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CITY OF INDEPENDENCE—a— ;;-_- .a _ - <br /> WORKSHEET FOR SEWAGE DISPOSAL WORK c <br /> WI <br /> . ' V Date ' 15— IC) <br /> Inspector i 1 t( e 1fib S Buildi Permit No. 2-© 10 " 0 0 7 1 3 <br /> Ownerl b►ex..1 5Ckre%A.r 4 Lice-1►.. 14)44✓M^QAN Fee <br /> Property Address Z(o3C) 1-0X S-i''' Kind of Building SRD <br /> Plumbing Contractor-Outside Sewage Disposal (4 Al�,., 4- s <br /> Septic Tanks <br /> Material C .-' 'k (-64(...i-v-) Capacities 3 -1300 <br /> Proper Outlet & Inlet? i� Baffle Plates? '-------- <br /> Drain Field: , <br /> Total length of lines (' I Number of lines 3 <br /> Type of soil 1' k.._ Percolation Test le-yS41 D cj <br /> crvi <br /> Width of trench Type of filter material (-bee g ' C- <br /> Amount of filter material below line /2- " 5":-Mb <br /> 3 f/Z_ <br /> Depth from top of tile to finished grade <br /> Check Vents ✓ Check Caulking ./ <br /> Check Grade in Horizontal Waste Pipes ✓`` Clean Outs <br /> Tonage or Yar s of Filter Material_i_� 1 44-6 Total Sq. Footage of Drain Field ( ) 34' <br /> Sand i A 3 9 Rock /0 1 X CO 3 <br /> e <br /> �i i it <br /> Overall Size of Mound System U (f D . Size of Mound System Rock Filter Material I "?- <br /> Draw detailed diagram to scale with measurements below. <br /> S <br /> xv,ell , bir°r.,e <br /> - <br /> I y I'r• r i'pe I`1 v e-s`f <br /> of i ;-4--f-aN k i N it <br /> - 0-, - 6,R FV1-Vae- <br /> C410 <br /> . <br /> °'° Ar I ' O <br /> 2- 72 <br /> 3"79 <br /> (3 <br /> /0 -z_-= Y ' <br /> 3 =6/ <br />