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SITE ~DRESS: <br /> <br />INDIVIDUAL ON-SITE SEWAGE SYSTEM RECORD <br /> (to be completed by system installer) <br /> <br /> ~0~- ;~yJ ~-N. ~F ~{~J~/~'¢~ ; PERMIT NO.. ~6-06~y~ <br /> <br />~-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 system in the future) <br /> <br />~r~perty Owner (per~itee) <br />Licensed Sewage Disposal SerVice <br /> <br /> (for Marion County use only) ~ <br /> The above septic system has been inspected by Marion County. The information has been determined <br /> to be accurate and the system is: <br /> ]' Approved <br /> <br /> Approved with corrections: see inspection report <br /> <br />~s-built~."f~m 4/95 ' WHITE:Marion County; YELLOW:Owner; PINK:Installer <br />MC-15-S41 <br /> <br /> <br />