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220 HIC..It ST NE <br />SALEM OR 97301 <br /> <br />DEPART~T O~ F21VIRONMENTAL SERVICES <br /> BUILDING ~NSp~CTION DIVISIO~ <br /> <br />588-5147 <br /> <br />ON-SI¢C SEWAGE DISPOSAL SYSTEM <br />CONSTRUCTION INSTALLATION PERMIT: <br /> <br /> --' --,- ~ ~21 '--. . - . ~, " - ..... -._.. <br /> <br /> 1. The septic -~$tem mumt be install~ as showA above an~ ~ b~ inset*ted pr,~or to cover. <br /> 2. All dis~mal t~ench~ shall be ~n$~alled so as to foll~ ~hc natural ~tour of the grounW. <br /> ~. rf there are questions ~ncerning the lagout of ~he s~stem, please call our office prior to <br />_ const~;ct~o~ oF th~ ,~yst~. , <br /> <br /> Tax ~t NO. ~neal F~t Dis~sal Field: <br /> <br /> W~ter Supp~g~ ~ Filter ~aterial ~ptb~ <br /> Issuance Date; ~T~.E~ Minimum Soil Backfi31; -- <br /> <br /> IM~RT~NT~ reep this do~u~nr with ~our .................... <br /> <br /> lnsta31utton of the s~st~m. ~g .............................................. <br /> deviation f~m th~ a~prov~ pl~ ~st <br /> have p~Yor 8pp~val from this office. <br /> <br /> Signature, ~ ~eff~ter~d <br /> <br /> <br />