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MARION COUNTY <br />COMMUNITY DEVELOPMENT DEPARTMENT <br />BUILDING INSPECTION DIVISION <br />220 HiGH STREET NE <br /> SALEM, OREGON 97301 <br /> PHONE: 588-5147 <br /> <br />CONSTRUCTION PERMIT TO INSTALL A SEPTIC SYSTEI <br /> <br /> 1 The septic system must be installed as shown above and must be inspected prior to cover <br />2, All c(~SPosal trenches shall be i~stalled so as to follow the natural contour of the ground. <br />3 If there are questions concerning the layout of the system, please call our office prior to construction of the system <br /> <br />Address:: _"3¢ ~-D.. 'T~f~r~& ~¢_.~ <br />Legal Description:: T... ~'5 <br />Tax Lot No. <br />System Will Sea, e: <br />Projected Sewage Flow: . 200 gal/day <br />Water Supply:: bO <br />Issuance Date:: <br />Expiration Date: <br />I~PORTANT: 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 />TH IS PER MIT IS NOT~. A~FER¢,~/// <br />Signature:: ~'0'~,- <br /> <br />SYSTEM SPECIFICATIONS: <br />Type of System:: <br />Septic Tank Capacity: <br />Lineal Feet Disposal Field:; <br /> <br />Distribution: <br />Disposal Trench Depth::__ <br />Filter Material Depth; <br />Minimum Soil Backfill:: <br />Curtain Drain Required; <br />Special Requirements: <br /> <br />( ) Yes; (,k9 No <br /> <br />gal rnin <br /> <br />Site Number:: <br />Permit Number'.'. <br /> <br />_Registered Sanitarian <br /> <br /> <br />