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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 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />OWNER: <br /> <br /> ZELLER, VIU1URiA <br /> <br /> ';555 PL)~'f R0 ~,¢ <br />. J 4,~V.[ LL~ OR ~7325 <br /> <br />USE OF BUILDING~ <br /> <br />SIGNATURE OF APPLICANT: <br /> <br /> r~¥ LOT. <br /> <br /> CONSTRUCTION TYPE: <br /> <br />' CONTRACT CITY <br /> <br />~4ARIDN COUNTY <br /> <br />UGB <br /> <br />NO <br /> <br />SUBDIVISION <br /> <br />R_O_ BOX 103'5 <br />AtJIv~v I LL~, OR 9'5325 <br />F:IqONE: ?49-3? 13 <br /> <br />LOT: <br /> <br />'WIDTH: :DEPTH: <br /> <br /> 2b 8~ <br />20' 30 ] 50 _ ~F <br /> <br /> ,.%.'[ 1[~ Nt.J~BEF~: 1043 <br /> VALUAT 1 ON <br /> <br />qANGE ZONE <br /> ~w AR <br />RREG. LOT 3ORNE~ <br /> NB NO <br /> <br />MAP: <br /> <br />IYPE: (]N-Si ~( ,~ENAGE <br /> <br />PERMIT' OR APPLiCAf'LON NO: 32849 <br /> <br />CON'f RACfOR, NO. <br />Z~LLER, VIC'FGRIA <br />P.O. BOX 1037 <br />AUMSViLLE, OR 9'5:325 <br />PRONE: '549,~'F1 :~ <br /> <br />WATER SUPPLY: PW <br />TEST HOLES R:EAOY: <br />Sif'E EVALUATION NUMBER: <br />EXISTING 'rANK SIZE: 1000 <br />EXISTING DRAIN FIELD LINES: <br />SEPTIC TANK PUMPE0: <br />PREV~OU~ NO. BEDROOMS: <br /> <br /> i FEM QLIAN f'l 'fY AMOUN <br /> REPAIR ,,~ MAJOR ~ <br /> 'f:OTAL ~ESSEO F'~ES $8o. <br /> PRE¥IOUS RECEIPTS <br /> THIS RECEIPT $0.00 <br /> <br /> BALANCE DUE $0.00 <br /> <br /> PAYEE: RECEJ F~'f' NO <br /> RECEIVED BY= CL2 IYPE; CHECK ~: <br /> <br /> 5~ Af'I'ACHED DBCU~ENT FOR RE~UiRENEN'f'S OF ON~SI't'E SEWAGESYS'f'E~. <br /> <br />~ THiS tS A VALID P6R~llf ~ THiS PER~IT EXPIRE~ 360 DAyS FROM iTS IEE4JE BATE_ IF <br />~ST~CT[~ FA[~ TO MEET ALL R~IR~TS OF STATE ~ ~D ~RI~ ~NTY BUILDING <br />Z~ING ORDiN~C~. THIS ~iT ~AEL BEdE NULL ~D VOID. <br /> <br />REMARKS: DRAiNPILEB RE:PAiR R~6505 SAND FILTER- REPAIR SYS'1EM .f~ ~ <br />~)NALD E, WOODLEY, MARION COUNTY BUiLDiNG OFFICIAL / 9Y~ <br /> <br />FORr~ ~ uc ~-~ ney, 4mo OFFICE COPY <br /> <br /> <br />