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MARION COUNTY <br /> COMMUNITY DEVF:LOPMENT DEPARTM!=NT <br /> BUILDING INSPECTION DIVISION <br /> 220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> PHONE: 588-5147 <br /> C¢ )NSTRUCTION PERMIT TO INSTALL A SEPTIC SYSTEM <br /> <br /> _.,~__~ ~0o ~_'~ <br /> <br /> ~ The ~eptic ~ystem mu~t b~ in~tafle~ a, shown ~ve and must be inspected prior to <br />2. All d~S~osal trenches shall ~ ¢n~talled SO as to fo/iow the natural contour of the ground, <br />3 If there ara questions concerning the layout of the system, p/ea$e cai/our office prior to construction of ~he system <br /> <br />Name,' -7-"':~' l©/J '~ ~A-~ ' ~ <br />Addres~.~ .,~,A~e~'~ ...~,.),c/ ~.. <br />Legal Descnpt, on: T ~ R ~ S ~ <br />T~x Lot No, <br />System Will Se~e: '~ 5~%~C~ <br />Prelected Sewage Flow: ~O ,gal/day <br />Water Supply: ~m~ <br />I~uance Date: ~ - ~ -~ ~ <br /> <br />E~piration Date:: '~ - ?-% -~. ~ ..... <br />IMPORTANT: Keep this document wiih your records. Show <br />this permit to the septic system installer prior to installation <br />of the system. Any deviation from the approved plan mu~t <br />have prior approval from this office.. <br /> <br />SYSTEM SPECIFICATIONS: <br />Type ct System::_. ~.~"t~/~ ~.~--__o. <br />Septic Tank Capacity: ...... <br />Lineal Feet Disposal Field: <br /> <br />Distribution: <br />Disposal Trench Depth: .. <br />Filter Material Depth; <br />Minimum Soil Backfill: <br />Curtain Drain Required: <br />Special Requirements: <br /> <br />( )Yes; ~)No <br /> <br />_gaJ mirl <br /> <br />Site Number: __ <br />Perm;t Number: <br /> <br /> Registered Sani~anan <br /> <br /> <br />