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MARION COUNTY COMMUNITY DEVELOPMENT <br />BUILDING INSPECTION DIVISION <br />220 HIGH STREET NE - SAI ~M, OREGON 97301 <br />PHONE: 588-5147 <br /> <br />CONSTRUCTION PERMIT TO iNSTALL A SEPTIC SYSTEM <br /> <br />1. The septic system must be instated as shown above al?C//1lust be inspected prior to cover. <br />2. Afl disposal trenches shaft be [natal/ed so as to follow the natura] contour of the ground_ <br />3. if them ate quesbbns concerning the layout Of the system, please call our office pdor to construction of the system. <br /> <br />Name: I I ~1 ~,~, -~YST~M SPECIFIOATIONS; <br /> <br />Address: ( ~'1 bq ~'~'~ ~. ~---,, A~4~ <br />Legal Description: T ~'~ R [~ S l[ ~ <br /> Tax Lot No. <br /> <br />S~stom Will Se~e: ...... ¢~/~ ~ ~ <br />Proje~ed Sewage Flow: ~ :gal/day <br /> <br />Water Supply: <br /> <br />E×pi atim Date: <br />(Reque~ for renewal of this permit must be ~ade Drlor <br />the e~p[mtion date,} <br />$,te ~: ~-~~ <br />Signature:--~~_ <br /> <br />Type of System: <br />Septic Tank Capacity: I ~C:::~2) gal. min. <br />Unee] Feet Dispose] Ffeld: <br />,'~"DJstribu'don: <br /> <br />Disposal Trench Depth: <br /> <br />Filter Material Depth: ..... <br /> <br />Minimum Soil Backfill: <br />Curtain Drain: ( ) Yes; <br />Specie] Requirements: <br /> <br />IMPORTANT! -- THIS PERMIT IS NOT TRANSFERABLE <br /> Keep this document with your records. Show this permit to the septic system nstaller pr or to nsta abort <br /> of the system. Any deviation from the approved plan must have prior approval from this office. <br /> <br />MC 15-S7 <br />REV 1/94 <br /> <br /> <br />