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Permit - 1301006
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Permit - 1301006
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Entry Properties
Last modified
4/11/2011 11:21:09 AM
Creation date
9/4/2003 3:07:40 PM
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Template:
Permits
Permit Address
562 11TH ST N
Permit City
Aumsville
Permit Type
Permit
Permit Site Number
6289
Permit Doc Type
Permit Document
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(Su$$1em~ntal Form) <br /> <br />In order ~o properlg e~aluate gout existing sswage ags~em, the £ollowing <br />information Will be necessa~g: <br /> <br />rf 9our sewage sgstem iS les__s than five (5) g~ars old, aud we <br />have ~ approved record of the sgStem, we oan proceed wt~hou= <br />an9 f~rther action on gout ~art. <br /> <br />If your sewage sgstem is le~s than five (5) ~ears old, and we <br />do not have a record of an approved installation of the swstem~ <br /> o~; <br />3~ gou~ sewage sgst~m is ~ore than f{ve (5) gea~s old or has not <br />been pum~d within ~h~ las-~ ~ive gears: <br /> <br /> You must have the s~ptic tank pumpe4. <br />b. ~ava the segtic tank pumper ~omplete the form <br />c. A field visi= ~i1 b~ required bw the Sanitarian to <br /> veri~ the location and ~onditio% of =he septi~ <br />d. If you have ~roof that ~o~r septic t~nk has been <br /> pumpaW with~ the last five (S) ~earS, sections a & b <br /> will not be reguired. <br /> <br />COMPANY <br /> <br />S~ay~on Septic Sez~Z,i. ce <br /> <br />DBQ AIC~N$E NO: <br /> <br />34916 <br /> <br />Aumsville, <br /> <br />gallons co~lc~e~e <br /> <br />IS TANK IN GOOD <br /> <br />ARE BAFFI, ES OR ~L~OWS IN pLACE? <br /> <br />SS DRAINF~$LD BACKING UP INTO <br /> <br /> If yes, explain; <br /> <br />_ ~ YEs; ..... NO <br /> <br />ho~h off~ <br />Lid is hO1 <br />with large <br />metal lid. <br /> <br />DFACRAM OF HOUSE AND <br />~3CATJ61V OF T~VK~ <br /> <br />6 ' ~ Septic Tar~¢ <br /> <br />Kev. 2/86 <br /> <br /> <br />
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