1988-821 •
CERTIFICATE' OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date November 15 19 83
•
This is to certify that work requested to be done as shown by Permit No. 38-821
has been completed.
This structure may be occupied as a MOBILE HOME — SINGLE FAMILY DWELLING
Location , OHIO AVENUE LOT° 5i4 &515
Owner JOHN DALY BR.
By Order Town Board
TOWN OF QUEENSBURY
/7
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Building & Zoning Inspector
BUILDING PERMIT
TOWN OF QUEENSBURY
No. 88-821
WARREN COUNTY, NEW YORK •
PERMISSION is hereby granted to John Daly sr.
OWNER of property located at Ohio Avenue Lots 514 & 515 Street, Road or Ave.
in the Town of Queensbury,To Construct or place a Mobile Home
at the above location in accordance to application together with plot plans and other information hereto filed and
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
1. OWNER'S Address is
RD#4 Box 222 Ohio Avenue
Glens Falls,New York 12801
2. CONTRACTOR or BUI LDER'S Name 9-'
)-C
Kenneth Cassant
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3. CONTRACTOR or BUILDER'S Address 0
Box 608 RD#4 Big Boom Rd
Glens Falls,New York 12801
4. ARCHITECT'S Name
O
4.
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5. ARCHITECT'S Address
CD
CD
6. TYPE of Construction— (Please indicate by X)
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( )Wood Frame ( ) Masonry ( ) Steel
7. PLANS and Specifications sr
No. 66'8" x 14' Mobile Home as per plot plan and application, including u,
septic. VARIANCE # XXXI 1431
8. Proposed Use
Mobile Home Single Family Dwelling
25.00 C/O
$ 108.00 PERMIT FEE PAID —THIS PERMIT EXPIRES MAY 1 1989 0'
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(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the
ro
town of Queensbury before the expiration date.)
0
Dated at the Town of Queensbury this 26th Day of October 19 88
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SIGNED BY . �7,/r' for the Town of Queensbury
Building and Zoning Inspector
;a - 4. - •
�j TO DE COMPLETED BY f1LUC. DEPT. 7'
...hill'', 01 QupriiJlWry Application No. D +L � _ j
BUILUING env ZONING D[PARTMNT • Permmit Issued 39
Permit •
Deeire tion • --�_ O 'T 1 8
Bay and Heviland Road, R.D. 1 Box fl8 • Zoning Dcieignation
OuuensOury, New York 12801 Varianc-
6UiLD1NG & CODE DEPT.
_ Site P• an ReVie • • ;�
I � APPLICATION FOR A
�+ PPr ,*" ' : - l Dg
el
MOBILE HOME , .1! f , . ��'
P.UILDINO AND ZONING PERMIT I '/(5120
. * * * * * * * * * * I * * . . . . * * • * * * . * *• * * * * * * * *::.
A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION. ANSWER ALL OF THE FOLLOWING.
The undersigned hereby applies for a Building Permit to do the following work which will
be done in accordance with the description, plans and specifications submitted, and •such '
special conditions as may be. indicated on the Permit.
The owner of this property is: :1-77/(1 f i79J1/ e 4�� 1_41 1 /�1�
P.O. Addre�8 ice-=' {
�D -V io f' ,2 DfYD iu uF (3/Eivs /ls/0 Tel. 79.2O c
Property Location: (WO /T11/_" L5 “/ 9 es /` . . 'street nuubur or building lot number Tax Map No.lZ�y /d f �'
Subdivision name (if applicable) •
CPAR� F
THE JERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS
gi_,u, vo
P.O. Address - • T
• e1. No.
Name of Installer /,5- ,0/3 4 Addrese linL✓IFSl n
Name of plunOur � 3Gl'� � (,�C Tel.
Address Tel.
Name of mason Address Tel.
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MOBILE HOME INFORMATION: w . ZONING INFORMATION:
New Home Placement )/- . '3 PLOT PLAN5l7UST BE PREPARED. AND SUBMITTED,
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Replacing existing Home drawn reasonably to scale and attached hereto,
i �/ " showing clearly and distinctly all buildings,
Size of new Home�C^, X /� ft . • " whether existing or proposed and indicate all
Single wile set-back dimensions from property lines. Give
I • .F� Double wide • street and number or lot number and indicate
No, of rooms (excluding baths) ' whether interior or corner lot. Show location
No. of bedrooms * of water supply and location and configuration
of septic disposal area.
