approve~l []~ Dtlapproved ~ <br /> <br /> <br />