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220 HIGH ST NE <br />SA LEM 0.~ 97301 <br /> <br /> MARION COUNTY <br />DEPARTMENT OF ENVIRONMENTAL SERVICES <br /> BUILDINO INSPECTION DIVISION <br /> <br />Pll. 588-5147 <br /> <br />ON-SITE SEWAGE DISPOSAL SYSTBM <br />CONSTRUCTION INSTALLATION PERMIT: <br /> <br />1. The septic system must be installed as shown above an~ <br />2. All disposal trenches shall be installed so as to foli <br /> <br />must be inspected prior to cover. <br />ow the natural contour o.f the ground. <br /> <br />3. If there are questions concerning the layout of the system, please call our office ,prior to <br /> ce~structio~ of the ~stem. <br /> <br />Legal Description= T <br /> Tax ~t NO. <br />System Will Serve:~~cc~ <br />Projected Sewage Flow: <br />Water Supply: ~trC~ <br /> <br />Exp.iration Date: 6~ <br /> <br />I~M~PORTA~N,~: ~ee~ this document with your <br /> records. Sho~ t;]is permit to the <br /> septic system installer prior to <br /> installation of the system. Any <br /> deviation from the approved plan must <br /> have prior approval from this office. <br /> <br />Signa t ute: <br /> <br />!SYSTEM SPECIFICATIONS= <br />:Type of System: <br />Septic Tank Capacity; ~_~ .... gal. min <br />Lineal Feet Disposal <br />Distribution: <br />Disposal Trench Depth: <br />Filter Material Depth: <br />Minimum Soil Backfill: <br />Curtain Drain Required: ( ) Yes; (~ No <br />Special Requirements~ <br /> <br />NUMBER: <br /> <br /> Registered Sanitarian <br /> <br /> <br />