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414,7 <br /> 3° <br /> C F I E--s (763) 479-0527 r l <br /> WORKSHEET FOR SEWAGE DISPOSAL WORK <br /> Date <br /> Inspector (7'`'"/'] ,,V Building Permit No. <br /> Owner �b� rFee <br /> Property Address 117 Lis /Ivy-31v,- 5lKi d of Building S/C <br /> Plumbing Contractor-Outside Sewage Disposal Hi, <br /> Septic Tanks <br /> Material e- '% I2Capacities 2-?' W1"1°13) -7 /1 Fr <br /> Proper Outlet & Inlet? ` Baffle Plates? <br /> Drain Field: <br /> Total length of lines 6. Number of lines <br /> Type of soil G:"� Percolation Test S/77 <br /> Width of trench Type of filter material /-4 L <br /> Amount of filter material below line etV /f <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 Yards of Filter Material Total Sq. Footage of Drain Field <br /> Sand Rock /6' X 6 3 <br /> Overall Size of Mound System Size of Mound System Rock Filter Material <br /> Draw detailed diagram to scale with measurements below. <br /> • <br /> Zany ( <br /> 3` 51 I,� <br /> 14 <br /> • <br /> 2" '3 Z 1 <br /> - 5i g 2 <br /> { <br /> A 4- 0. <br />