OPProperty Location: SR# A 117Y Ids ONitrification Line ❑ Expansion
Subdivision 7 /,- H, i 1.� Lot# Tax lD# Quadrant #
(i jklr-�, J
Contractor:
Registration #
J,
Basement with Plumbing: ❑ Garage: fiil
Water Supply: ❑ Well Public ❑ Community
Distance From Well:
Following are the specifications for the sewage disposal system on above captioned property.
Type of system: ❑ Conventional * Other 'A ke 14�2j
I - I
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