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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-~147 <br /> <br />--%. ~... ~""'~,~ <br />, <br />" ~.,~' ,)_"/ I ~ <br />1 <br />· '!.. ., , <br />ON-SiTE SEWAGE SYST/EM iNSTALLATION INSPECTION <br /> <br />OWNER: <br />ADDRESS: <br />INSTALLER: <br />SEPTIC TANK: <br /> NOt GALLONS: <br /> . MATERIAL; <br /> . MANUFACTURER: <br /> <br />~- ~ ~Ub~' J~l~SC.~ SITE NO. <br /> <br />BUILDING SEWER MAT'L: <br />EFFLUENT SEWER MAT'L: <br />COMMENTS: <br /> <br />Iq- to~'7 <br /> <br />PERMIT NO. <br />DISPOSAL FIELD: <br /> TOTAL LENGTH: <br /> PIPE MAT'L: <br /> TRENCH DEPTH; <br /> ROCK DEPTH: <br /> DIST. TO WELL: <br /> B OX ES: <br /> <br />In accordance with Oregon Revised Statute 454.665; this certificate is issued as evidence of satisfactory <br />completion of a subsuff~,e or..a~ter.native, seWage disposal System at the above location. <br />INSPECTED BY: ~?,, __~ZT~~ DATE: TITLE: ]¢~.,~' ~. <br /> <br /> <br />