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' � METRO WEST INSPECTION SERVICES, INC. • 763-479-1720 <br /> , <br /> '' ' BOX 248 • LORETTO, MN 55357 <br /> CITY OF � �Y'`CJ Vl C,� <br /> WORKSHEET FOR SEWAGE DISPOSAL WORK <br /> Date /C,� �- �- f `� <br /> InsNector�i� v� � '� �� Building Permit No. Z.c1 ! �/ " %U �� i <br /> Owner_ � ✓i C.. 'i- �v�Z.t:.�t.e �-�� 5�v� <br /> Property Address � � �� (:!-��t `��_�+�-e � (Z-. <br /> Kind of Building � � �� <br /> SSTS Installer ��-,��, .�S t-- 5� n S ��ZJ�8�Q��OLicense# �-�O `-1 G <br /> Septic Tanks <br /> Material C Uv�Cv �'-� ,7�}rw�►1 NumberofTanks � <br /> Size { 3 uo 3 c�l� /3 c�0 i F� <br /> Drain Field: � <br /> Total length of lines Gr7 I Number of lines ,� <br /> Type of soil ���,:.�� Percolation Test �Z v>�!-�, Ut$� `J�/g,/`� <br /> Width of trench � " Type of filter material ��� �y}�:-+Z <br /> Size of Rock Bed�D � � � Size of Absorption Area $,5 X �"`� v;.c�� �� <br /> Draw detailed diagram with measu�ements indicating distances to septic tank risers from a <br /> permanent structure. ;,,U-t (� <br /> �1',. <br /> ���� � _� ^ �� , <br /> ��, � � ��, <br /> �..�,�,S�' �'1 1 <br /> � z � lzrf <br /> � 3 � � 7�, <br /> f I �3 � � : �� ' <br /> l 1 ' �° `� , <br /> � �Z = r�s- <br /> �, l � � 3 = rd b , <br /> � � G1��Y <br /> �� � � <br /> 1 �- � .— ,.,, ._.-. ! <br /> ��� <br /> i � c�� (���1 � <br /> � 3(� C��F''` <br /> �3 , r��w:� <br /> � ��.�� <br /> �� <br /> � %' <br /> o �3Z {��s <br /> � <br /> r � <br /> � 3�,dN �.��, ✓ <br />