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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. Ail disposal trenches shall be instal/ed so as to follow the nature/contour of the ground. <br /> <br />3. If ~here are questions concerning the layout of the system <br /> <br /> Name: ~--~t~J <br />Address: (~ ~ <br /> Legal D~cdpfion: T <br /> <br />System wilt Sewe: <br />Projected Sewage Flow: ,~ gal/day <br />Wster Supply; <br /> <br />Expiration Date: <br />(Request ~r rental of this permit must be <br />the~x~iration date.) <br /> <br />)lease call our offi'ce prior to con~tttlction of the system, <br /> <br />SYSTEM SPECIFICATIONS: <br />Type of System: ........ <br />Septic Tank Capacity: { ~ gal. min. <br />Lineal Feet Disposal Reid;.,~..~ <br />Distribution: ;~/~¢ , <br />Disposal Trench Depth; ~.~ <br />Filter Material Depth: <br />Minimum Soil Backfill: <br />Curtain Drain: ( ) Yes; (,¢.._) No <br />Special Requirements:" <br /> <br />IMPORTANT! --THIS PERMIT IS NOT TRANSFERABLE <br /> Keep this document with your records. Show this permit to the Sel3tlc system installer prior to installation <br /> of the system. Any deviation from the approved plan must have prior approval from this office. <br /> <br />REV 1/94 <br /> <br /> <br />