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4. <br />SEPTIC SYSTEM INFORMATION <br />STREET ADDRESS 1y50 4RC-4CKa--r7-C 1077 /ESD <br />LOT BLOCK SUBDIVISION_Rf4C,&,fM )PoiiyT <br />MONTH AND YEAR TESTING DONE - Ali GUST I <br />ITEMS ALREADY COMPLETED 6-1 Pte.& <br />NEED TO COMPLETE BEFORE ISSUING BUILDING PERMIT <br />OBORINGS <br />OPF.RC TESTS <br />SYSTEM <br />DESIGN <br />0 SITE PLAN <br />0 OTHER -* c�aek��luc Avew-ce—r- e:2& -z> <br />= i <br />SUBDIVISION FILE NO. 6Y2 <br />DATE THIS SHEET FILED X9-2LI) BY "a -—/z-, <br />