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MARION COUNTY BUILDING INSPECTION <br /> COMMUNITY D~V~LO~ C~l~ <br /> 285 Clinch St, NE - Rc~m 13:2 <br /> Salem, O~n 97301 <br /> 8:00~un*4;30pm Phone ~8-~147 <br /> <br /> SITE EVALUATION AND/OR SEPTIC PERMIT APPLICATION <br />L LOCATION OF INSTALLATION <br /> <br />2. CONTRACTOR INFORMATION <br /> <br />3, <br /> <br /> s~te Eva ua~o~ Comm=~ <br /> <br /> ~., ~.~ ~o ~ w.,, ............. ~ ....... · ............ :":..:.......:~ <br /> <br />Tank Pure l:w~: <br /> <br />Pomp/r~g C~:l~;ificafion A~tacbed: (y) (N) <br /> <br /> <br />