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CERTIFICATE OF SATISFACTORY COMPLETION <br /> <br /> MARION COUNTY <br />COMMUNITY DEVELOPMENT DEPARTMENT <br />BUILDING INSPEC'fION DIViSiON <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> PHONE: 588-5147 <br /> <br />OWNER: <br />ADDRESS: <br />INSTALLER: <br />SEPTIC TANK: <br /> NO. GALLONS: <br /> MATERIAL: <br /> MANUFACTURER: <br /> <br />BUILDING SEWER MAT'L: <br />EFFLUENT SEWER MAT'L: <br />COMMENTS: <br /> <br /> ON-SITE SEWAGE SYSTEM INSTALLATION INSPECTION <br />~./~ ~ d~.,.,, H~-~ S~TE NO. c14-,- <br /> ~&'~ 5~At4 ~ " PERMIT NO. <br /> DISPOSAL FIELD: <br /> TOTAL LENGTH: ~. <br /> PIPE MAT'L:., ~ .... <br /> TRENCH DEPTH: ~ <br /> ROCK DEPTH: <br /> DIST. TO WELL: /- <br /> /' <br /> ~ ~h ~' ~ ~O~ BOXES: ...... / <br /> / <br /> <br /> In accordance with Oregon Revised Statute 454.665; this certificate is issued as evidence of satisfactory <br /> completion of a subsurface or a~temative sewage disposal system at the above location. <br /> INSPECTED B ¥.'~- "--~ , (~r'~%,~, DATE:, <br /> TITLE.-:- ...... <br />MO 15-S6 Rev. 12/92 <br /> <br /> <br />