OPCOUNTY DEPAR' "ENT
• •
OPERATIONS PERMIT
Name: (owner) Ca,r4s. ew Installation Septic Tank
Property Location: SR# / `/ S L 0 Repairs Nitrification Line
Subdivision TAT W��� !�
Tax ID #
Lot # ,74
Quadrant #
Contractor. ( Registration #
Basement with Plumbing: Garage:
Water Supply: 0 Well ublic 17 Community
Distance From Well: G � ft.
Following are the specifications for the sewage disposal system on above captioned property.
Type of system: Conventional Other;t
ems-Ilc .�--2 R
Size of tank: Septic Tank: L gallons Pump Tank: -AS ( gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches S� of each ditch ACI ft. ditches ft. ditches 3 t in.
French Drain Required: Linear feet
Date: r l0
Inspected by:�
nvi onmental Health Specialist
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