HomeMy WebLinkAboutBRUIN PARK BLK 2 LT 3o00
SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT
Residence Add~ess ~ofe~)~f. ~,~ ~WP_.. Location of Installation _.. ~P~vLE .......
Application to Install: Septic t~k... , Seepage pit _X , ~ain field~, ~he~
To Serve the Followin~ Facility . ................
Financed Th~ougb _ ..... To be Installed
Percolation Test Results ................. Antielpated Date of Completion .......
BELOW TO BE FILLED OUT BY HEALTH DEPART~NT
~S descPtbed below. Size of ~it to be semved J ,b~ d~o~
~ ~'~v~ _ , o~page ~e~,~,,~ Type
DIST~CES: DIAGRAM OF SYSTEM
cePtify that I am fam~llat 'with the Pequi~ements of G~eate~ ~ehoPage Amea BoPough
~Pdin~ce No. 28-68 and that the ~ove descPibed system ~8 in accomd~ce w~th sa~d code.