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BUILD - 1348942
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BUILD - 1348942
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Last modified
2/1/2013 8:33:51 AM
Creation date
1/14/2004 1:42:27 PM
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Template:
Permits
Permit Address
13853 EHLEN RD NE
Permit City
Aurora
Permit Number
555-96-01591
Parcel Number
041W11C 01500
Permit Type
BUILD
Permit Doc Type
Permit Document
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~CBI POLICY~PROCEDUR~ <br /> <br />SEPTIC SYSTEM CERTIFICATION <br /> <br />Section 1313 <br /> <br />- Procedure - <br /> <br />Whenever a building permit application is submitted for an accessory structure <br />or alteration/addition where bedrooms (or sewage flows) are not affected, and <br />there is an existing septic system, the applicant must complete the following <br />statement. This statement is to be attached to the application/permit. <br /> <br />SEPTIC SYSTEM CERTIFICATION <br /> <br />PROPERTY OWNER: <br /> <br />SITE ADDRESS: <br /> <br />SITE NUMBER: <br /> <br />I, hereby, certify that the attached site plan is an accurate representation <br />of the conditions on my property, and that the proposed structure meets all <br />minimum setback requirements from the existing septic system, and the future <br />septic system replacement area. <br /> <br />I further certify that I have, to the best of my abilities, thoroughly <br />inspected the septic system and found no evidence of any failure. The system <br />appears to be, functiqning in a s/atisfac~Qry manner at this time. <br /> <br /> (~GPe-r%y owner or author~ze~agent) <br />Name (please print): ~~ <br />Mailing Address: !% ~ <br /> <br />RECEIVED <br /> <br />MARION COUNfY <br />BUILDING INSPECTION <br /> <br />Mc15-S38 <br />Rev 2/93 <br /> <br /> <br />
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