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Dote, <br /> <br />Permit Issued'~o, ~'-_c~.=irf_C Eorthwes'k...._ <br /> 67~5000 <br /> <br />lot ~urvey <br />Other requlre~eMs: <br /> <br />,. Width of trench sq. ft,. __ <br /> <br /> ' ' Record' Individual Sewage Disposal System <br /> <br />lolal number: Llv~ng ~'[t~. 8edrooms~, ~oths <br />Waier ~ppiy: Public system~_ Individual well ~ ~Com~unify syslem~ <br /> <br /> al I~q d capacity ~ ~ ~ gal, J~sJde length ........ ~t~ }nside wldlh ..... <br /> D~ameter ...... fi, Liquid ~epth .... <br /> <br />L~ngth Of each hne~__ -0 " ~ ....... <br />T~tal ~englh of all lines ~ ft. DistanCe ~rom: <br />WId~h of trench ~O ~ ~fa Well <br /> <br />fi <br /> <br />Type oF hher material: Groveh ~/'*'~'~ ~0 <br />Depth a~ }ilter moterlol over tile ~_:~ . .loc <br /> <br /> ~otch of In,folio/Jan, <br /> <br /> Inspection wll~ not be made until co~pl~ <br /> <br />DATF ...... ,_ <br /> <br />System opparnnfFy will ~. <br /> <br /> s Foundation:: ,ft. ¢,..,, <br /> r~ Depth beneath tile_.~~ _inche,'L ~ <br /> , ~epth of t~ie bel~ origi~O} ground surface: ~'~ inches <br /> <br />~unctlon sati~foctorily, a~d Is the~etore approved ~ Disappre~ed ~ <br /> <br />! <br /> <br /> <br />