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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 /> C()NSTRUCTION PERMIT TO INSTALL A SEPTIC SYSTEM <br /> <br /> : <br /> <br />1, ~0 sept~ system must De installed as shown a~ve and must ~ Insp~t~d prior to ~ver. <br />2. All dis~sal f~hes shMI be installed so as to ~l~w the natural contour of the <br />3./f the~ a~ quost~n~ ~ncem/ng the tayout Of the System, O/ease call our office prior to ~nst~ct~a of the system. <br /> <br />Address: ...... II~-~ l 4~t~.d~4~ ~~'~ <br />LegalDescrJ[~tion: T. ~ R /tO, S ~, <br />Tax LorN0, * ~ <br />Sy~em ~11 8e~e: <br />Projected Sewage Flow: ~ gel/day <br />Water Supply: '~ ~ <br />Issuance Date: . ~- ~ %,~ ~ <br />Expiration Dele: ~ ~ ~ - ~ <br />IMPORTANT: Keep this do~ment with your records. Show <br />this permit to lhe sapac system installer prior to installafio~ <br />of the system. Any deviation Imm the a~mved plan mu~ <br />have prior approval from this office, <br />',HI~ PERMIT IS NOT .A~,L~~ <br />Signature: , ~~ ~~ <br /> <br />SYSTEM SPECIFICATIO.~NS: <br />Type of System:.. ,~,~,,',J'O 4~ ~_ ~ ~.., <br />Septic Tank Capacity: . / ~d::~ gal. min. <br />Lineal Feet Disposal Fie]d: <br />Distribution: ....... /,~, (:~(.(. <br />Disposal Trench Depth: /.,~ ~,t ~. ...... <br />Filter Matedal Depth; /,.~- <br />Minimum Soil Backfill: ~,~,., <br />Curtain Drain Required: ( ) Yes; (J0 No <br />Special Requirements: _ <br /> <br />Site Number: ~ <br />Permit Number: .,~'~ ~ <br /> Registered S~nit~dan <br /> <br /> <br />