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MARION 'COUNTY:HEALTH D'~PT. -Sanitation Specifications <br /> ........ ~.~..-..~ .................................. 12, ........... :, ~. ~.~ ............ t.....?..,~ ................... <br />~rmit h~e~ ~o- Diane ~c~t~bsk~ ~pe~x Address .................. ~t. 2~ ................................. BOX 65 B~ ............................................ A~vill~ <br />~tic t~--... _...._.....~...--. ~.-...~.`~-"~..r..~..~`~`~d..~y~.~-~`~.~-~ ,, <br /> <br />....................................................................................................................................................................... ~.~.-~ ...................................... <br /> <br /> RECORD OF INDIVIDUAL S~AG~ DISPOSAL SYSTEM <br /> <br />~'~ ~ ..,,~..~,~ ................ ~, ,~A~,~.~.. .~,, ............................... ~. ~...Z~.~.~ <br /> To~ai numar: Mvln~ unite .............. ~. ................... ................... ~ ............ ~ ................................... ... <br /> <br /> Water eup~iy: ~bli~ ~ymem ~ I~l~u~l, ~ll ~ Co--unity I~ltem ~ <br /> <br /> 8~plla tank: Distan*o tram well ........ ~,~ ............ ti, Mate~l ............................................................................................................. <br /> <br />Tile gl~ipo~l tleld: <br />Length of ec~ch ll~ ............. ~,-~,l ...................... "?'"~",i ............... <br />T~t~l lsllgtb o[ ~11 lines ....... .~.~,.~,..~ ........... lt. <br />Wi~lth ot t~o~h ......................... ~,,~....~, ....................... <br />Dl~tc~r~ce between lines ................ ~,.1~,,,~. ............... ,., It, <br /> <br />CLF4%N NO. ~ RO~K: <br /> <br /> /¥ <br /> <br />not be made until ~m~ <br /> <br />~cltrm is retum~l to Health Dept, <br /> <br />w,m ........ ...~d~.. .................. it. <br /> <br /> Lot line~ F~ont ~ /lids ~ <br /> <br /> <br />