HomeMy WebLinkAboutON SITE SEWAGE DISPOSAL SYSTEM�tI T$E
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Applicant
Septic tank
aerobic unit
Septic .tank
aerobic unit
G raywater
tank
Laundry
waste tank
STATE OF FLORIDA
DEPARTMENT OF HEALTHAND REHABILITATIVE SERVICES
ONSITE SEWAGE,. DISPOSAL SYSTEM CONSTRUCTION AND INSTALLATION PERMIT.
Authority: Chapter 381•, FS
Chapter 1 OD-6, FAC 7 i t
r n, ` 1 2 a��F�Q'r , Permit Number i�
J."
1T 1 - SYSTEM CONSTRUCTION SPECIFICATIONS AND CONSTRUCTION APPROVAL .................
Treatment Tank
1 Grease
gallons interceptor gallons Square Feet
gallons Dosing tank gallons Square Feet
— gallons Square Feet
gallons it Square Feet
Minimum Draintrench OR
Size
Minimum Absorption
Bed Size
r
�` l -75- Square Feet'
Z.
Square Feet
Square Feet
Square Feet
,
Other Require dents:
(a)• Installatio '� must be in accord with requirements of chapter 1 OD-6, FAC.
(b) A system construction permit is valid for a period of one calendar year from date of issue.
(c) Final installation inspection and approval is required before the system is covered. ,, f
(d) Invent of st�I b-out forr''�: i <:�, to be benchmark.
Invert of stlab-out for to be r benchmark.
Invert of stub -out for to be benchmark.
Invert of stJlb-out for to be benchmark.
(e) Fill quality and quantityg_ j < K c=- G- �, t),/) `0,;u ;..r, _, f `� X ( �ti ✓
I` EXCAVATION MUST BEE CHECI,LD � .
BY THIS DEPARTMENT PRIOR TO
IDRAINFInL D INSTALLATION.
.III
(f) Other -IF A" EA Cif' DRAINFIELD IIS SUBJECT TO SA`xURATIOW
.ROOF 'iMCTST 131, GUTTERED P-RIOTS TO FINAL APPROVAL.
System design 4nd specifications by:
Construction authorized by:
i St. L,tic.ie
Note: Complete
AUDIT CONTRO
HRS-H Form 4016, Feb 85
.(Stock Number.. 5744-001
a
County Public Health Unit
Title
Date
copies of this form will be provided to the applicant, installer and the building department.
NO. J ,.370,nOf- +
SQUARE MILE
6-0)
previous editions which may not be used) -
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