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MARION COUNTY HEALTH DEPI'. -Samtat,on SDecjficat~.on~~-~--~ .... ' ' <br /> o=te ,....~.:~g~.r:~-/~. ................................................... . (Repair) ~%'~-m kOoD. gl~'k~n~ .......... .,~.......~....~ .................... <br /> <br />/a ~.&, ......... :.:..~........~ ............................ . ~ ~.......u....~:. ............ ~: ................ g~ ~ ~' : ...................................... ~z~ ~.~.s., ~ ......................................................... ......... ~,=,o ~.......:_..........5:..::.......% ............ <br /> <br /> ~0, BE OOMPL~i~ BY NST L <br /> Total rmmb~r'. Ulv~ ~nit= ............ ~ ........................................ D~o~ ........... ~ ....................................... <br /> <br /> s~.~ m~,. ~.~ f~om ~on ...Z.e..~ .......... ~. ~=to~ ....... ~..~ ................................................................... <br /> <br />CLF..AN NO, 2 ROOK; <br /> Depth undot tile ~ ~ ~ inches, <br /> <br /> Depth ave: tile ....... ,,~,.,~, ~ inches ' <br /> Depth el [ilo below oriqinal..ground..urf~eo.__. ...._.._......~..~.-- '/ .............. inchem <br /> <br />............ i. ~..e ........................ [.. q..~ ................ <br /> <br />well ......... /..~..~? ................... ~l. <br /> <br /> Foundation ....... ~...~.,.~..--., .~, ,e.......... ft. <br /> <br /> <br />