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DATE: ...... <br /> <br />SiTE EVALUATION <br />FILE NO: <br /> <br /> SYSTEM DESICN <br /> <br />Tank: <br /> <br />Distribut~on: <br /> <br />Trench Depth: <br /> <br /> SYSTEM MUST BE INSTALLED AS SHOWN; Rock Dept:h,! / _~.~: <br /> <br /> .; i ~ ~., - ] .' ' ~ ' ~ ~ {'~ ; ~- <br /> , .,. <br />Test Holes: 0 = A~ceptable;~~ - t Acceptable <br /> <br />This document is a technical report for on-site sewage disposal only. It may be converted <br />to a permit only if, at the ~ime of application, the parcel has been found to be compatible <br />with applicable LCDC~acknowledged local eompremhen$tve land use plans a~ implementing <br />measures or the Ststewide Planning Goals. Authorized Agen= approval isfkequ~A'~d before <br /> <br />The proposed si=¢ cf the sewage system installation has been reviewed and approved by the <br /> <br />This permit expires one year from date. <br /> <br /> <br />