HomeMy WebLinkAboutSEWAGE CONSTRUCTION & INSTALLATION PERMITApplicant
Septic tank
aerobic uni
Septic tank
aerobic uni
Graywater
tank
Laundry
waste tank
'Other Requ
STATE OF FLORIDA
DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES,
ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION AND INSTALLATION PERMIT SCANNED
Authority: Chapter 381, FS ��
Chapter 10D-6, FAC ���'S-ONF14k/
Permit Number
G
PART I - SYSTEM CONSTRUCTION SPECIFICATIONS AND CONSTRUCTION APPROVAL -------------
Treatment Tank Minimum Draintrench OR . Minimum Absorption
Size Bed Size
Grease
gallons interceptor • gallons Square Feet / Square Feet
xRJ
_ gallons Dosing tank gallons Square Feet Square Feet
gallons
gallons
Square Feet
Square Feet
Square Feet
Square Feet
(a) Installation must be in accord with requirements of chapter 10D-6, FAC.
(b) A syst m 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 c vered. �� benchmark.
(d) Invert f stub -out for _,���- to be �� ���
Invert q'' stub -out for to be benchmark.
Invert �f stub -out for to be benchmark.
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Invert f stub -out for to be benchmark.
(e) Fill'
f
and quantity:
EXCAVATION MUaT BE CHECKED
rNcnTDTMT:TTT TYRTOR T
DRAINFIELD INSTALLATION.
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Other: I�
IOOF MUST BE GUTTERED PRIOR TO FINAL APPROVAL.
I,
System des n and specifications by:
authorized by:
Public Health Unit
Title �'5,7
Date b
V
j Note: Complleted copies of this form will be provided to the applicant, installer and the building department.
AUDIT CONTROL NO. 62043
I
HRS-H Form 4016, Ieb 85 (Obsoletes previous editions which may not be used)
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