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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 5"~8-5147 <br />CODE-A-PHONE 4;30 P,M, - 8;00 A,M. <br /> <br /> I am performing work on a property I own or occupy. <br /> l am a registered builder OR ( ) the authorized representative <br /> of a registered builder, <br /> The work will be performed by a registered builder. <br /> Other ' <br /> I I~ave read and agree to the terms stated on the reverse side of <br /> this document. <br /> <br /> DATE: 10/20/87 TIME: 3.*51 ~.40p <br />OWNER: <br /> BUTTEVILLE COlflVlUNITY CHURCH <br /> <br />SITUS ADORESS: <br /> <br />', TAX LOT: <br />,, 70380-190 <br /> <br /> CE)N~TRUOTION TYPE: <br /> <br /> 10848 ARNDT RD <br />AURORA OR 97002 <br /> <br />USE OF BUILDING: <br /> <br />MAILING ADDRESS: <br /> <br />10858 ARNDT RD NE <br />AURORA, OREGON 87002 <br />PHONE.- 678-1188 <br /> <br />LOT: BLOCK: <br /> <br /> SITE NURSER: 2718 <br /> VALUATION; <br /> <br />: SECTION; i TOWNSHIP'. , RANGE: ZONE: <br /> 82 I 35 1N : AR' <br />AREA: fUN;TS; : IRREG. LOT: NO :COR~g: <br /> <br />CATEGORY; R <br /> <br />35 <br /> <br />MAP: <br /> <br />TYPE= ON-S'fTE SENAGE <br /> <br />PERMIT OR APPLICATION NO; 4775 <br /> <br />CONTRACTOR, NO+ <br />BUTTEVILLE CON'UNITY CHURCH <br />10858 ARNDT RD NE <br />AURORA, OREGON 97002 <br />PHONE: 678-1188 <br /> <br />NATER SUPPLY: PN <br />TEST HOLES READY.' <br />SITE EVALUATION NUNBER: <br />EXISTING TANK SIZE: <br />EXISTING DRAIN FIELD LINES: <br />SEPTIC TANK PUNPED: 10-15-87 <br />PREVIOUS NO. BEDROONS: <br /> <br /> ITEM <br />AUTHORIZATION NOTICE - FLD. VISIT <br /> <br />OUANTITY AHOUNT <br /> 1 $65.00 <br /> <br /> THIS!RECEIPT $0.00 <br /> BAL~CE DUE $0.00 <br />PAYEE: .... iRECEIPT NO: <br />RECEIVED BY: pb .... ~ ~::::: <br /> <br />SEE ATTAC~IEB DOOUNENT FOR iRF.~IEEMENT8 <br /> <br />* THIS IS A VALID PERI, IT ~' THIS PE~IT EXPIRES 360/,DAYS F~ ITS ISE~JE DATE. IF <br />C~TI(~ FAILS TO I~EET ALL RE(~LII;~:::(~F;;STA'~= ~ NIARION O3U~Fr~ ~UILDIN~ AND <br />ZONING ORDI~,, THIS PEI~IT ~,:B~:Z;NU~iAND VOID.., <br /> <br />RF. NARK~: USING CHURCH SEPTIC A~36g? <br /> <br />DONALD E. NOODLE"Y, MARION COJNTY BUILDING OFFICIAL / BY <br /> <br />· o.~ ,, M..~.~ R~v ~7 OFFICE COPY <br /> <br /> <br />