HomeMy WebLinkAboutONSITE SEWAGE DISPOSAL SYSTEM PERMITSTATE OF FLORIDA
DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES
ON SITE'SEW/AGE DISPOSAL SYSTEM CONSTRUCTION AND INSTALLATION PERMIT
Authority: Chapter 381, FS
Chapter 1 OD-6, FAC AS
1 rCaa�g. �V°0:
Permit Number as%�i5
PART I - SYSTEM CONSTRUCTION SP IFICATIONS AND CONSTRUCTION APPROVAL----------------
Treatment. Tank Minimum Draintrench OR Minimum Absorption
Size Bed Size
Septic tank Grease
aerobic unitegallons interceptor gallons Square Feet 137.5 Square Feet
Septic tank or -
aerobic unitgallons Dosing tank gallons - Square Feet Square Feet
araywater
tank 1 allons Square Feet Square Feet
waste"I
Other F
a) Inst
b) As)
c) Fin,
d) Inve
InvE
I nvE
I nvE
;e) - Fill
Ot
k �iallons Square Feet Square Feet
uiremen
lation must be in accord with requirements of chapter 1 OD-6, FAC.
tem const uction permit' valid for a period of one calendar year from date of issue.
installatio inspection d approval is required before the sys 9m i&covereA
'of stub-o' t for to be benchmark.
of stub-oljt for to be benchmark.
of stub-
o�t for to be benchmark.
of stub-ol t for to be benchmark.
jality and iiquantity: A L4� )
EXCAVATION MUST BE•CHECKED.
BY THIS DEPARTMENT PRIOR TO
�I DRAINFIELD INSTALLATION.
TO.SJTURATION FROM ROOF DRAINAGE, ;
RnnF mlisT RF G TTFR .D PRTOR TO'
FINAL.1 APPROVAL.
ystem design and
onstrgcti in autho
ote:
JDIT
ipl.eted.
NTROL
ications by:
by:
Title
Dateld�z
Countyfyblic Health Unit
es of this form will be provided to the applicant, installer and the building department.
N° 57283
Form 1016, Feb 85 (Obs„ Metes previous editions which may not be used)
cumber 5744-001-4016-0) Page 1 of 2