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INDIVIDUAL ON-SITE SEWAGE SYSTEM RECORD <br /> (tc* be completed by system installer) <br /> <br />SITE ~DRESS,~ O. ~r~_rO~ ~. .; PE~T NO. <br />AS-BUILT P~ OF CONSTRUCTED SYST~: <br /> <br />scale: 1" = ~_' <br /> <br />-=---~ <br /> North <br /> <br />~JUL 1998 <br /> <br />MARION COUNTY <br />BUILDING INSPECTION <br /> <br />(show all details and dimensions necessary to locate all components of the system in the future) <br /> <br />Distribution; [ ] Drop / ~ Concrete; [ ] <br /> ~,. <br /> <br />Company <br />(please 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 />to be accurate and the system is: <br />[ ] Approved <br />[ ] Approved with corrections: see inspection report <br />[ ] Denied <br /> <br />Title: Date: <br /> <br /> ~.frm WHITE:N YELLOW:Owner; PINK:Installer <br />MC-15~S41 <br /> <br /> <br />