HomeMy WebLinkAboutSEWAGE INSTALLATION PERMITm STATE OF FLORIDA
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V DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES
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E ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION AND INSTALLATION PERMIT
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•,�r'DD WETAuthority: Chapter 381, FS
Chapter 1 OD-6, FAC SCANNE
Applicant IQ 6 `Permit Numedr L ; �
rU $ .
---------------PA T -�YSTEM CONSTRUCTION SPECIF IONS AND lDraienqh,
RUCTION APPROVAL---------------
Treatment Tank Minimum OR Minimum Absorption
Size Bed Size
Se�tic
tank fiI
Grease n��??11
b interceptor Square Feet Sw Square Feet
aerobic
Septic
unit
tank 01,
jalIons gallons
CS(I K9
aerobic
unit
gallons Dosing tank gallons Square Feet Square Feet
G raywate
r
takk
gallons Square Feet Square Feet
Laundry
waste
tank
gallons Square Feet Square Feet
Other
Requir
,ments:
(a) Installatio' must be in accord with requirements of chapter 1 OD-6, FAC.
(b) A system , onstruction permit is valid for a period of one calendar year from date of issue.
(c) Final inst I�Ilation inspection an approval is required before the system is covered.
(d) Invert of s ub-out for to be I�OADbenchmark.
Invert of s ub-out for to be benchmark.
Invert of s ub-out for to be benchmark.
Invert of a ub-out for to be benchmark.
(e) Fill qualit and quantity: AxT _ / -�„--Jj
BY THIS DEPARTMENT PRIOR TO
c/
(f) Other:
F AREA, OF DRAINFIELD IS SUBJECT TO SATURATION FROM ROOF DRAINAGE,
OF MUST BE GUTTERED PRIOR TO FINAL APPROVAL.
m design and specifications by,
nstructionIauthorized by:
County Public Health Unit
Title eS
Date
ote: Comply ted copies of this form will be provided to the applicant, installer and the building department.
JDIT CONT OL NO. No 37866 SQUARE MILE
Form 4016, Ft 85 (Obsoletes previous editions which may not be used)
Number. 57441001-4016-0) Page 1 of 2 Z