No, of bathrooms / '
COMPLETE INFORMATION REQUIRED BELOW.
Fireplace? JUQ Wood stove? ,4)0 +
Size of property 6D ft X /OD ft.
Foundation style and size: " Existing building(u) Size ft X ft.
+
Piers- No.of Size- - ft x ft. + Existing building (s) Uue
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Depth below grade ft.
FOUNDATION - Poo tin size l * Proposed building, disLance from property line.
_ g /.i`F�' X ,,2, "
y
+ Front_ yard ,D ft Rear.Wall material Yard4�� f t
» Sid. -yards /0 ' ft and ' ,q0 ft
Wall thickness " Height ft. + If on comer, setback from side street ft
Total depth below grade ft. OCCUPANCY INFORMATION
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Grade to •Home floor level ft. . PRIMARY BUILDING -
* * + One family dwelling •
• Two family dwelling •
Proposed date of placement/0 / / / " Multiple dwelling / Number of units
Aprox. Value, of Home $ / 7/ DOD + ._..Pe rmanent occupancy
Water supply - Well Municipal t/ " Transient occupancy
p . Business
Septic Permit required? V - + Inhertrial
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other •
e If addition, what will use be?
FURTHER INFORMATION REQUESTED •
11 ACCESSORY BUILDING-
ON THE REVERSE SIDE OF THIS SHEET.*
Detached garage/one car/ two car/ car
' Attached garage/one car/ two car/ car
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* Private storage building
' Other
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Form MIl P 5/06 and-vl
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APPLICATION FOR MOBILE HOME PERMIT, (CONTINUED)
State of New York Division of Housing and Community Renewal
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INSIGNIA OF APPKOVAL OF THE STATE . BUILDING CODE
I . INSIGNIA SERIAL NUMBER A/ 72 .1 j//
2 . NAME OF MANUFACTURER /--/O//y •
3 . PLAN APPROVAL NUMBER •
4 . MODEL OR COMPONENT DESIGNATION •
5 . MANUFACTURER.',.S. SERIAL NUMBER 141 /44( '?/- <' /OS
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G. DATE OF MANUFACTURE •.3ACAR
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Ail the above information is to be found on •a plate or sticker which
should be affixed to the Mobile Home. Complete..above with that information. •
A 4 4 4 4 4 4 4 4 4 4 +1 4 4 4 4 4 4 4 4 4 •4 4 ' * 4 * 4 4 4 4 4 4 4 M 4 4 4 4
Town of Qucenubury
County of warren A F F I D A V • I • T STATE OF NEW YORK
I swear that to the best of my .knowledge; and belief the statements contained
in this application, together. with the plans and specifications submitted, are a true and
complete statement of all proposed work to be done on the described premises and that all
provisions of the BUILDING CODE, THE ZONING ORDINANCE, and all other laws pertaining to
the proposed work shall be complied-with, whether specified r not, and that such -work is
authorized by the owner.
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st—N.
Signature_ �2'1� _--
er, •owner's agent,arcnitect,contractor
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• • • • * • ,• • or ,* * • '* • • * * * • • •• * • * * * * • * • * *- * • * • • • • • * * * • * ••
SPECIAL CONDITIONS OF THE PERMIT: •
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...?,74.11, ateaLie-al
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DATA
APPLICATION FOR SEPTIC DISPOSAL PERMIT • 20HIHG L GLDG CODES
10Vitt OF QUE /a11UkY
DATE • ( o2 ( / •
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LOCATION OF PROPERTY FOR INSTALLATION O#/Q /Q() .
/�JE/J
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Owner's Name: f-7AJ t(Y.,4/2OL 0/52,2/ Telephone: 2910
Address: 130,1/,22? D y , /C-1.3OO/1/ Ems- G/EIS �f 15 /U Grp 142,4< 42,W/
Installer's Name: /�� >F (2% /94� Telephone: 79�-Oi�
/r�1�/,
Number of bedrooms (residential only) _ _
Total daily flow (compute @ 150 gal per bedroom) _ .�00
Topography: circle one:iter Rolling Steep Slope % of slope
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Soil Nature: circle one: Sand Loam Clay Other / Depth: feet
• Ground Water: At what depth? feet
Bedrock or Impervious Material At what depth? _ 6--- feet
Percolation test: circle one: t required required / rate min. inch.
Domestic water supply: circle one:. Munich • Well Other
IF domestic water supply is a Well:
Separation: Watersupply from Septic absorption feet
PROPOSED SYSTEM: Septic Tank /000 gal. (minimum size: 1,000 gal.)
