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SESPNEW - 1370230
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SESPNEW - 1370230
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Last modified
2/9/2013 2:04:12 PM
Creation date
2/9/2004 11:30:42 AM
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Template:
Permits
Permit Address
11532 TEGEN LN SE
Permit City
Aumsville
Permit Number
555-96-02657
Parcel Number
091W18C 01200
Permit Type
SESPNEW
Permit Doc Type
Permit Document
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INDIVIDUAL ON-SITE SEWAGE SYSTEM RECORD <br /> (to be completed by system installer) <br /> <br />AS-BUILT PLAN OF CONSTRUCTED SYSTEM: <br /> <br />scale: 1" ' <br /> <br />North <br /> <br /> (show all details and dimensions necessary to locate all components of the sy~in the future) <br /> ! <br /> <br />· fflu~t ~r~ size:~ ~ 1:~ ~ -- ~ [~ I ~ve ~ested ~he septic t~ ~d certify <br /> I/ / I it tO ~ watertight. <br />~(es) ~ [~ Distribution; [ ) Drop / [~ Concrete; [ ) Plastic <br /> <br />D~i~ld ~i~ Size: ; ~ter~al: Header: ; Perf:__ -- ~ [ ]~o~rty ~er (~itee) <br /> ~ [~ Licked Sewage Dis~sal Se~ice <br />To~ Dra~field F~tage: ; ~ek ~ Total: ; ~der pi~: [ / <br /> <br />X~ ~, Mini~m: ; ~i~m: ; ~rtain Drain ~pth:____ I ~~ ~ Si~: ~ ~~ <br /> (please <br /> print) <br /> <br /> (for Marion County use only) <br /> The above septic system has been inspected by Marion County. The information has been determined <br /> t~Abe accurate and the system is: <br /> [~ Approved <br /> ~ ] Approved with c;rrections: see inspection report <br /> <br /> s-b~ilt.frm 4/93 ~ WHITE:Marion CoUnty; YELLOW:Owner; ~INK:I~st~ller <br />MC-15-S41 <br /> <br /> <br />
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