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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:: §88-5147 8::00 - 4::30 <br />24 HOUR CODE-A-PHONE:: 588-7904 <br /> <br />OWNDAfE: 07/24/91 iME: 1'!:09:53 <br />,sram ^OORES~8ORNER' DONALD <br /> <br />8512 HOLMOUiSf RD <br />AUMSViLLE <br />LJ~;E OF BUILDING <br /> <br />OR <br /> <br />5E <br /> <br />LOI <br /> <br />8582 HOWlqU151 RD SE <br />AU~ViLLE, OR 9'7325 <br />PHONb: 749-1092 <br /> BLOCK <br /> <br />SECTION <br /> <br />~IGNATLJRE OF APPLICANT <br /> <br /> RESIOEN/I&L <br /> <br />MARi(tI~' COUNfY NO .0 0¢ <br /> <br />SI'IE NUIVlBER: 13389 <br />RANmVeALUArIOX~: ZONE <br /> <br />DEPTH AREA <br /> <br />8S InnEG LOT 1~ CORNER AR <br /> NO NO <br /> <br />4-8 <br /> <br />lYPE: ON-SiTE SENAGE <br /> <br />PERMIT OR APPLiCAtION NO: <br /> <br />C(~'rRACF'OR, NO. <br />BORNER, DONALD <br />8582 HOMOUI~'I RB ~B <br />AUlv~V~LL~, OR 97325 <br />F~ONE: 'f49~-1092 <br /> <br /> PPLY: <br />F~SF READY: CALL 1 WK AMEAD <br />Sllg NUFC~BCR: lO GOING OUl <br />~Xi~IiNG 4K SIZE: <br />EXISTING IN FIELD LINES: <br />~EPFIC lANK J~PED: <br />PREVIOUS NO. <br /> <br /> ifEM <br />5[fb EVALUA/ION, PiRSI <br /> <br />FOIAL A.~ED FEES <br />PREVIOUS RECEIPIS <br />THi~ RECEIRf <br /> <br />BALANCB DUB <br /> <br />PAYEE- <br />RECglVbD BY: c'l <br /> <br />IYPE: <br /> <br />SEE AIIACHED <br /> <br />FOR REQUIREMENTS OF ON-SIIE SENAGE SYSTFJVt+ <br /> <br />QUANI'IIY AIVYOUNI <br /> 1 $1'75.00 <br /> <br /> ¢175,00 <br /> 175.00 <br /> $o.0o <br /> $o,,oo <br /> o <br /> o <br /> <br />~DTE: THI <br /> <br />NOT GRANT OR IMPLY PERMI,5510N TO BUILD ON THIS PAROEL. NS AND <br />PEFCliTS r, IUST 8E OBTAINED 8EPORE BUILDING OR SEPTIC INSTALLATION ;INS. <br /> <br />E. NOODLEY, ¢4ARION C~UNfY BUiLDiNG OFFICIAL / ~Y ............... <br /> <br />FORM ~ MC 15.~8 R~V 4/gO OFFICE COPY <br /> <br /> <br />