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.~ ~ MARION COUNTY ~ <br />,~' COMMUN TY DEVELOP,I~rL-~T I)~RTMENT~,~?~-/ <br /> <br /> 220 HIGH STR~T NE L. ~ ~,, <br /> SALEM, OREGON 97~01 ~'~ 4~ <br /> ~ PHONE: 588-5147 <br /> <br />OWNER: <br />ADDRESS: <br />INSTALLER: <br />SEPTIC TANK: <br /> NO. GALLONS:/~"'~ <br /> MATERIAL: Y~,,.~ C,.K,,.~ ~'-¢.- <br /> <br />ECTION <br /> <br />PERMIT NO. <br />DISPOSAL FIELD: <br /> TOTAL LENGTH: <br /> PIPE MAT'L: <br /> <br /> MANUFACTURER: //~/~/¢/:~' TRENCH DEPTH: <br /> - ~-/~¢~ f,~, ROCK DEPTH: <br />BUILDING SEWER MAT'L: ~M ~¢~¢, DIST, TOWELL: <br />EFFLUENT SEWER MAT~: ~~' BOXES: <br />COMMENTS: p~, ~/~'~~~' ¢ <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: ~/~&y~ ~- " <br /> <br /> <br />