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!] 12 12 09: 29p Brad 7638820977 p. 5 <br /> N <br /> O <br /> o CITY OF CPPLOittiO <br /> 0 <br /> o WORKSHEET FOR SEWAGE DISPOSAL WORK <br /> r- Date /Q -141 -�I O <br /> Inspector (J; 01(e- ,._,,,.,,Building Permit No. <br /> Owner j ep.. 1 i"a...,,.'1.-e..t2? <br /> Property Address 11;35 0 ClZ 14 CD G-- <br /> Kind of Building 5 'FT) <br /> SSTS Installer /4 4-5 -5 License* 1-' 4. . <br /> Septic Tanks <br /> Material et/An-044- Number of Tanks 3 <br /> Size /0("0 j 1)00 -e¢'j75+4is /net /6o 4 ',`5 t,6.t airwisi <br /> Drain Field: <br /> Total length of lines '3 G. Number of lines 3 <br /> Type of soil (e..k.e-- Percolation Test 5. •P. 71--`G,5 <br /> Width of trench Type of filter material a.+ 4 J -r2.. <br /> Size of Rock Bed t U Y 3 1' Size of Absorption Area — <br /> Draw detailed diagram with measurements indicating distances to septic tank risers from a <br /> permanent 41atructure_ ��j, 11 " <br /> MI 1 <br /> L LA) I -+ <br /> ell S <br /> \ -ell <br /> ,/ -.. <br /> 1'' <br /> 2`� <br /> �,�rl' "" 12.x, <br /> --,2. 6 - Us.� <br /> \ -.\\N„.„,....,_ ...E_$;.....,,i_tv, <br /> +AvK--s <br /> i F,s l! 1- t oo() -ki 14 n4-c^ <br />