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INDIVIDUAL ON-SITE SEWAGE SYSTEM RECORD <br /> (to be completed by system installer) <br /> <br /> SYST~: <br /> <br /> I <br /> <br />Ishow all deta±la and d±mensions necessary to loca~ <br /> <br />Distribution; ~ ] Drop / [~] Concrete; [ ] Plastic <br /> <br />)onents of the system in the future) <br /> <br />(please print) <br /> <br /> (for Marion Count~ 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 />Signed: Title: Date: <br /> <br />as-built.frm 4/95 WHITE:Marion County; YELLOW:Owner; PINK:Installer <br />MC-15-S41 <br /> <br /> <br />