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12 12 09:27p Brad 7636820977 p.2 <br />4- <br />N <br />N <br />4a <br />J j CITY OF <br />LO <br />WORKSHEET FOR SEWAGE DISPOSAL WORK <br />Date 69 � Z <br />iv <br />2� �' Building Permit No. <br />Owner Se) �. P — <br />Property Address �t �e,.rk S - <br />Kind of Building �� <br />SSTS Installer k -2-S-0wS licensed G <br />Septic Tanks <br />Material C(TKr-Ye-4e- D*yLAj+n/ Number of Tanks a - <br />Size <br />Drain Field: <br />o <br />Total length of lines (q/ Number of fines <br />Type of soil .134,t,k,7 Percolation Test 13 a !L±11 �• <br />Width of trench Type of filter material vg- ., <br />Size of Rock Bed 1.O 3__ Size of Absorption Area <br />Draw detailed diagram with measurements indicating distances to septic tank risers from a <br />permanent structure. <br />L <br />kAov- Sri' <br />4,J) <br />13joigo <br />puvvy <br />I <br />?tee l Ce"r <br />W /14 <br />Z. CIO <br />6`_''tLo: <br />