A29 251.. �j �
CJ l �
�\I��
V
v �;
�� (f jj-j)�110.��1 �y Name: _
~•''���..�- �� Subdivison:
������
lE��sm��e�¢8Il ]E-��mIl�
c
y''SL P��^
System Type: ��
Septic Tank: /Gb0 gallons
Pump Tank: /ODD gallons
Total Linear Feet: ��i �
Max.Trench Depth: �"
EHS:
Date: <'7
�
I Tax T�1ap: �2�9
IParcel: Z✓'��/ I
�:,
Scale: / �=57> �
Note: 1) Drain lines represent approximate contours. Drain line locations must be flagged prior to installation.
2) Contact Person County Environmental Health with any questions (336) 597-1790.
Additional Comments: �/O/{���2/I��D2 /y1!!ht" „%/�t�rl G�di✓�DU2 ��t �G�� �' S