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~ALEM OR 97301 <br /> <br /> MARION COUNTY <br />DEPARTMENT OF ENVIRONMENTAL SERVICES <br /> BUILDING INSPECTION DIVISION <br /> <br />PH. 588~5147 <br /> <br />ON-STTE SEWAGE DISPOSA~ SYSTEM <br />CONSTRUCTION INSTALLATION PERMIT: <br /> <br />~. The septio ~ystem ~ust be installed as shown above and must be lnspeoted prior to cover. <br />2. All disposal trenches sh~12 be installed so as to follow the natural contour o~ the ground. <br />3. It' there are questions concerning tho layout of the sgstem, please call our off, ce ~.uior to <br /> <br />construction of tho system. <br /> <br />System Will Serve:...~.~~~ <br />Pro3~cted Sewage Flow: ~ gal~day <br />Nm~;er Supply: h~_~ <br />Issuance Date: ~- ~_~(~O <br />Expliration lDate:__..~? - ~ -q{ <br /> <br />I~PORTANT: Weep this document with your <br /> ~eoords. Show this permit to the <br /> septic system installer prior to <br /> instadlation o~ the system. Any <br /> deviation from the approved plan ~ust <br /> have plier approval from this of Tice. <br /> <br />TNIS PERMIT IS NOT~~ <br />S~gnaturc: <br /> <br />SYSTEM SPECIFICATIONS': <br />Type of System: <br />Septic Tank Capacity: <br />Lineal Fee~ Disposal Field: <br />Distr~bution~ <br /> <br />gal. min. <br /> <br />Disposal ~'rench Depth: <br />Filter Matezial Depth: <br />Minimum Soil Backfill: <br />Cl~rtain Drain Required: <br />Special Requirements: <br /> <br />( ) Yes; (~) No <br /> <br />PERM rT NUMBER: ~ 4~-~ <br /> Registered <br /> <br /> <br />