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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 58,9-5147 <br />CODE-A-PHONE 4:30 P,M, - 8:00 A,M, <br /> <br />lam8reg~steredbullderOR( ) the authorized representative <br /> <br />o,~4~T~E: 02/05/88 T~IVlE: "]1 ;3] :03~ I TAXLOT: [CATEGORY: <br /> <br /> ATKJNSON, GERTRUDE i~0ON~:FROCTION TYRE: ¢;C;LPANGY:[OC, U RE,DIZEN ...... <br />SITUS ADDRESS: <br /> <br /> { CONTRACT CITY: UGB: ,OCCUPANT LOAD: <br /> ?82 <br /> TERRANCE <br /> LN <br />AUHSV~LL, E OR 9?325 ~ ~ ~ <br />US~ OF 8UmLDIN~: ~A~O~'-~ ~ ~ N0 0F 8EOROOM5: <br /> <br />MAILING ADDRESS: .... <br /> <br /> SAME <br /> <br /> PHONE; 749-269? <br /> <br />LOT: , DLOCK~ <br /> <br /> i SITE NUHBER: 3593 <br /> VA~LJATtON <br />!~+lON: TOWNGH P , RAN~'~ ' ~ ZONE: MA~'. <br /> <br /> 8.. 88000 AC NO..-. ~ NO <br /> <br />SEWAGE <br /> <br />PER~[T OR APPLICATION NO: <br /> <br />CONTRACTOR, NO. 34915P-2 <br />STAYTON SEPTIC SERVICE <br />4]]55 STAYTON SCIO DRIVE, SE <br />ST&YTON, ORECr.E)N 9?383 <br />i>HONE~ ?69-2302 <br /> <br />5504 <br /> <br />WATER SUPPLY: PN <br />TEST HOLES READY: <br />SITE EVALUATION NUMBER: <br />EXISTING TANK SIZE: <br />EXISTING DRAIN FIELD LINES: <br />SEPTIC TANK PUMPED; NO <br />PREVIOUS NO. 8EDROOMS~ 2 <br /> <br />I'T'E~ <br /> <br />QUANT I TY AMOUN'T <br /> $35. JO <br /> <br /> TOTAL ASSESSED FEES $ 3 5,0 C <br /> PREYIOU,5':':.RECEIP, ITS' ';, ~ ~' ~ '" <br /> THIS' R~EI'PT .... $0,0O <br /> <br />?AYEE: . ~ ~ "/ :://2 , R~CEID? NO: <br /> <br />,~c,:, A ? TAt,HE,300CUNENT FOR REQU Z RE~EN~S QF., ~=S'~TE~ ,~AGE :~ i EN. <br />* ~IS IS A VALID PE~IT * ~IS PE~i,~':'~Pi;R~',,3'~ ]~ ;P~ ,:ITS I~E DATE. IF <br />~ST~CTI~ FAI~ TO ME~:ALL RE~I~TS*OF}STA~E,~,~D:~I~ ~N~ BUILDING ~D <br />Z~ING ORDIN~C~, mis PE~IT ~ALL ::,, <br /> ,,-- -, <br /> <br />RE~ARKS: SEPTIC TANK REPAIR ONLY R~888'0] : <br />DONALD E. WOODLEY, MARION C~NTY BUILDING OFFICIAL / BY <br /> <br />),M'~ MC ~s.5~ n~v.o/~* OFFICE COPY <br /> <br /> <br />