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CERTIFICATE OF SATISFACTORY COMPLETION <br /> <br /> MARION COUNTY <br /> COMMUNITY DEVELOPMENT DEPARTMENT <br /> BUILDING INSPECTION DIVISION <br /> 220 HIGH STREET NE <br /> SALEM, OREGON 97301 ~,~-~.~ <br />. ~ -.~ .... P._E.U~HONE: 588-5147 <br /> <br />OWNER: <br />ADDRESS: <br />INSTALLER: <br />SEPTIC TANK: <br /> <br /> ON-SITE SEWAGE SYSTEM INSTALLATION INSPEC.._TION <br /> <br />.~P,~,.c¢¢ ~/-.,.t~ PERMIT NO. '4.,4¢,¢'$ ~ <br /> <br />NO. GALLONS: /~., ~ <br />MATERIAL: ~.'"¢'._~..~C r-,-,¢ ~--,¢_- <br />MANUFACTURER: /,.V~ / ,¢,.~.-,._- <br /> <br />BUILDING SEWER MAT'L: .~,~'./¢/5~_,/ <br />EFFLUENT SEWER MAT'L: <br />COMMENTS: ¢~ ~' ~ <br /> <br />DISPOSAL FIELD: <br /> TOTAL LENGTH: <br /> PIPE MAT'L: ~- <br /> TRENCH DEPTH: <br /> ROCK DEPTH: <br /> DIST. TO WELL: <br /> BOXES: ~-~ ~ ~ <br /> <br />In accordance with Oregon Revised Statute 454.665; this certificate is issued as evidence of satisfactory <br />completion of a subsurface or alternative sewage disposal system at the above location. <br />INSPECTED BY~.~. ~ DATE: ~////~- .////'~ *~-- <br /> TITLE.'- <br />MC 15-65 Rev. 1/91 <br /> <br /> <br />