HomeMy WebLinkAboutPermit Septic Tank 1992-08-28,-\y'-
D6bb-qz
PERMIT #
REAUEST
FOR:
I have
READ CAREFULLYI Your Authorlzatlon ts Based On The Foilowl Condltlons
APPROVED BY,DATE z-FEES DUE: 9
CALL FOR ,/sPECTIONS E c,BA OFK(sE FORFORM 68 '-40657,INSTRUCTtONS)ermlts are torp onegood LLA theroyear.Iatterexpirepermlts 80 unlessdays areinspections cu116nt.
SEPTIC
-tf;
IE
o
:
Hpr,flrfrar,,,r H:rL.LrKHN, ,.,u.skFll" c0t'r'rrY PHIrtnHHY ffHiltE1lifitAflrr-r,t,r$$*?frrrIHI.F.0fifrHel
]',t..* 1'?03t43303
NH:tJ [tl...DI TY[iH:
tildNtrft NHE t'lI L.fifrilI ril]l]l- Nl]
E[:'
Bri
rJF
rJ F.
fiF'
Ft_
MHCH
SUR
pct(
Lft
{]r.tT{i : F'|.-N
,1ti('t.J :
AHEN BY ftI...I..I
{,tr I X./Br\TH
l-.{:: 3f}6C}?il SDS'V
$,t^ili: [rT. LIl'Fi :
MHH{AHl:f_:AL. rH:h"
:i 1' ATH: *r't.t[tf_:l.lAft $H.
t::.t...AN fjt_lHIK r'[:t_
LSS
?,
FT, I{AIN :
?.:>z
/ SI MTE
IIHPU'SIT **
:li}o *tLJB$ I V l"-uT rJ[-K
u.sH rr rrllRHS s uNI.rs s01 s''rfiRIL.s *trl*0f,,s o0t l''H0NH 485 'J:.1?3
t..IKf;:N, ..J{lSEt}}'l AnfJR {3'7 *H:}'lTht'iNIAt- [-F", '$t]EINEf:IE:1.0, t]HIi:
A{]'fIilN fE,S'fiftIF'tItlN "lE tT' LTNIT'CU,SI'VAL.LIAT']:fit'l FEH D. rS
F1'
I
Sfr,S E:I...H l}(]K
1
EST. i.:fiMT..L.HTIflN I}A'TH
?5 " 0r1
r)-ut t-.
Ii
r'- Fl
I
11z-
Tkf'n n?-n.L -sr2-€trT
&,I ------._---->
b
t-).
trtz
$
(
N
ili*
so
ztda+
YAdrd
d{ryzq3.6uilbmnv
'/ eot
(
n1
Please complete all llnes inslde whlte boxes, il posstble.Exlstlng Bulldlngs or
lmprovements on
Proplrty
6tlou""E Bam
EI Garage
E lrlobile. Horne
E= Shed
SEPTIC INSTALLED
bo 8-Z-1)-'mr-
4*-LzztTN6T_Z Cf\-nZ+l A4- G
H-t ?
ztP
E YesEtlo
Water7IJt- 2223
nol Ema B
tffi .IIc.=-T-
lromDlrectlons to slte
nearest maln lntersectlon
cg=t$apt+r_-
MAP, PARCEL NUMBER
(Found on tar mrpa ln lha Arfa3amanl & Turtlon D.pL)/-? 07 27 37 4tVZoo
Towmhip F.ne. !,.cllon l/a ll.ction Tu Lot
ffi EiF ffi rEiii-"'-fii;-
Townrhip F.ng. !!.clion t/a EGtion Tu Lol
FLOOD PLAIN
ADDRESS
For Moblle Home
Placement Only
No. ol Bedrms
License #-
Brand
Year
Size
PERM'T 7O.. ..
P
Dlstance lrom Moblle
Home to:
Water Sarer/Seplic
TBS Verilied E
Allowed Use El
STAFF EVALUATION
lnlormation Req
Land Management Div. staff can
not be held responsible lor
evaluation3 or recommendataons
based on lalse, inaccurete or
t4s- 21s2 incomplote i
r{r 4-68 02/92
:*
TEd[_
BctN Noe*t
-
L
[:i
I
--/
t
I