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1, TI <br />2. Al <br />3. If, <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 />ONSTRUCTION PERMIT TO INSTALL A SEPTIC SYSTE <br /> <br /> ~ septic system must be installed as shown above and must be inspected prior to cover. <br />disposal trenches shall be installed so as to follow the natural contour of the ground. <br />here are questions concerning the layout of the system, please call our office prior to construction of the system. <br /> <br />Name: <br />Address: <br />Legal Description: T~ R <br /> Tax Lot No, <br />System WiJJ Serve: <br />Projected Sewage Flow: <br />Water Supply <br />issuance Date: <br />Exp rat on Date: <br /> <br /> t¢ s (.~ <br />qos-f ~- O:~ <br /> <br /> q-~cq't"'~ ' , ........gal/day <br /> <br />IMPORTANT: Keep this document with your records. Show <br />this permit to the septic system installer prior to installation <br />of the system. Any deviation from the approved plan must <br />have prior approval from this office. <br /> <br />Signature: <br /> <br />SYSTEM SPECIFICATIONS: <br />Type of System: <br />Septic Tank Capacity: <br />Lineal Feet Disposal Field: ~'~,.~--- <br />Distribution: <br /> <br />gal. min, <br /> <br />Disposal Trench Depth: ___~-~_~_~" <br />Filter Material Depth: I ~5- ~r <br />Minimum Soil Backfill: { -'.%," <br />Curtain Drain Required: ( ) Yes; ()<~ No <br />Special Requirements: <br /> <br />Site Number: <br />Permit Number: <br /> <br />Registered Sanitarian <br /> <br />MC 15-57 Rev. 1~91 <br /> <br /> <br />