OPHam-,NETT COUNTY HEALTH DEPAR' ENT
ENVIRONMENTAL HEALTH SECTION
OPERATIONS PERMIT
Name: (owner) ~ ~ JE S~Cc..
Property Location:
Subdivision
TAX ID#
N° 15603
U/New Installation 0 <S tic Tank
❑ Repairs Nitrification Line
Lot #
Quadrant #
Contractor: _ 6lwj Registration #
Basement with Plumbing: ❑ Garage: ❑
Water Supply: ❑ Well Public ❑ Community
Distance From Well: Sb ft.
Following are the specifications for the sewage disposal system on above captioned property.
Type of system: [j Conventional ❑ Other
Size of tank: Septic Tank: oOD gallons
Pump Tank: gallons
Subsurface No. of exact length width of depth of
Drainage Field ditches y of each ditch 70 ft. ditches 3 ft. ditches ff~Za in.
French Drain: Linear feet
Date: 7- 2 y- J Z
PERMIT NO. Inspected by: Zn-L
~Environmental Health Specialist
J
Sk 11cC'O).v`