TILE FIELD: Each Trench feet / Total system length feet
SEEPAGE PIT(S): Number of / / Size each l> feet by /0 feet
Size of stone to be used •II 3 / Depth or Thickness feet
44 . * * * * 4 * * * * * * * 4 * * * * * * * * * * * * * * * * * * * * * * *
IMPORTANT
...Please...LIST NEW EQUU M.:N'1"1'O BE INSTALLED •
* * * * * * * * ► * * * * * * s * * * * * * * * * * * * * * * * * * * * * * * * *
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(over)
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Section II Septic System Inspections: •
A. All applications for septic system installation, alteration or repair, as
;, required by the Town of Queensbury Sanitary Sewage Ordinance, shall
be submitted to the Building Dc u t neut at least 24 hours before start
of construction and shall include a plot plan showing:
1.) the proposed location of the: system
2.) location and distance to lot lines
3.) location and distance to structures
4i.) location and distance to any water supply
• 5.) -size and dimensions of all tanks, distribution •
boxes, tile fields and/or drywells
B. No system shall be covered before inspection and approval by the building
Inspector. Failure to comply with this requirement may result in the
uncovering of the system by the installer and a fine of up to $250.00.
C. An approved copy of the plot plan shall be available on the construction
site. Failure to produce said plot plan at time of inspection may result
in an immediate work stoppage.
D. Should unforeseen problems during construction prevent proper installation, •
alteration or repair of an approved system, a new proposal must be submitted
to the Queensbury Building Department before further construction.
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I have read the regulations above and agree to abide by these•and all requirements
of the Town of Queensbury Sanitary Sewage Disposal Ordinance.
• Signature of responsible person: 4/P7A d
Date: /c2
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Town of Queensbury
Building and Code_Department
Bay at Haviland Road
Queensbury, New York 12801 •
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• (518) 792-5832
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7' 11 1
- YOU ARE-HEREBY REQUESTED TO j;
- INSPECT AND ISSUE CERTIFICATES
- ' • - :. FOR THE FOLLOWING ELECTRICAL- , :II.. ' - -;"
- . EQUIPMENT TO BE INSTALLED_BY = ,.-
•
THEUNDERSIGNED 1s
. ' TEMP.H - • ' - DATE j. • ; -
CITY OR VILLAGE _ - TOWNSHIP' COUNTY ' }
STREET AND NO.OR ROAD .- II POLE NUMBER
- . /:,')/ -.-%.1 . ./, /- 0/:/:.'c) -/-,/i; " Cc c <e C o So t;� Aixa�Ci t tO - /e--
BETNIEEN WHAT TWO CROSS STREETS IS PREMISES LOCATED?. .- .• - . ,SECTION . • BLOCK . • .. - 1 • - .LOT- .
r— I cam- _r/`7 / _ Ii'
OCCUPANTS NAME.- ...- BUIL CCUPANCY - -II -
- .� ,% ., '�i ' /.J/�a:A //'` f, /.1 /• t r/1 .5/7)a.,r// - - ��/7,-7, -
OWNER'S NAME A-„�II DADORESS J - - - HOME TELEPHONE NUMBER—_. • -
CURRENTSUiPP/}'TED BY - ' / //,, FROMT,HtEIR-_ - - -' , OFFICE ' , / ' WORK TELEPHONE NUMBER-
- A 1,/.ir,.. _V ,�, �,/7/!:A///�1ijJr'1 -" -. �!✓=--;' / A j/� - II
BUILDING IS /,/J - - '' / - '
NEW PM . . - • -OLD❑ - - • WORK IS . NEW❑ - ADDITIONAL❑ I, DEFECTS REMOVED❑
• -. '- LIST BELOW-ALL EQUIPMENT WHICH YOU INSTALLED II - -
NUMBER OF OUTLETS -No.of Fixtures&; BRANCH ;OFFICE USE
Loca- - - -- - Lamp Receptacles . MUI• UR$ HEATERS. CIRCUITS . 6 ONLY
lion Side Attach't • H.P. Watts A.W.G.
Ceiling- Wall . Recep'Is Switch Pendant Bracket No: Type Each NO- Each Na Gauge INSPECTION -' .
il
SIDE: > - - ,
SUB- - . - -
BASE - • `- • - - -
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MENT - - • . - - • 9i.
