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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-$147 <br /> <br />CONSTRUCTION PERMIT TO INSTALL A SEPTIC SYSTEM <br /> <br /> I Thesepticsystemmustbeinstalledasshownaboveandmustbeinspectedpriortocover, <br />2, All disposal trenches shall be installed so as to follow the natural contour of the ground. <br />3 If there are questions concerning the layout of the syetem, please call our office prior to construction of the system, <br /> <br />Name:: '~-F L~ <br />Address,, <br /> <br />Legal Description:: T <br />Tax Lot No,, <br />System Will Serve:: ~' "'"'"'"'"'"'"'"'"'~=-z ~.~WOC_._~{- <br />Projected Sewage Flow: q~ ,.~ gal/day <br />Water Supply:., <br />Issuance Date; (',~ - (~ -~'; <br />Expiration Date: ~, - ~, - ¢2.- <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 /> IS N 'h" SF E <br /> <br />Signa~Jre, <br /> <br />SYSTEM SPECIFICATION%~ <br />Type of System:: <br />Septic Tank Capacity: <br />Lineal Feet Disposal Field: <br /> <br />Distribution: <br />Disposal Trench Depth:: <br />Filter Materiel Depth: <br />Minimum Soil Backfill: <br />Curtain Drain Required:: <br />Special Requirements: <br /> <br />gal, min <br /> <br />? <br /> <br />( ) Yes; ()() No <br /> <br />Site Number:: <br />Permit Number <br /> Registered Sanitarian <br /> <br /> <br />