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INDIVIDUAL ON-SITE SEWAGE SYSTEM RECORD <br /> (to be completed by system installer) <br /> <br /> ! <br />AS-BUILT PLAN OF CONSTRUCTED SYSTEM: <br /> <br />(snow ali Qe~a~is an~ Q~mens:ons neces~y, sp z~ ~l 'o~p ~ _c ~ ~cn sysse zn cne fuchre) <br />; ~a:.r~al: Sea~er:~ ; Perf: [ ] roperty ~er (permitee) <br /> <br /> (for ~arion County uae 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 />[ ] Approved with corrections: see inspection report <br />[ ] Denied <br /> <br /> Si~ned: Title: Date: <br />as-bullt.frm 4/95 WHITE:Marzon County; YELLOW:Owner; PINK:Installer <br />MC-15-S41 <br /> <br /> <br />