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Dote__ 3-18-69 <br /> <br />Perr~h:it Issue,~ To Laurence M. ~ll~er 749-2605 .Property Address~ ~A~sville <br />Septic tank Mm,mum liquidcopocdy with di~tnbutio~ box ..... .~ Gals <br />~ubsurface Disposal Fjej~uired ~_.__Lin, ft,,__~ ~~Width of trench sq, fl <br /> <br />Other requi~omenls <br /> <br /> ~u~d by:: <br /> <br />Record Of Individual Sewage Disposal System <br /> <br />To Be Completed by Installer <br />INSTALLEgS NAME ~ ,1] ~-.~."~4~.~"~./.L~- Phone No · · <br /> <br />Total number Living units, r' Bedrooms <br />Waler supply~ Public system ., , Individual well Y , Community system <br />Septic lank:: Distance from well ~_ .~ .... feet, Material /~/-"-~.4."J.',~.r~- No of cor'op/ortments._./ <br />Totollqudcopac ~ ~)~ ga nside length /7 ~-~ nsdewd ~ '/7z' ~ ft <br /> Diameter /,~ z ...... ft Liquid depth .~'"~'~ ft <br />Tile disposal field:: Distribution ~ox? Yes -~-"~ No [] Other <br />Leng,h at each hoe / ~ o._...~-_~.._ _.// ~ i;7- ........... <br /> <br />Total Length of all lines_, <br />Width oJ trench <br />Total square footage.. <br />Distance between lines./'"' <br /> <br /> fi, Distance from: <br /> <br /> ft Nearest <br /> fl. Lot llne:: Front [] Side [] <br /> Foundation /,/ ft <br /> Other__ Depth beneath tile <br />inch~s D~pth of tile below original ground surface ,//~'~" <br /> <br />Yyp~ of filter material:: Oravel <br />Depth af Jilter material o~er tile <br /> <br />,inches, <br /> inches <br /> <br />Sketch of insralloti0n <br /> <br />Nole Indicate Northerly direOion <br /> Inspeclion ~iH not be made unlil completed form is returned to the Health Dept <br /> <br />S~stem apparently will [~wilt not ~ <br />Remarks <br /> <br />Cop~ ,: (I) 071g.~6 Files <br /> <br /> (FOR HEALTH O~PT. USE) <br /> <br />f~nclion soHsfactorily,, ~nd is therefore opproved ~'"'~'DisopproYed [] <br /> <br /> <br />