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MARION COUNTY COMMUNITY DEVELOPMENT <br />BUILDING iNSPECTION DIVISION <br />220 HiGH STREET NE - SALEM, OREGON 97301 <br />PHONP: 588-$147 <br /> <br />CONSTRUCTION PERMIT TO INSTALL A SEPTIC SYSTEM <br /> <br />1, The septic s <br />2. All dis~ <br />3. If there are questions concerning the layout of the system, please carl our office prior to construct/on of the system· <br /> <br />Name: ~flIC/P /~'~-7'3:f~y <br /> <br />Legal Description: T ~ 5 R ~ <br /> <br /> Tax Lot NO, ~O~- ~ <br />System Will Se~e: ~(D~ <br /> <br />Projected Sewage Flow: L{'~-'~O gal/day <br />Water Supply: <br />Issuance Date: [ - q - ~'~-- ,, <br /> <br />Expiration Date: <br />(Request for renewal of this permit must be made prior <br />the expiration date,) <br /> <br />Signature: <br /> <br />SYSTEM SPECIFICATIONS: <br /> <br />Type of System: ...-.%"P~O O ~ <br />Septic Tank Capacity: C~..-~77t t.~j 77,OG., <br /> <br />Lirmal Feet Disposal Field: ~O <br />Distribution: ~ M ~ <br /> <br />gal. min. <br /> <br />Disposal Trench Depth: <br /> <br />Filter Material Depth: <br /> <br />Minimum Soil Backfill: <br /> <br />Curtain Drain: ( ) Yes', <br />Special Requirements: _(.~="f2 <br /> <br />Keep this document with your records, Show this permit to the septic system installer prior to installation <br />of the system, Any deviation from the approved plan must have prior approval from this office, <br /> <br />MC 15-S7 <br />REV 1/94 <br /> <br /> <br />