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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO. 225 <br />220 HIGH STREET NE <br /> SALF:M, OREGON 97'301 <br /> <br /> PHONE: 588-5147 8:00 - 4:30 <br />24 HOUR CODE-A, PHONE: 588-7904 <br /> <br />of a registered builder. <br /> <br />et her,L <br /> <br />I have reed and agree to the terms stated on the reverse side of <br />this document, <br /> <br />¢ OwNIng'rE: 03/"8/91 <br /> <br /> O'fW <br />~ ~i~U~ ADDRESS: <br /> <br />'CONSTRUCTION ~PE; ;OCCOPANCY: <br /> <br />R,8~ I DENT iAL <br /> <br />t4927 ALBER~ HAY <br />AURORA OR <br />USE OF EIU[LDINC: <br /> <br />97002 <br /> <br />NE <br /> <br /> CONTRACT CITY: [0~61 16~CO~N'f LOAD: <br /> <br />~'O~ ................... ~ NO ~ i~o' o~ ~,~,oo~.,' <br /> <br />24755 ~ 65'f'H <br />I'UALATiN, ORE 9?062 <br />PH(~NE: 638-8291 <br /> <br />LOT: BLOCK: <br /> <br />9g. <br /> <br />AEBER5 'CRE..%T ADD <br /> <br /> ~iI'E NUIV~ER: 12600 <br /> F~ GV'~'LuA T 'I'GN "' [~ <br /> SECTIOn: ~¢ TOWNSHIPZ <br /> <br /> : ~ <br /> ~EA: 12 '~'~i~S; ~S , IRREG LOT[ lW CORNER: 'R1 <br /> <br />236 ~ ~ SE [ .......... ~ NO <br /> <br />3 <br /> <br />'rYPE~ ON-SITE SEWAGE <br /> <br />PEF~lLT OR APPL[CAT[0t4 NO: <br /> <br />CONTRACTOR, NO. <br />DTW HOI~IES <br />24755 ~ 65TH <br />TUALATiN, ORB 97062 <br />PHONE: 638-8291 <br /> <br />~TERSUPPLY= OH <br />TE~ST HOLF-~ READY: <br />SiTE EVALUATION NUJ~BER: 21964 <br />EXISTING TANK ~[ZE: <br />EXISTING DRAIN fftELD LINES: <br />SEPTIC TANK PUMPED: <br />PREY/BUS NO. 8EO~OI~: <br /> <br /> I l'£1vl QUANTITY <br />STANDARD ON-SITE SYSTEI~ 1 $165.00 <br /> <br /> T(~I',AL A.,,%~ESSED FEES $165.00 <br /> PREVIOUS :RECEIPTS $0. O0 <br /> %; THIS,RECEIPT $165.00 <br /> <br /> BALANCE DUE <br /> <br />PAYEE*. BTIN HOI~IES INVOICE NO.- 32935 <br />REC£[VE0 BY~ ¢] TYPE: IN CHECK ~t: 0 <br /> <br />SEE ATTACHED DOCUMP.~T P'OR RE~.:IREt,IENT$ OF C~I-S[TE SE"~E <br /> <br />* TH15 15 A VALID PERI, iT ~ THiS..PEI~IT E~PtRE~360 DAY5 Ff~0f4 ITS [~E DATE. IF <br />CONSTRUCTION FAILS TO ~ ALL RI~I~JZ~ OF 'STATE ~ AND I~RION COUNTY BUILDING AND <br />ZONING ORDINANCES, THiS PERIRIT SHALL BECO~*"~.N~LL AND VOID. <br /> <br />R F. JV1ARKG: ~ <br />DONALD E. NOODLE:Y, D4ARION C'TJUNTY BUILDING OFFICIAL / BY ................................................................................. <br /> <br />~ORM # MC 15-56 REV, 4/90 OFFICE COPY <br /> <br /> <br />