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220 L~IGI¢ ST NE <br />SA LEM OR 97301 <br /> <br />, ~R~ON COUNTY <br />DEPARTMENT OF ENVIRONMENTAL SERVICES <br /> BUILDING INSPECTION DIVISION <br /> <br />PH. $88~5147 <br /> <br />ON-SITE SEWAGE DISPOSAL SYSTEM <br />CONSTRUCTION INSTALLATION PERMIT: <br /> <br />L <br /> <br /> ' i I I ii It .... i ' I l~] I l~ <br />2. AIZ disposal' trenches shall be installed sopslto fol2ow the natural contour of th~ ground. <br />3. If there are qtlestions concerning the layou~o~ the system, please call our office prior to <br /> construotiou o$ the S~lStem. I [ <br /> <br />L~:q~I] Bes~ripei~7 ~ ]sll I llR~[ Septic Tank Capacity; I <br /> <br />s~tem Will Serve: <br />Projected Sewage Flow: ~0 gal~day <br />Wate~' Supply: ~ ' <br /> <br />I~PORTANT: WO~ this document ~ith your <br /> records. Show this permit to the <br /> septie system installer prior to <br /> installation of the system. Any <br /> deviation from the approved plan must <br /> have prior approval from thls office. <br />Signature:~IS PERM. IT IS NO~]~~: <br /> <br />Lineal Feet Disposal Fiald: <br />Distribution: <br />Disposal Trench Depth: <br />Filter Material Depth; <br />Minimum Soil Backfill: <br />Curtain Drain Required: <br />Special Requirements: <br /> <br />(~<~) :.~es; ( ) ~o <br /> <br />~,ega~z~red Sani ta 'i~h <br /> <br /> <br />