Laserfiche WebLink
PARCEL SIZE 38. 0 a APN <br />o L)gJQ <br />66 <br />CRY/STATE/ZIP 71g/t/ G.1 ,9711 <br />/41 LICENSE 0 _C-42 0 LC-36 OTHER <br />TYPE OF WORK: NEW INSTALLATION <br />REPLACEMENT <br />Crry/Zip <br />/1 Vol/ <br />OWNER NAME !A. h./A, do 7„,,,Nezz._ <br />OWNER ADDRESS Po I ox 6 9,5” <br />CONTRACTOR .6111,8 r let4.21.10 Cir ' <br />CONTRACTOR ADDRESS / d_ <br /> <br />NUMBER B.XPIRA1ION DATE „4, <br />o -6() WATER TABLE DEPTH: ft GEOGRAPHICAL INFORMATION: Coordinates X <br />JOB ADDRESS <br />CROSS STREET 67-• rry <br />PHONE <br />PHONE '1,4 <br />i-c)4 ke ro roi C4 ck--,1*-7 <br />'T <br />CITY/STATE/ZIP <br />PERC TEST # BUILDING PERMIT # <br />k....-REPAIR/ADDIT1ON <br />_ OUT-OF-SERVICE SEPTIC SYSTEM <br />_ ENGINEER DESIGNED /ALTERNATIVE <br />_ DESTRUCTION <br />LAND USE APPLICATION # <br />42-01 <br />4/14/18 <br />ONSITE WASTEWATER TRTMNT SYSTEM PERMIT <br />afif.4 <br />g- <br />IMO <br />Application Accepted By <br />DEPAR <br />Date <br />TMEN <br />0 <br />T <br />4 <br />,U*E ONLY <br />Area L.] q e) Employee ID# DA /91 <br />Final Inspection By '1I9563P,,C Date fIjv/7J -"ro SPECIAL PERMIT Approved by <br />Character of Soil to Depth of 3 Ft: Pit/um p S Sracter: <br />COMMENTS FA i I Cys-te wt. No del& 14+ t14,01 setbAcks per END recoras- -Per It <br />PE <br />Code <br />SC <br />INFO <br />Receive <br />y <br />Check#/ b? <br />IsCash / <br />Amount <br />Remitted Oat , <br />q <br />Permit/ <br />Service Request # Invoice # Permit ID# <br />Lial° 11S— <br />1 1? 7 4?-00 Gatxg3s44 1 <br />PAYMENT <br />RECEIVED <br />FEB- 11-4 2021 <br />J ArQUIN COUNTY <br />ENVIROAIMENTAL <br />EALTH DEPARTMENT