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.. .-- INDIVIDUAL ON-SITE SEWAGE SYSTEM RECORD <br /> (to be completed by system installer) <br /> <br />SITE ADDRESS: ,/_~._~ ~f~,, /-%~%~ ~k~- ; pERMIT NO. ~'~ <br /> <br />AS-BUILT PLA~ OF CONSTRUCTED SYSTEM: <br /> <br />scale: 1" = ~ / North <br /> / <br /> / , <br /> <br /> (show all details and dimensions necessary to locate all components of the system in the future) <br /> ~ c~zsszom <br />· f~l~ S~r~ Size: ~S' Mar'l: ,~]~ [~I ~ve tested the septic t~ ~d certify <br />~-/~~ ~e system WaSL~' ~alled by: <br /> <br /> ~mp ~cle Time: ; Gallons per ~cle:__ __~ ] <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 /> ~g. Approved <br /> [ ][ ] Appr~with.m~rrections: see inspection repO~Denfed~ll q/. - [ /~ / <br />s-built.f~95 ~ ~ITE:Marion Co~ty; YELLOW:O~er; PINK) Installer <br />MC-15-S41 ~ <br /> <br /> <br />