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DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 4.19 -1 -8 BOX 3 .. I,yL , ,,� � r `I . am J6 ,. Ile '1 r I 'j . I I r 11 � �� {� .� l ■ AJ I w 1 '. NMI m Q..__v� LOCGI Bl oC G7 �0C__ -_ != y- � =__ ^� , ^= �J. ~- ____J.�.. �..._ -� _.• -- ��_____ -. .._ � = ^_ V� -I• - -_ _vim ��_MJ__. � 0F V zi ij T- 1 �er 0"i, Inve& sc-I—Le) - Wd v-9et&,yo,,,e 6 Poured /7i -4?. Afa,ihcla' to be crtendqd to Surface murder toot moy be GO�VSW fo dose o1/ ehed Y'O* depth over ferej file or P,)" is tscd •/0 v sircriom L-3 7", ,eamove S / �, a, a,,9mal ground • 15tsR D t... ±": X box ryPICAL FILL SICTIOM -F,09 91-DiPING• -GgOUAPO et 4AI OF FILL SEC710AI --4 1 o. TA K-- J'Vljc�t )CIO :S.c, i7 - P-r v r7 50 A 6 ALL CONSTkOC11ON T o C O N f 0 K I 1111 A- TO 'E L0 C A L COUNTY —., , , , c J-� �l -�, \ Folded 6 $lea prrcESs jr YR/ c4C ,va A4 r* s I e i f PU C 0 AI;V IE C)II 0 M TYPICAL jEr- Aump C 0 W, Af f c f/ o'm W-f L I DfTAIL•S At# r r 0 - 5 c4 L f rL- c kA _,..__ III ��- � r _ 4 to coato"s A -aK. to odddwollalcrol row J r01", for total lcrntf) L. Afa,ihcla' to be crtendqd to Surface murder toot moy be GO�VSW fo dose o1/ ehed Y'O* depth over ferej file or P,)" is tscd •/0 v sircriom L-3 7", ,eamove S / �, a, a,,9mal ground • 15tsR D t... ±": X box ryPICAL FILL SICTIOM -F,09 91-DiPING• -GgOUAPO et 4AI OF FILL SEC710AI --4 1 o. TA K-- J'Vljc�t )CIO :S.c, i7 - P-r v r7 50 A 6 ALL CONSTkOC11ON T o C O N f 0 K I 1111 A- TO 'E L0 C A L COUNTY —., , , , c J-� �l -�, \ Folded 6 $lea prrcESs jr YR/ c4C ,va A4 r* s I e i f PU C 0 AI;V IE C)II 0 M TYPICAL jEr- Aump C 0 W, Af f c f/ o'm W-f L I DfTAIL•S At# r r 0 - 5 c4 L f rL- c kA _,..__ III ��- � r _ +: 0 y + . CONSTR UCTI O Located at- 8 ` ii Subdivision owner Address Bwidin9 TYPe 16t 1Q Lot Area l -f /fYis .� ya►� /.` iY'� 7 0 ' Number of Bedrooms �P Total Habitable Space` ® Cfi ° Square Feet Separate Sewerage System to consi`sf of f��'� Gal. Septic Tank .� Jineal feet 'X ,� �+ w idth 'trench' •. /� S"6a To be constructed by �AE/ %dai? ,: © �H y` Address Water Supply: ublic:Supply From it Private SuPPIY to be,drilletl by ii Address f Other .Requirements, i.l represent that l`am wholly and completely resporisible for the design and location of /the proposed 'system(s)c`1) that the separate= sewage disposal system 1. ., S`above dgscribed; will be constructed as -shown on,the approyed:amendment there to -and in accorclance,with the standards,' rules and,regu ations o `.the -u nam 'County Department, of Health, and ;that on completion. thereof a "Certificate of,.Construction.COmpliance' satisfactory to the Commissioner of Heaithwill F•be submitted to 'the' Department, and .a written °guarantee will be`furnished' the owner, his successors heirs or assigns °by the bwlder, that said builder wilh' 'place in good operatirig, condition any'•part of. said sewage disposal system during the period of two (21yyears imm diately' following thedate of the issu- ance of the -'a' approval of ;t Fie. Certificate `of :Construcrion' Compliance of "the original - system orany repairs',thereto,' 2j that -the drilled `well `desc'ribed above' Twill be located as shown on the approved plan and that said'well Will -be- installed : in accordance with #h andards rules and regulations of_ ,the Putnam . SCounty`Department'of Heal tFi. .•i ,. - -ems :,_ °,., i_ _ .. . - Date. ti l a� 5�9n PEE ` 'R A. Add A ress License No. �--,- �- rAPPROVED. FOR CONSTRUCTION: T..his approval expires one year from :the date'-issued�` unless `construction of'the`building. has been undertaken "and is revowble;for. cause or_maybe amended .o►:modified.when,consitleretl necessary b ;the Commissione[ of Health Any�change;or alteration of construction, requires a new permit.' Approved fop disposal of ome , " a "ry se age a or, rrvate wat supply only Date s►�r' By T ilt le