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D O H CONSTRUCTION - INSTALLATION PERMIT
STATE ,OF FLORIDA DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION AND INSTALLATION PERMIT Authority: Chapter 381, FS s Chapter 10D-6, FAC OV'Applicant I f Permit Number ------------ PART I - SYSTEM CONSTRUCTION SPECIFICATIONS AND CONSTRUCTION APPROVAL------------ i t Treatment Tank Minimum Draintrench OR Minimum Absorption . ,. Size Bed Size I. Septic tank Grease. l aaerobic unit ©� gallons interceptor gallons Square Feet— Square Feet Septic tank or aerobic unit �' gallons Dosing tank- gallons Square Feet Square Feet Graywater I; tank gallons Square Feet Square Feet Laundry waste tank gallons Square Feet Square Feet .other Requirements: SCANNED BY (a) Installation must be in accord with requirements of chapter 10D-6, FAC. St Lucie County (b) A system construction pe mit is valid for.a period of one calendar year from date of issue. (c) Final installation inspect' n and approval is required before the syst� gyered. h (d) Invert of -stub -out for - to be benchmark. Invert of stub-t for to be benchmark. Invert of1``stub-ouout for to be benchmark. Invert of stub -out for to k_e benchmark. (e)- Fill quality and quantity: A � 'X 2Z ' S / l f� EXCAVATION MUS BE CHEC D BY THIS DEPARTMENT PRIOR TO DRAINFIELD INSTALLATION. Other:' ther 1IF AREA OF DRAINFIELD IS SUBJECT TO SATURATION FROM ROOF DRATNA9R, APPROVAL. ,,ROOF MUST BE GUTTERED PRIOR TO FINAL PP AL. System design and specifications a -�,-Construction,authorized by:. Public Health Unit Title L S - — Date 71t5 1 C i � J1 Note: Compl ted copies of this f04/ yliill be provided to the applicant, installer and the building department. AUDIT CONTROL NO..1®6 66 4 SQUARE MILE J� g 4. p HRS-H Form 4016, Feb 85 (Obsoletes previous editions which may not be used) - (Stock Numberr5744.001-4016-0) Page 1 of 2