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SITE~ADDRESS: <br /> <br />INDIVIDUAL ON-SITE SEWAGE SYSTEM RECORD <br /> (to be completed by system installer) <br /> 23_'-/0 OP . <br /> <br />AS-BUILT PLAN OF CONSTRUCTED SYSTEM= <br /> <br />scale: 1" = <br /> <br /> North <br /> <br />h'~ <br /> <br />(show all details and dimensions necessary to locate all components of the system in the future) <br /> <br />Mfg: <br /> <br />] Drop / [ ] Concrete; [ ] Plastic <br />; Material: Meader: ; Perf: <br />; ~o~k Dmpth~ Total: ; Under pipe: <br /> <br />Maximum: ; Curtain Drain Depth:__ <br /> ; Static Head in System: <br /> <br />ft. <br /> <br />PrOperty Owner (permitee) <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~/be accurate and the system is: <br /> ~-~Approved <br /> ~ ] Approved~with corrections: see inspection report <br /> [ ] Denigd~ /; /%~ / ~ /~J / ~ <br /> <br />as-built.rrm 4/95 WHITE:Marion County; YELLOW:Owner; PINK:Installer <br />MC-15-S41 <br /> <br /> <br />