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Health Department <br />Identification Number <br />Schematic drawing of sewage disposal system and topographic features. PAGE 2—OF <br />Show the lot lines of the building lot and building site, sketch of property showing any topographic features which may impact on the design of the system, all existing arid/ <br />or proposed structures including sewage disposal systems and wells within 100 feet of sewage disposal system and reserve area The schematic drawing of the sewage disposal <br />system shall show sewer lines, pretreatment unit, pump station, conveyance system, and subsurface soil absorption system, reserve area, etc. When a nonpublic drinking water <br />supply is to be located on the same lot show all sources of pollution within 100 feet <br />❑ The information required above has been drawn on the attached copy of the sketch submitted with the application. <br />Attach additional sheets as necessary to illustrate the design. <br />1, � �.�'�li1,� lJ 2�, � � SS CLcf� � Gn✓1 r�ce�� � s f,,��l <br />a. y-�e cam, sfi�► fia, Vin /< < <br />a)�M -NuJ POY <br />S 4 �e- Ak <br />A-� i w��K w► � s�- � � � s,�c�� �� -,OL/)� <br />� � *- Wp6�) LAI <br />Ni T P-V>04 (&*IlT� J4*/7-X00AJ A- Wv ei7i 4T- <br />-h <br />lr- ?tlyr p 571 i o �j °i—� ►�'� `� . <br />7pr— rVdSr1A)6 1s 1-0 <br />t1pp ly rxmz' Avi t o APPP W A-t- . <br />