HomeMy WebLinkAboutSWG94-00279 - SWG As-Built •
AS-BUILT FORM -. PAGE TWO A..1..d 08/24/94
PARCEL IDENTIFICATION - I
1
Applicant' s Name ,, - A/0 (f
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Permit Number SWG9 "� - �`�- / Subdivision
' Cvamefuivision/gsiock/Lot)
Installer's Name 'Ci4 evt i'J -ram Assessor's Parcel No. .•-lsQ.2/>>+" .- ?Oai
Twelve-IDigiL Number)
Designer's Name 'S0Y C ,Tv1,X So N
I AS-BUILT DRAWING
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CAUTION: Minor adjustments to septic bank location and dreinfield orientation made in the field by the installer are generally ac-
ceptable to both the department and the designer, but could in certain cases compromise the viability of the system. It is the in-
staller's responsibility to obtain prior written approval from either the health department or the designer before making any devi-
ations from the design that affect system viability. Any deviations from the approved design must be shown above.
AS-BUILT CHECKLIST I
I--4 f
L .J Observation port location Undisturbe native soil
► bj Drainfield orientation between tr ches
and layout 1-1
L& Cleanout location f�
1 � r' North arro
Trench/bed dimensions and
critical distances within Manifold placement I--I
1--I Scale of d awing shown
n
layout Orifice placement on scale bar
1 1 D-Box/"T"/"L" location L�
l. Lateral placement, with Additional Mound Information
U L
Septic tank/pump chamber distances to edge of bed U
location Endslope width
Location of wells, roads
uLocation of buildings U Overall fill dimensions
H c i ite ; a-r )(TT Mason City D
Panted from Mason County DMS