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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 SYSTEM <br /> <br />1. The septic system must be installed as shown above and must be inspected prior to cover. <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 system, please call our office prior to construction of the system. <br /> <br />Name: ~J~ ~/~, <br />Address: ~.o~q ~ ~,.,~ ~'~ <br />Legal Besoription: T ~ ~,,,,, RI¢ S ~ ,,, <br />Tax Lot No. <br />System Will Serve: <br />Projected Sewage Flow: /~ gal/day <br />Water Supply: <br />issuance Date: <br />Expiration Date: <br /> <br />(Request for renewal of this permit must be made .QdQ.r_tQ the <br />expiration date.) <br />IMPORTANT: Keep this document with your records, Show this <br />permit to the septic system installer prior to installation of the <br />system, Any deviation frfo~ the apl~ov,,gcj plan/rpust have prior <br />approval from this offic,~ ~ ~/'/,/~_ .~7z~ <br />Signature ~u ~ g~ ,, , <br /> <br />SYSTEM SPECIFICATIONS&_ <br />Type of System: ,~ <br />Septic Tank Capacity: . /~.~;~O gal. min. <br />Lineal Feet Disposal Field: /.._~ <br />Distribution: ..... <br />Disposal Trench Depth: <br />Filter Material Depth: [,-~-- <br />Minimum Soil Backfill: <br />Curtain Brain: ( ) Yes; ( ~ NO <br />Special Requirements: ~/O <br /> <br /> Site Number: <br /> Permit Number: <br />THIS PERMIT IS NOT TRANSFERABLE <br /> <br />MC 15-57 <br />REV, 11/92 <br /> <br /> <br />