1st•. - - - - - ii - -
2nd - . ' - -
. . it --
3rd - _ - - - . 1I
FL. - '
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REMARKS:LIST OTHER ELECTRICAL DEVICES NOT SET FORTH ABOVE: . • - • - f. "_
It.
THIS APPLICATION IS INTENDED TO COVER THE ABOVE-LISTED EQUIPMENT TO BE INSPECTED,BUT IF AT TIME OF INSPECTION,THERE IS - •
FOUND ADDITIONAL EQUIPMENT NOT ABOVE LISTED,YOU ARE AUTHORIZED TO MAKE THE INSPECTION AND ADJUST TOE FEE TO COVER
THE ADDITIONAL-EQUIPMENT,AS PROVIDED BY THE APPLICANT. - -- - - '
SIZE OF MAINS FEEDERS - .ELECTRIC SIGNS/LAMPS - " ' '. -TOTAL WATTS
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.. CI-ILI� ER OF WORK ,_,I r g EXPOSED GAS TUBE SIGN/TRANSFORMERS OF, li - VA
// /:'///'i /-' ;/ _-/ li./l`+`•- - 0 CONCEALED - _ . .
DATE WORK TO BE ST RTED , _- DATE OMPLETED SIZE OF SIGN(NUMBER)- - - -I - CAPACITY
SERVICE ENTERS BUILDING - `� - ' / /- . 'MANUFACTURER OF SIGN
• 0 OVERHEAD . - - IW UNDERGROUND II� -
DATE INSP���REpUE�'D.O :NEAR AS POSSIBLE) - ', MUST ENTER APPLICANTS
/ 7 • IDENTIFICATION NUMBER I I II
AVOID DELAYS BY GIVING FULL AND ACCURATE INFORMATION.ALL SPACES MUST BE FILLED IN OR APPLICATION MAY BE RETURNED.
PRINT:NAME AND ADDRESS: ti
NAME OF APPLICANT -----;j"r:'- ', /3 / D/AT •F APPLICATION, SIGNATURE OF A/PPLICANT
• A,--.4I/// `/T" i////_ "( i)L,///;tl/ .! : /,/.5. X ;ram -A! /�� I
/ ' TELEPHONE NO:. _ . .
.• . . . _ ..
. STREET ADDRESS - .i•. //. •
/yC� / /
- 7.7::,1/l :'y /. ,/r_.c// /i-> ,. -' . �./1_,t i// -/J.'// - _ - - //I:'. - i�(J- -.t . .
CITY OR POST OFFICE- - >/ % : - . ,Z P CODE-: LICENSE NO.WHEN APPLICABLE --
)c l /i•. '
❑ 85 John Street - 41 State Street- ❑ 584 Delaware Avenue 0'217•Lake Avenue --- 01202 Arterial Road
NEW YORK,NY 10038. ' ALBANY,NY-12207 - BUFFALO;NY-14202 r 'ROCHESTER;NY 14608 i)SYRACUSE,NY 13206
- Tug"nipviv.vnpv RnQRn (IF FIRE- I INf1FRWRITFRS
,i------ ------,, .. /
TOWN OF QUEENSBURY AP/
BUILDING AND CODES DEPARTMENT
BAY & HAVILAND ROADS
QUEENSBURY, NEW YORK 12801
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT/
REQUEST FOR INSPECTION RECEIVED //// (/ g"
NAME -- � y
LOCATION 0.-.,/ - /
DATE ///��j �/c� PERMIT # 9-- 'I/
/.
APPROVED
. /
/YES NO
FOOTING/PIERS /
MONOLITHIC POUR FORMS
FOUNDATION/DAMP-PROOFING
BACKFILL APPROVAL
ROUGH PLUMBING
FRAMING \
ELECTRICAL ROUGH-IN
INSULATION':\ /
FOUNDATION
FLOORS \ /
WALLS \ /
CEILING
�INAL INSPECTION'.
CHIMNEY HEIGHT \
ROOFING (fl
SIDING /`f//�(/'l q.
EXTERNAL PORCHES/STE S /
STAIRS-CLEARANCE & RA S A
PLUMBING FIXTURES RELIE VALVE INTERIOR TRIM/PR./VACY DO S
FINISHED FLOORS /
GARAGE FIREPROO'ING
DOOR CLOSER(S)
SMOKE DETECTO S
FINAL ELECTRIC L INSPECTI-ON
FINAL APPROVA OF CONSTRUCTIONL.
