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SESPEXIS - 1594724
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SESPEXIS - 1594724
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Last modified
6/28/2010 6:25:39 PM
Creation date
2/15/2005 12:42:16 PM
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Permits
Permit Address
12737 DONALD LOOP RD NE
Permit City
Aurora
Permit Number
555-99-01747
Parcel Number
041W22B 01000
Permit Type
SESPEXIS
Permit Doc Type
Permit Document
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The following Sequirements apply to the evaluation of an <br />sewage system. ~le~se select the appropriate section and follow the d£rec~£ons <br />carefully, <br /> <br />If your sewage system is less than five (5) years old and a <br />Ce=tificate of Satisfactory Completion has Deen issued for the <br />system, the septic tank does not require pumping at this tlme. A <br />field inspection will be made of the entire system and a report <br />will be issued. <br /> <br />If your sewage system is more than five t5) years old and the <br />septic tank has not been pumped with£n the lasu five (5) years, <br />follow the directions below. If you have proof that the sept£c <br />tank has been pumped within the last five (5) years, sections (a) <br />~nd (b) will not be required. <br /> The septic tank mus~ be pumped by a D.E.Q. licensed septic <br /> tank pumper. <br />b. The septic tank pumper must complete the form below'. <br /> c. A figld inspection will be required by our on-site staf~ to <br /> verify the location and condition of the septic system. <br /> <br /> *for septic pumper use only* <br /> (please print) <br /> <br />~PP~oxI~T~ sz~s o~ TX~: /OO~ ~a~lo.s <br />SEPTIC TA~K ~TERI~: Concret~ ; Steel ; Other__ <br /> <br />IS TANK IN GOOD CONDITION? ............. Yes KT'- ; No <br /> <br /> If "No", explain: <br /> <br />AJ{E INLET & OUTLET FITTINGS IN PLACE? .. Yes '; No <br />IS DISPOSA~ F~ELD BACKING INT~TANK? ... Yes"/ ; No <br /> If "~,s', explain: ~ <~C~u~'j (~J.('~--~ A~W~~ ~ '~L~"~~ <br /> <br />DIAGPJ% OF HOUSE AND SEPTIC TANK: <br /> <br /> N <br /> <br /> liAR 1 1999 <br /> MARION COUNTY;~'~' ~ '~ <br />BUILDING INS PEO'F, JON <br /> <br />DAT~ OF ~.UM~ <br /> <br />~ IGNATUP~E <br /> <br />(503) 58P,-~147 <br /> <br /> <br />
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