Onsite Wastewater Disposal Application Form - Health Department - Peoria - Illinois Page 4

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Sketch
Office Use Only
Application Approval:
By:
Date:
Permit #
Date Issued
Expiration Date
Construction Approval:
By:
Date:
Final Approval:
By:
Date:
Peoria City/County Health Department • Environmental Health • 2116 N. Sheridan Rd. • Peoria, IL 61604 • 309/679-6161 •
11/15

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