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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 /> <br />CONSTRUCTION PERMIT TO INSTALL A SEPTIC SYSTEM <br /> <br />1. 7he septic system must be installed as shown above and' must be inspected prior to cover. <br />2. All disposal trenches shall be installed so as to follow the natural contour of the ground, <br />3. If there are questions concerning the layout of the system, please call our office prior to construction of the syetem. <br /> <br />Name: ..0-o~e ~-,+ ~ ~ <br />Address: I ur~.( ~' <br />Legal Description: ,T <br /> Tax Lot No. <br />System Will Se~e: <br />Projected Sewage Flow: ~ gal/day <br />Water Supply: <br />issuance Date: <br />Expiration Date: .~, , <br />(Request for renewal of this permit must be made ~rior to the <br />expiration date.) <br />IMPORTANT: Keep this document with your re~rds. Show this <br />permit to the septic ~tem installer prior to ins~llation of the <br />system. Any deviati¢~f~he a~p~ plan~ust have prior <br /> <br />Signature <br /> <br />SYSTEM SPECIFICATION_S: <br />Type of System: <br />Septic Tank Capacity: ( ~S;:~,c::~ gal. min <br />Lineal Feet Disposal Field: .,...~' <br />Distribution: <br />Disposal Trench Depth: L/ <br />Filter Material Depth: ..... <br />Minimum Soil Backfill: <br />Curtain Drain: ( ) Yes; (,¢_..) No <br />Special Requirements: <br /> <br /> Site Number: <br /> Permit Number: <br />THIS PERMIT IS NOT TRANSFERABLE <br /> <br />MC 15-S7 <br />REV. 11/92 <br /> <br /> <br />