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00418
<br /> wonK ORDER I/ /q-.3C --37-7 • Ttpo,tTp e , acv. ........_
<br /> TAX MAP it 4711 41
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<br /> LOT I • -
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<br /> NAME OF PROPERTY OWNER: ,A4,1 4.(.1‘-c. , cC( i e •,* ,.
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<br /> PERSON REQUESTINO-TEiT: ' . 0.C4•.• ; -'-•'----, , 'LL..."...-L-.4.;-.--....-..................--:-..7.---, , . -.
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<br /> If different front owner .• authorized by owner: ..,,,---"LYES : .-..r....,,..NO
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<br /> TELEPH6NE: 9 / - ) /j ,
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<br /> . DIRECTION/PROPERTY DESCRIPTION: ' : : . . .
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<br /> WORK REQUESTED: . . FEE PAID: - -
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<br /> --PRELIMINARY LOT EVALUATION: ,
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<br /> inn- ANALYSIS -
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<br /> ---""--' IMPROVEMENT PERMIT INSPECTION . I i- : :-- -
<br /> „ . CERTIFICATION OF COMPLETION INSPECTION
<br /> PURPOSE OF REQUEST is to determine suitability for ground absorption sewage dis-
<br /> - . posal system.
<br /> SPECIFICATION OF PROPOSED STRUCTURE: : i: - - ., i” •:. •''-' : I : :_. , • ,,,, ,,,, : :-.:
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<br /> (OWNER OF AUTHORIZED AGENT tA, • ,, , , ' / • , , .
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<br /> •-..-2.."'7..' (This signature indicates pe-rMission has been .ranted to enter property for . .: ..-;;•,'
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<br /> purposes authorized by this work order.)„ .. ";;;;',;;',":!,:',"'"•.':.-% ,. .: ::: . ; .,7:- .-_-,.
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<br /> ':---:•;:- ' CLASSIFICATION OF SOIL FACTORS (CIRCLE): ' :,',,.. :..;;-.::-.;;;;;• ;•;;:.,',-;V.4..,:';'.:;'„:;,-,--. -,•:'i . 1,:";;;.;;,--... "}:',-;.;,-2,-..;„.
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<br /> ;".'.:";..-'-;•)'.,.j;`.' ' • -`,'•,-,,S',.s.',; 'i..*:.:.::':-,„ .-;,';;;;:.,";':'-:.'!." ,".' •.: -;::;- :;•• -:...L: _ 4SLOPE TEXTURE0 STRUCTURE(E DEPTH ;' ''?'._'.',':•;.-'.,,,,'_"-;;,,;,;;,„O...,.•:-•.,;,,..:.';:.f;!:1,',.;.•:-'-:--.:,'":.' ',,":::";;,.•; ..',.F;:::,:•:.',:f. 'o',..,,,••,•:•,,:;-;',.-.;:,
<br /> RESTRICTIVE HORIZONS PS:, ;..,..:
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<br /> DRAINAGE. ,p4,,,,,::, ,, PERMEABILITY (P&*--4,-. • .. ..,,, -,.• ... ' •, ;.; :::„.". ..... '-;:,..:.,.
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<br /> SITE tiASSIFICATION'(DIRCLE):..-.7'.---,--:-. ..".:-.-': :.;!: .'•:,:777#;z"----;.:".:;'"::::;;!..;;; :/1 :: ::',:• "•-•:',.>:'•:-.,'"'?.:-.-7••?, :•"':;--:-."..
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<br /> ..:''...;■:1::;':;;:-:.;'SUITABLE: '. .:: UNSUITABLE , . :.- PROVISIONALLY--SUITABLE: ExPianation: ',,, '-.Z:':::-.„,',„:":::::.,',-.:.;2,,,,,,..'„ ,-.
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<br /> . ' DATE OF ENVIRONMENTAL SERVICES: ti, ■)‘/L'\: ;;lik:`.:7'0 ksOar.," -
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