HomeMy WebLinkAboutSeptic As-Built Card, ins
Town of Yarmouth 26 N CIS
Subsurface Sewage Disposal System As-Built Information !1 ti-x 3 oevtO6 is
Street Address: 0 '^1Q 6-it- Map: `S Parcel: C`/.
Owner Name: k`"" OCkrbcR.ks Permit#:4oCiDC"-- -O5'3
Date Installed:/60-5/200NV Repair:
Installer Name: RD✓L5 w Installer Phone:"5015 07 cri 77
Installation of(list all components, both newly installed and existing to remain in use):
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Leach Capacity(gpd): 330 Ground Water Depth (inches): Pri Health Inspection by: 12--
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• As-built Diagram
(Print Clearly in Black/Blue Ink and Use Straight Edge)
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