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SITE ADDRESS~ "~7~ ~c-{'~-_~r~.~ ~> <br />AS-BUILT PLAN OF CONI~TRUCTED SYST~: <br /> <br />INDIVIDUAL ON-SITE SEWAGE SYSTEM RECORD <br /> (to be completed by system installer) <br /> %.~. A-,.,',~'~ ~,~ZT ~o. q~'' 0'~'~ <br /> <br />North <br /> <br />(show all details and dimensions necessary to locate all components of the system in the future) <br /> <br />Ft. <br /> <br />DEQ License Number: <br /> <br />signed: <br /> <br />Date: <br /> <br /> (for Marion County use only) <br />The above septic system has been inspected by Marion County, The information has been determined to be accurate and <br />the system is: <br />~_Approved <br />[ ] Approve.~m~co~ctions: see inspection report <br />[ ] Denie~ ~ %~, . <br /> <br />W~ITE:Marion County; YELLOW:Owner; JPINK!Installer <br /> <br /> <br />