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220 HIOH ST NE <br />SALEM OR' 97301 <br /> <br />,~ARION COUNTY <br />DEPARTMENT OF ENVIRONMENTAL SERVICES <br /> BUILDING INSPECTION DIVISION <br /> <br />PH. 588-5147 <br /> <br />ON-STTE SEWAGE DJ'SPOSAL SYSTEM <br />CONSTRUCTION INSTALLATION PERMIT: <br /> <br />I <br /> <br /> I i I ! ! <br /> <br />~- ~e septic .system must be installed as shown above and must be inspected prior to covez. <br />2. Ali dispoa~] trenches shall be it]stalled so as to follow the natural contour of t~;e ground. <br />?. If Lbere are questions concerning the layout of the system, please call our office pzioI to <br /> construction of the system. <br /> <br />Logai l~scziption: T <br />zaz ~t No. ~07~0o0 <br />System WiZ.I Serve: <br />Proj~cted Sewage Flow: <br />Water Supply: <br /> <br />IMPOR?ANT: ~eep this docu~nt with your <br /> iecords_ Show this permit to the <br /> septic system installez prior to <br /> installation of the system. Any <br /> deviation from thc approved plan must <br /> ~ave prior approval from this office. <br /> <br />']:HIS PF~M~i' IS NOT T~FER_RABLE /~ ~ <br /> <br />SYSTEM SPECIFICATIONS: <br />T~pe of syste~: <br />Septic Tank Capacity~ <br />Lineal Feet Disposal <br />Distribut]o~: <br /> <br />ga]. mis. <br /> <br />Disposal Trench Depth: <br /> ~ilter Material Depth: <br /> ~nimum Soil Backfill: <br />C~rtain Drain Required~ <br />Special Requirements: <br /> <br />( ) '?ns; (k:) <br /> <br />PEPOtFT NUfIBUR : <br /> <br /> RegJstcro-d Sanitaz'ia~ <br /> <br /> <br />