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INSTRUCTIONS <br /> 1 A sanitary ;:ermit is valid for two (2) years, <br /> if any naw <br /> V,,!-c:2- ,, Safety K Hu ,s:<r. , Coo-, i5 - <br /> TO be c0141plt,[0 and a,,,. rate this sanitary permit application muse include: <br /> P• ,rer4� ;ncr'�. �.. .ir, .,v,rS ! <..I: :-y �� S . ., 'r>;;., ': the It )'! nemr pfinn and parcel tax numher(sl of <br /> where the system Is to be installed. <br /> it Type of nvlirjlnr hemp ca.van Che<-k w,lv npe ann ^r)^ ( � ' , -jw'! <br /> 3uildiny use. If ixn rg lype '•';': oheek ail dpprupria.c boxes th:.t .f=ply. <br /> Tyne of per!nit :;heck r'y p Cu!npleie line i3 if pe(mii s 1.,r ... r o:",i a:onne•,i�on, <br /> reuair. <br /> r"" �)f SYsten; Checr ystern type. <br /> ..n �f:�n rp° /fir•.. 1( ,:<�: ., :. i' 'tr.;tl '�,. . : � <br /> ark's amt , a ,!,'r•. e!'s oan!e Inoif ,e . . Y 9nk nr.. -ial <br /> septic, pu ,.'_i `,:11 inn -n+ sl r:. . <br /> '.� ;iay/lepartmeni 1 'i;:'ie <br /> ., i;ounty/C)eprrtm�an! tse :7r!� <br /> r. r. <br /> , -'regi � •_. .. _I ... -� <br /> OROUMnwATFfd SURCkA RGF <br /> SBD-6398(R.11/88) <br />