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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. me sep~ s~tem must be ~s~d as shown above and must be ~ec~d p~r to ~ver <br />2. A# d/spesal t~nches shaft be ~s~#ed so as ~ ~w the na~l contour of the g~un~ <br />3. If ~e~ are quest~n$ concem~g the ~ut of the ~$te~ p~ase caft our office p~r ~ const~c~n of ~e s~tem, <br /> <br /> Address: /5~ ¢~¢,~/' ,,¢-z¢/¢-. ~ ,¢~.~/..~. ......' ..... <br />Legal Description: T ~ R ~S ~ <br />Tax LotNo. ~ /¢~~ ~ <br />System Will Serve: ¢~ ~.~ ¢ / ~ ~ <br />Projected Sewage Flow: ~ ~ gal/day <br />Water Supply ~/~ ¢~.... ~e/~ <br />Issuance Date: //~/~ ~,~ <br />Expiration Date: '/~¢~ <br />(Request for renewal of this permit must be made ~or to the <br />expiration date.) <br />IMPORTANT: Keep this document with your records. Show this <br />permit to the septic system installer prior to installation of the <br />system. Any deviation from the a~roved plan must have?rior <br />approval fro~ice.~ / b ~ __ / <br /> <br />MO ~5-S7 <br />REV. 11~2 <br /> <br />SYSTEM SPECIFICATIONS.' <br />Type of System: ~; <br />Septic Tank Capacity: /',¢¢,¢ gal. min. <br />Lineal Feet DisRosal FieJd: <br />Distribution: <br />Disposal Trench Depth: ....~¢~ <br />Rlter Material Depth: / <br />Minimum Soil Backfill: <br />Cu~ain Drain: ( ) Yes; <br />Special Requirements: <br /> <br /> Site Number: ~ <br /> Permit Number: ' <br />THIS PERMIT IS NOT T~NSFERABLE <br /> <br /> <br />