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INDIVIDUAL ON-SITE SEWAGE SYSTEM RECORD <br /> ~'~ ~/ p~/__T'/'(to be c~ted by system installer) ~ <br />S~TE ADDRESS: . ; PERMIT NO. <br /> <br />AS-BUILT PLAN OF CONSTRUCTED SYSTEM: <br /> <br />North <br /> <br />(show all details and dimensions necessary to locate all components of the system in the future) <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 />Signe~ ~~ Tit le: ~~~~Dat e: <br />as-built.frm 4/95 WHITE:Marion County; YELLOW:Owner; PINK:Installer <br />MC-15-S41 <br /> <br /> <br />