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CERTIFICATE OF SATISFACTORY COMPLETION <br /> <br /> 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 />OWNER; <br />ADDRESS: <br />INSTALLER: <br /> <br /> ON-SITE SEWAGE SYSTEM INSTALt,.ATION INSPECTION <br />,~o~ ~. S~TE NO. <br /> <br />~-N,'~'~5,0~ ~o,~J..- t~..~. I~_.? PERMIT NO .... <br /> <br />SEPTIC TANK: <br /> NO. GALLONS: <br /> MATERIAL: <br /> MANUFACTURER: <br /> <br />DISPOSAL FIELD: <br /> TOTAL LENGTH: <br /> PIPE IVIAT'L: <br /> TRENCH DEPTH: /.~ ~. <br /> ROCK DEPTH; <br /> DIST. TO WELL: <br /> BOXES: <br /> <br />BUILDING SEWER MAT'L: <br />EFFLUENT SEWER MAT'L: <br />OOMMENTS: <br /> <br /> rn accordance with Oreg'on Revised Statute'~54.665; this certificate is issued as evidence of satisfaciory <br /> comp, etlon of a subsu~c~}~or al~t~/a~Jve ~wage d,sposa, system at the above location. ' <br /> <br /> INSPECTED BY:.. K.,.~5/dO'~J~-~. .DATE: <br /> TITLE. ~-~--~ .. - ..... <br />~¢ is-S6 S6v. 12,~2 <br /> <br /> <br />