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CER;I'IFICATE OF SATISFACTORY COMPLETION <br /> <br /> MARION COUNTY <br /> COMMUNITY DEVELOPMENT DEPARTMENT <br /> BUILDING INSPECTION DIVISION <br /> 220 HiGH STREET NE <br /> SALEM, OREGON 97301 ~_~,~,~p~ ~ <br /> PHONE: 5~$-~t47 "~ ~.~;.~ ~ ~ <br /> <br /> ~[ .~ ~ . ~ , ~.~ · . ~ w~,~ ~ ....... <br /> <br /> .... <br /> <br /> '; ..... .......... : ...... <br />~1 :'~' : · '".' .............. C'}"~': · <br />~ .~ ................................ ~ .,. ~ . ~ ~~'"'~)~ <br /> <br /> ON. SITE SEWAGE SYSTEM INSTALLATION INSPECTION <br /> I~?-tt~,~f ,Y}~,~m,~ _$~TE NO. 'Y~----/~ ~ <br />'~~~ ' P~No ..... ~'~ ...... <br /> <br />OWNER: ............. <br />ADDRESS: <br />iNSTALLER: __- <br />SEPTIC TANK: DISPOSAL FIELD: , ~._... <br /> NO. GALLONS: . /~ <br /> MATERIAL: ~W~ ~ ~... ' .,,, PIPE MAT'L: P- ~. ~ ~ ~ ~ ~ ..... <br /> MANUFACTURER: ~ / ~ T~ENCH DEPTH: ~- ,~ .... <br /> <br />BUILDING SEWER MAT'L: ~. ~G/ ~o -~ DIST. TO WELL:~~,, <br />EFFLUENT SEWER MAT'L:' '~e$-~G~-~ BOXE~ .~~, ~'~ ' <br /> <br />In accordance with Oregon Revised Statute 454J~65; this cer~fi~e' i~ issued as eVidenCe of satisfact~ <br />completion of a ~ubsurface or alte~ative sewag~ disposal system at the above Iooation. <br /> <br /> <br />