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RTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM CONSTRUCTION PERMIT CONSTRUCTION PERMIT FOR: New System Repair Existing System Abandonment Holding Tank Temporary Innovative APPLICANT: PROPERTY ADDRESS: BLOCK: LOT: SUBDIVISION: SECTION, TOWNSHIP, RANGE, PARCEL NUMBER OR TAX ID NUMBER PROPERTY ID #: SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF SECTION 381.0065, F.S., AND CHAPTER 64E-6, F.A.C. DEPARTMENT.

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