A SIGNED CERTIFICATE OF OCCUPANCY MUST E
OBTAINED FROM THE BUILDING DEPARTMENT BEFORE
THESE PREMISES ARE OCCUPIED!
REMARKS:
- 1 f
G� L_ 7 G7
I SPECTOR
I NFORMATION FOR BUILDING DEPARTMENT 1
WE ARE IN.THE PROCESS OF. ISSUING A CERTIFICATE -
OF COMPLIANCE FOR THE ELECTRICAL INSTALLATION
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AS COVERED IN AN APPLICATION FILED WITH OUR
DISTRICT OFFICE. - I
THE NEW YORK BOARD OF FIRE UNDERWRITERS �I ;
• e
`' • APPLICATION ND
FY ZZ2- U
LOCATION c I
� 1 3 � TO j
i>., DATE
`r- FORM IBD(REV.1/86)
Town of Queesj.. .,,
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
BUILDING INSPECTOR' S REPORT
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NAME
tl
LOCATION I -;� i1e)
Date III /66 Permit No.
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* * * * * * * * * * * * * * * * * * * * * * *
✓ = APPROVED - Y S / NO
\Footing/Pier Forms
Foundation
Waterproofing
Backfill
Framing
Roofing
Siding
Masonry Ven er
Rough Plumbig
Relief Valves\
Ext. Porches \
Finished Floors
Interior Trim \
Stairs & Railing`
Cellar Drain Tile\
Concrete Floors
Plbg. Fixtures
Gar. Fireproofing /
Door Closers
Smoke Detectors /
Chimney /
INSULATION:
Foundation
Floors /
Wails
Ceiling
FINAL LECTRICAL INSPECTION \
DRIVEWAY APPROVAL A, .
Final Building Survey
Next scheduled inspection (call when ready)
Remarks-
/ )
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,� kk+ \+-' tI L' C j/,
cotott►
Building flspector
6/86 and-vl
Jotun o� Quemitury •
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME .-.MTI )
LOCATION ( :-^', "t; '.
DATE 1'I '- / ri PERMIT NO. Y'-,."
1s
SOIL TYPE - Sand - Loam - Clay -
Percolation Test Required? YES - NO
Percolation rate - Min/Inch
• TYPE of SYSTEM:
Absorption field, total length
Length of each trench
Depth trenches
Size of ravel'_ _
SEEPAGE P TS-Number of) _ /
Size- t. X _ ft.
Gravel size
PIPING: S'ze Type
Bldg. to tank
Tank to dist. .x
Dist. box to fi- d/• t�
Openings sealed? ES.. NO Partial
LOCATION/SEPARAT • S:
Foundation to t. k
n ft.
Foundation to ...sorp ion ft.
Absorption to of li e ft.
Separation of pits ft.
LOCATION OF :YSTEM ON PROPERTY(circle one)
Front - Rea, - Left s'de - Right side -
COMMENTS:
SYSTEM USE APPROVED YES) NO
1`.
Biiild'ing" Inspector
01/86 and vl
Jown of 2ueCni1ur,
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME - Ok-h...) er A-.
LOCATION(")( b t= _.)
•
DATE b I /J PERMIT NO. 8 - /1
SOIL TYPE - , lD - Loam - Clay -
Pe olation Test Required? YES - NO .r•'
Per lation rate - Min/Inch _
Ea
TYPE o SYSTEM: ;f
Absorpti field, total length_,;''
Length of ach trench
Depth of t nches / .
Size of gray I I' _
SEEPAGE PITS{ umbhr of) �, Z
Size- 6p ft. ft./'
Gravel size /
PIPING: Size Type
Bldg. to tank
Tank to dist. box 11/ 4L �l/(v
Dist. box to field kit 4 I)
Openings sealed? l YES NO /gartia9
LOCATION/SEPARATY•5ONS
Foundation to if 1 ft.
Foundation to�yfbsorption ft.
Absorption toy lot line ', /9f t.
Separation of pits ‘ /0 ft.
LOCATION OF'SYSTEM ON PROPERTY(circle one) •
(Fron - Re r - Left side%- Right side -
COMMENTS: A
;►
OK /D 11" /,41\/,< -4- -0,46-� ./
ore - ,�sr --
£.-c, i. 7 -1 �0 dc ,�
w
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SYSTEM USE APPROVED YES ,NO>
''''' /LZ4 )a.a-/- 4 •
Building I s ector
01/86 and vl
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