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MCB.~ POLICY/PROC~DD~LE <br /> <br />SEPTIC SYSTEM CERTIFICATION <br /> <br />Section ~313 <br /> <br />- Procedure - <br /> <br />Whenever a building permit applieatio~ is submitted for an accessory structure <br />or alteration/addition where bedroom~ (or sewage flows) are not affected, and <br />there is an existing ~ep~ic system, ~he applicant must complete the following <br />statement. This statement is to be at~aehed to the application/permit. <br /> <br />PROPERTY OWNER= <br /> <br />SITE ADDRESS; <br /> <br />SITE NUMBER: <br /> <br />SEPTIC E¥sTF~M: CERTIFICATION <br /> <br />I, hereby, certify that the attached isite plan is an accurate representation <br />of the conditions on my property, and that the proposed structure meets all <br />minimum setback requirements from thei existing septic system, and the future <br />~ep%ic system replacement area. <br /> <br />I further certify that I have, to ~the best of my abilities, <br />inspected the septic system and found:no evidence of any failure. <br />appears to be¢~. ioning in a s~.factory manner at this <br />SIGNATUR~ ~_~ .~.~' ~ ~ DATE: <br /> (property owner Or authori"~ed agent) <br /> <br />thoroughly <br />The system <br /> <br />MclS-S3$ <br />Rev 2/93 <br /> <br /> <br />