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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 sc 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: ~E:~t,5~ E_~C-~. <br /> Address: i ~ ~, ~.,.~ , ~<~A.~-. ~.~'. <br /> Legal Description: T~ R <br /> <br /> System Will Se~e: ' <br /> Proje~ed Sewage Flow: ~ ~ gal/day <br /> <br /> Water Supply: <br /> U t.: [O-q <br /> Expiration Date: <br /> (Request for renewa~ of this permit must be made prior <br /> <br />_, ~he expiration date,~ <br /> <br /> Signature: _ <br />tMPORTANTi ~THIS PERMIT IS NOT TRANSFERABLE <br /> <br />SYSTEM SPECIFICATIONS: <br /> <br />Type of System: <br /> <br />Septic Tank Capacity: <br /> <br />Lineal Feet Disposal Field: <br /> <br />Distribution: <br /> <br />gal, min, <br /> <br />Disposal Trench Depth: ¢,,q~ -.~¢ <br />Filter Material Depth: <br /> <br />Minimum Soil Back-'fill: <br /> <br />Curtain Drain: ( )Yes; ( ,~No <br /> <br />Special Requirements: <br /> <br />Keep this document with your records. Show this permit to the septic system installer prior to installation MC 15-$7 <br />of the system, Any deviation from the approved plan must have prior approval from this office. REV 1/94 <br /> <br /> <br />