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• <br /> 12 12 09: 29p Brad 7636820977 p. 6 <br /> CITY OF .......,CMON 0 <br /> WORKSHEET FOR SEWAGE DISPOSAL WORK <br /> lnspectorjg• 1,,�._. ' l'b 5 Building Permit No. <br /> Owner Pe, - GIS So i + . <br /> Property Address_ P 5 1- L./4,v Farm CZcL <br /> Kind of Building 5 PO <br /> SSTS Installer_ 14 4,1 5 a,^,.5 License* L (0 4/4 <br /> Septic Tanks <br /> Material C ¢t e_ (C)4+e wi i"- Number of Tanks, 3 <br /> size 13 4U 1 1 3 OO , 13 GCS 1112--r— . <br /> Drain <br /> ,"r--r-- <br /> Drain old: i <br /> Total length of lines 4 Number of fines <br /> 'Type of soil f t.c,� Percolation Test Is2.a.-t-4 0.l5 <br /> Width of trench, ' --- Type of flibm' l Co b vit. <br /> Size of Rock Bed j 0 Size of Absorption Area <br /> Draw detailed diagram with measurements indlcating distances to septic**risers from a <br /> permanent structure. <br /> t - Ito' "'....`.- W _, <br /> �,— LW5 <br /> i, Dom <br /> IPt <br /> 2- <br /> •‘ ,,,P � <br /> -p <br /> Mme , <br /> (10.--, ,..., d11 i <br /> p ,�� <br /> "11110P-. <br /> , ice 44l'hbi„ ,uQN;� <br />