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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG NO 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE ~88-5147 <br />CODE-A-PHONE 4::30 PM, - 8::00 AM, <br /> <br /> efa registered bulPder <br /> <br /> Other <br /> <br />DATE: 02/01/88 TIME: 10~47:26a <br /> <br />SIGNATURE OCr APPLtCANT <br /> DATE <br /> <br />I ~A× LOT <br /> <br />/ CONST~bC~ION T¥~E <br /> <br /> 4?6? OUMORE OR :OCCU~^NT LO~,D <br />AUh4.S¥ I L LE OR 9?325 r <br /> <br />1335 Rf:~EWAY CT SE <br />S,~, L E/'4 9. 302 <br />i-HONE: 378.-4000 <br /> <br /> C4,SCA DE PARK <br /> <br />SITE NU~ER: 1 <br /> VALUAT ;[ON: <br /> <br />ICi' E, LOCK iS~C'¢(ON (T0"WN~Hi~ : ~Nd~E ' ZON'E , MAP <br /> <br /> 4. 1 '(2 ~ 8S 2N... ~ ~R5 82 6 <br />W~OTH DEPTH ' ARE~ ~NIT~ IRkEd' LOT ' :~ORN~R <br /> 3.00000 ~ AC NO ~ NO <br /> <br />TYPE; ON-SITE <br /> <br />PErMIt OR APPLICATION NO: <br /> <br />CONTRACTOR, NO. <br /> <br />:3:~5 ROSENAY CT SE <br />SAL..FJ'4 97302 <br />PHONE: 378~4000 <br /> <br /> NATER SUPPLY; PN <br /> TEST HOLSS READY= <br />6174 SITE EVALUATION NUMBERt 1-16~74 <br /> EXISTING TANK SIZE: <br /> EXISTING DRAIN ~IELD LINES: <br /> SEPTIC TANK PUMPED. <br /> ~REV[OUS NO_ 8EOROOMS: <br /> <br />ITEM OUANTITY ~¢40UNT <br /> <br />TOTAL ~SESSED FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />$125.0J <br />$¢25.08 <br /> $0.0O <br /> <br />BALANCE DUE $0.00 <br /> <br />PAYEEr RECEIPT NO~ <br /> <br />RECEIVED ~Y: pb TYPE; CHECK :~: <br /> <br />SC£ ATTACHED OOCUMENT ~OR REOU;[REHENTS OF ON-S~TE~S.EW~E ,SYSTE~. <br />~ ~IS IS A VALID PE~IT ~ ~IS PE~IT ~I~ 3'60 ~ F~ iTS I~E DATE. IF <br />~T~CTI~ FAI~ TO ME~ ALL REdIReCT5 POE: S~TE~ ~ ~D ;~RI~ ~N~ BUILDING ~D <br />Z~I~ O~IN~C~. ~[S PE~IT ~AEL 8E~E NUL~,.~B ~ID~ <br /> <br />~N~,_~ E..WLOOLEY, MARICN COUNTY SUJLJING OFFiCIaL / ~Y <br /> <br />OFFICE COPY <br /> <br /> <br />