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AARNETT C011111,777AEALTN
Certificate of Completion
I
N9 1487
Owner 0 1V #'f _J� j
L A
Address . Z-52 41 (Z) t v 2 i l ,
2l Concrete 0 Other
MUST.- SZ FILLED 1N)
MAI L1 N.G, ADDRESS)-
Contractor
mix t
2
L2
A�L_Add '"Wh"i ff Ah- �c
ress
Capacity Gallons
W t�
V
(MAILING ADDRESS)
Location of Premises
A Y s I -
Depth of
Drainage Field
kSUBDiViSION. STREET OR ROAD NAME OR NUNTBER. LOT NO.)
Details of Septic Tank System
Kind of Material
for Tank:
2l Concrete 0 Other
Size of
Tank:
Capacity Gallons
Subsurface
No. of Exact Length
Width of
Depth of
Drainage Field
Ditches of each Ditch
Ft. Ditches
Ft. Ditches -,,'Inches
,e17
7
, Surface Drainage Linear
Square Feet in
Absorption Fieldy
Required Ft.
Inspected
SANITARIAN)
J,
Permit No.
-Date
H