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MARION COUNTY <br />COMMUNITY DEVELOPMENT DEPARTMENT <br />BUILDING INSPECTION DIVISION <br />220 HIGH STREET NE <br /> SALEM, OREGON 97:301 <br /> PHONE: 588-5147 <br /> <br />CONSTRUCTION PERMIT TO INSTALL A SEPTIC SYSTEM <br /> <br />L Th~ septic SyStem must be installed as shown abe ve and must be inspoctecl pr/or to cover. <br />2. At! disposal trenches ~hall be instatled ao as to tollow tl~e rlatural contour of ti~, ground. <br />$. ff thoro are questions concerning the la?out o! the system, please call our office prior to construction et tho s?stem. <br /> <br />Name; '~1:~-~/Vk fr_~.-y <br />Address; ~o%-~'~- ~DL'F ~----L~'~ ~, S~ <br />Legal Description: T ~S R~¢ S ~ Tax Lot No. <br />System Will Se~e: '~0 ~ ~ <br />Projected Sewage Flow: ~ gal/day <br />Water Supply: .,~% <br />Issuance Date: ~ /~ ~ ~ <br />Expiration Date: , , ~¢~ f~ ~¢~ <br />IMPORTANT: Keep this document with your records. Show <br />this permit to the septic system installer prior to installation <br />of the system. Any deviation from the approved plan must <br />have prior approval from this office, <br /> <br />Signature: <br /> <br />SYSTEM SPECIFICATIONS: <br />Type of System: ..~'~ ¢~ ~ ~ ¢~ ~_~ <br />Septic Tank Capacity: J.~ <br />Lineal Feet Disposal Field: <br /> <br />Distribution; ,, <br />Disposal Trench Depth:__ 11~- ~'~ <br />Filter Material Depth: ID_" <br />Minimum Soil Backfill: ~:~ <br />Cudain Drain Required: ( ) Yes; 0~) NO <br />Special Requirements: <br /> <br />_gal. min. <br /> <br />site Number: <br />Permit Number: <br /> <br /> Registered Sanitarian <br />MC t5-57 Rev, <br /> <br /> <br />