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SITE ADDRESS: <br /> <br />INDIVIDUAL ON-SITE SEWAGE SYSTEM RECORD <br /> (to be completed by system installer) <br /> ~.20~-- ~'*~-~3 ~o~ j~ ~4~$&~,'//~ ; PERMIT NO. 9~-O~--O~6 <br /> <br />~-BUILT PLAN OF CONSTRUCTED SYSTEM: <br /> <br /> scale: 1" <br /> (show all details and :rdim~nsions necessa~ to locate all co~ )onents of the system in the future) <br /> ' ~ T " <br /> ' it to ~ wate~ight. <br /> ~(ms} ~ [ ] Distri~tion; [ ] D~p / [ ] Concrete; [ ] Plastic <br /> ~a~i~d Pi~ Size: ~ ; ~te=Aal: Header.: ,~ ; Perf:~ ~ [ ] Pro~y ~er (pe~tee) <br /> To~ Dr~AeXd ~, ,~; ~k ~, Total: /~ ; ~der pim: A~ [~ Licked Sewagenl~Dis~sal Se~ice <br /> <br /> The above septic system has been inspected by Marion Co~1 ~. The info~ation has been dete~ined <br /> ~e accurate and the system is: <br /> ~Approved <br /> ' [' ] Approved with corrections: see inspection repot <br /> <br />as-b~ilt, f~ 4/95 ~ITE:MarJ ,n Co~ty; YE~LOW:O~er; P~NK: fn~taller <br />MC-15-S41 <br /> <br /> <br />