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SITE ADDRESS: <br /> <br />INDIVIDUAL ON-SITE SEWAGE SYSTEM RECORD <br /> (to be completed by system installer) <br /> <br />AS-BUILT PL~.N OF CONSTRUCTED SYSTEM: <br /> <br />scale: 1" =(~1%3~'/ <br /> ~ ~ ] North <br /> o <br /> , <br /> <br /> (show all details and dime cessary to locate ~11 components of the sys em in the future) <br /> <br />~q~ l? I/ / /~ ~icensea~wa~e Disposal ~ice <br />~ ~' ~rtain Drai. Depth: <br />· fflu~t ~: ~ Model:~; Static Head in Sys=em:~ C~ny name: <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~h,~orrec~i~ns: ,~e inspection report <br /> <br /> ~ITE:Marion Cowry; YELLOW:O~er; PINK:Installer <br /> <br />~s-built.frm 4/95 <br />MC-15-S41 <br /> <br /> <br />