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CERTIFICATE OF SATiS,[=ACTORY COMPLETION <br /> MARION C(~INTY <br /> COMMUNITY DEVELOPMEN~ DEPARTMENT <br /> BUILDING INSPECTION~,IVISION <br /> 220 HIGH STREET NTt% <br /> SALEM, OREGON 97301~ <br /> PHONE'S88-5147 ~ <br /> <br />OWNER: <br />ADDRESS: <br />INSTALLER: <br />SEPTIC TANK: <br /> NO. GALLONS: <br /> MATERIAL: <br /> MANUFACTURER: <br /> <br />BUILDING SEWER MAT'L: <br /> <br />,¢ ON-SITE SEWAGE SYSTEM INSTALLATION INSP..ECTION <br /> <br /> DISPOSAL FIELD: <br /> TOTAL LENGTH: <br /> PIPE MAT'L: ~- <br /> TRENCH DEPTH: <br /> ROCK DEPTH: <br /> DIST. TO WELL: <br /> <br />EFFLUENT SEWER MAT'L: ~'~. ,~.,¢-.,MA/,~. ,, 'Z,~r~ ,,~..~., ' BOXES: <br />..¢~ /.¢ ~>.,? d-~,-¢, ....... <br /> <br />In accordance with Oregon Revised Statute 454.665; this certificate is issued as evidence of satisfactory <br />completion of a subsu[face or al, t~rnative sewage disposal system at the above location. <br /> INsPECTEDB,~ .~/ ~ DATE: '~'L¢/*~ <br />MC 15,S6 Rev. 12/92 <br /> <br /> <br />