Laserfiche WebLink
CITY OF ELK RIVER <br /> <br /> P.O. Box 490 · Elk River, MN 55330 · (612) 441-4900 <br /> <br />L~cationofjob // 7~-/O c77'O~-7~/~1 /'//]P/~ A.,} <br /> <br />Signature ~,~ ~ ' d Date ~ ' / 7 ~' ~ o <br /> ~ (Show location of house, t~k, drainfield, prope~y line and well) <br /> <br />NOTE: On ALL replacements and additions, tanks must be exposed for baffle inspection: <br />COMMENTS: <br /> <br />New Work t~l Outside Lift <br />Replacement O Ejector <br />Addition [21 Gravity <br /> Mound System <br /> Tank Size /,5' o o'c,~~ "."~' m t~,a <br /> Tank Size / ]q4- It. o O <br />Square Footage of Drainfield Area <br />_~epth of Rock Under Pipe ! <br /> pth of Rock Over Pipe <br />Graveless <br /> Depth of Dirt Cover t [ ~ <br /> Number of Bedrooms L[ <br /> <br />DATE <br /> <br />INSPECTOR <br /> <br />COMMENTS <br /> <br />THIS FORM MUST BE FILLED OUT BY A LICENSED INSTALLER (ASBUILT) <br /> (1) CITY COPY, (2) OWNER COPY, (3) LICENSED INSTALLER COPY <br /> <br /> <br />