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MARION COUNTY COMMUNITY DEVELOPMENT <br />BUILDING INSPECTION DIVISION <br />220 HIGH STREET NE - SALEM, OREGON 97301 <br />PHONE: 588-5147 <br /> <br />CONSTRUCTION PERMIT TO INSTALL A SEPTIC SYSTEM <br /> <br />1. The 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 system, <br /> <br />Name: K~./e ~ <br />Address: { '~,1,,,,~ ~ <br />Legal Description: T <br /> T~ Lot No, ~- ~,~ <br />System Wilt Se~e: <br /> <br />Projected Sewage Flow: ~ gal/day <br />Water Supply: <br /> <br />Expiration Date: <br />(Request for renewal of this permit must be made prior to <br />the expiration date.) <br /> <br />Site #: <br /> <br />Signature: <br /> <br />SYSTEM SPECIFICATIONS: <br /> <br />Septic Tank Capacity: ( ~ gal. min. <br /> <br />Lineal Feet Disposal Field: <br />Distribution: ~ ~ <br />Disposal Trench Depth: ~)5~ <br />Filter Material Depth: <br />Minimum Soil Backfill: <br />Curtain Drain: ( ) Yes; ([) No <br /> <br />IMPORTANT!- THIS PERMIT IS NOT TRANSFERABLE <br /> Keep this document with your records. Show this permit to the septic system installer prior to installation <br /> of the system. Any deviation from the approved plan must have prior approval from this office. <br /> <br />MC 15-S7 <br />REV 1/94 <br /> <br /> <br />