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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:: 588-5147 8::00 - 4::30 <br />24 HOUR CODE-A-PHONE:: 588-7904 <br /> <br />Other <br /> <br />SIGNATURE OF APPLICANT <br /> DATE <br /> <br />OWNE-~FE: 08/21791 tIME: 17:15:22 <br /> <br /> BORNER, DONALD <br />SITUS AD[~SESS <br /> <br />TAX LOT <br /> <br />CONSTRUCTION TYPE <br /> <br />CATEGORY <br /> <br />OCCUPANCY <br /> <br />h~bSI D~N ] iAL <br /> <br /> 8512 HOLJ'cOUIS! RD <br />AUMSViLLE <br /> <br />OR 97325 <br /> <br />SE <br /> <br />OONTRAC¥ CITY U~B <br />IVtAR 1 FJN COUNf Y NO <br /> <br />SUBDIVISION <br /> <br />8582 H~IST RD SE <br />ADfc~V I LLE, OR 97325 <br />PHONE: 749-1092 <br /> <br />LOT BLOCK SECTION TOWNSHIP <br /> <br />NUMBER: 13389 <br />VALUAfION= <br /> <br />DEPTH AnEA ~1' ' UNITS 8~ IR~EG LOT llAI CORNER AR <br /> <br />48 <br /> <br />1.8. AC NO NO <br /> <br />T'YPE: ON-~[IE S~WAGE <br /> <br />PbRMIT OR APPLICATiON NO: ~234 <br /> <br />CON fRAC[OR, NO. <br />BORNER, DONALD <br />8582 HC'~IS) RD SE <br />AUIv~VILLE, OR 97325 <br />PFIONE: '749-1092 <br /> <br />HATER SUPPLY: P~ <br />rssr HOLE~ READY: CALL 1WK AHEAD <br />Si1E EVALUAllON NUr,~ER: 10 GOING OUT <br />PDKISTING FANK SIZE: <br />EXiSiING DRAIN FIELD LINES: <br />SEPI'IC rANK PUMPED: <br />PRE¥1C~JS NO. 8ED~: <br /> <br /> iIEM <br />SiTE EVALUAIlON, FIR%~l LO1 <br /> <br />FOFAL A~E,~EO FEES <br />PREWiOUS RECEIPTS <br /> <br />quANrlfY AMOUNt <br /> 1 $1 '~5. oo <br /> <br />115.00 <br />$0.00 <br /> <br />BALANCE DUE $0.00 <br /> <br />RECEIPr NOt <br /> <br />RECEIVED BY: CL TYPE; CHECK <br /> <br />SEE ATIACHBO DOCUMEN1 FOR REQtJIREMEN1S OF ON-SIIE SELVAGE SYS1EM. <br /> <br />NOTE: THIS DOE~ NOT ~RANT OR IMPLY PERMI,~,~ION TO BUILD ON THIS PARCEL+ PLANNING AND <br />CON~TRUCTIO~ PERMITS D'LI~T BE O~TAiNEO BEFORE BUiLDINB OR ~EPTiC INSTALLATION BEGINS. <br /> <br />RE~ARKS: SE R~5593 7-24-91 (DENIED) (8-20-91 <br /> <br />LYgNALD E. NOODLEY. MARION CC~3NfY BU~LOJNG OFFICIAL / BY <br /> <br />OFFICE COPY <br /> <br /> <br />