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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG NO 225 <br />220 HIGH~.STREET NE <br /> SALEM, OREGOI'¢97301 <br /> <br /> PHONE 588-5147 <br />CODE-A-PHONE 4::30 PM - 800 AM <br /> <br />I am a registered budder ORi ) the authorized representative <br /> <br /> I ha~e read and agree to the terms stated on the reverse side of <br /> <br />©~,TE: 06/19/8'7 TIME: 10=55:58a <br /> REID, ALAN <br /> <br />SIGNATURE OF ARRLIGANT <br /> DATE <br /> <br /> TAX LOT <br /> <br /> CONSTRUCTION TYPE <br /> <br /> 210 CLIFFORD AVE CONTRACTCIT¥ <br />QEMROtT OR 9?342 <br /> <br />UGB <br /> <br />420 ROY ST <br />SHERNOOD, OREGON 97140 <br />PHONE: 625-8549 <br /> <br />~ CT BLOCK S~CTION TOWNSHIP <br /> 26 5 I 10 <br />WIDTH DEPTH AREA UNITS <br /> ?5 135 10125.0 SF <br /> <br />N <br /> <br />PATTON <br /> <br />CATEGORY <br /> <br />OCCUPANCY <br /> <br />OCCUPANT LOAD <br /> <br /> NO OF BEDROOMS <br /> <br />SITE NUI'48ER t 1586 <br /> VALUAT I ON: <br />RANGE ZONE MAP <br /> SE 105 <br />IRREG LOT CORNSR <br /> N N <br /> <br />TYPE: ON-SITE 6ENAGE <br /> <br />PEr'~IT OR APPLICATION NO= 2550 <br /> <br />CONTRACTOR, NO. <br />REID, ALAN <br />420 ROY Sf <br />~ER¢¢OOD, OREGON 97140 <br />PHONE: 825,~5549 <br /> <br />NATER SUPPLY: CN <br />TF.,ST HOLES READY: <br />SITE EVALUATION NUMBER; PATTON II <br />EXISTING TANK SIZE: <br />EXISTING DRAIN FIELD LINES: <br />SEPT1C TANK PUMPED: <br />PREVIOUS NO. BEDROOMS: <br /> <br /> ITEM QUANTITY AMOL/NT <br />%-¢~ND&RD ON-SiTE SYSTEM <br /> <br />TOTAL ASS~ED FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />$125.0u <br />$~25.:.~ <br /> $0,00 <br /> <br />BALANCE DUE $0.00 <br /> <br />PAYEE: INVOICE NO: <br />RECEIVED BY: dm TYPE_* CHECK <br /> <br />~ THIS IS A VALID PERMIT * THIS PERMIT EXPIRES 360 DAYS FROM ITS ISSUE DATE. IF <br />CONSTRUCTION FAILS TO MEET ALL REQUIRENENT~,OF STATE LANS, AND MARION COUNTY BUILDING AND <br />ZONING ORDINANCES, THIS PERMIT SHALL BECOME NULL AND VOID. <br /> <br />REMARKS: PERMIT <br />DONAL0 E- ~OODLEY, MARION COUNTY BUILDING 0FFtCZAL / BY <br /> <br />OFFI{ :E COPY <br /> <br /> <br />