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MARION COUNTY BUILDING INSPECTION <br />SENATORBLDG 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 />06/04/91 fINE: 12:15:25 <br /> <br />5PENNER, JACOUIE <br /> <br />RESiDENf IAI <br /> <br /> 10741 LbYERMAN RD <br /> AU~MV]( LLE <br />USE OF BUILDING <br /> <br />OR 97326 <br /> <br />MARION COUNTY NO <br /> <br />3 <br /> <br /> SANG <br /> ~I~iONE: 'l&9~l 320 <br />LOT Bi OCK <br /> <br />S~CTION TOWNSHIP <br /> <br />SIl~ NUMBER: 13150 <br />VALUAf'~CN: <br /> <br /> 32 <br /> <br />294 718 211092. <br /> <br />~P NO NO <br /> <br />AR <br /> <br />PERf4I! OR APPL[CAilON NO: 9032684 <br /> <br />CON IRACIOR, NO. 359~6 <br />~AYI'ON N~gL C~IY S~LVERr'(JN SEP <br />41165 SfAY1ON ~C~O DRIVE, SE <br />STAY[ON, O~EGON 97383 <br />PHONE: '169~2302 <br /> <br />REPAIR - ~JOR ~ <br /> <br />NAlER ~UPPLY: PiN <br />TESf' HOLES READY: <br />5i'IE 8¥ALUAIiON NUf~BER: <br />~.~iSrlNG ['ANK SIZE: <br />EXiSIlNG DRAIN FIELD LINES: <br />SEPrlC ~'~K ~PED: <br />PREVI~S NO. <br /> <br />TOfAL A~dxS~O FEES <br />PRE¥iOU~ REC~IPfS <br />rHIS RECEiPt <br /> <br />BALANCE DUE <br /> <br />PAYEE; 5rAYf©N MiLL CiFY SiLVERTC~N 5EP'IIC <br /> <br />qUAN'fiFY Zd'4OUNF <br /> $80.00 <br /> <br /> $80.00 <br /> $80.00 <br /> <br />RECEIP[ NO: 344?? <br /> <br /> RECEIVED BY: CL 1YPE: CK CHECK ~t: 3653 <br /> <br /> SEE AIIACHED DOCUMEN~ ['"OR REf,~JiRENENI$ OF ~-511E SEWAGE S~TE~. <br /> <br />~ THIS ~S NOT A PE~[T. THIS APPLI~T1~ ~ST ~ TH~ A R~i~ P~ ~ THE <br />FOLL~ING ~T BE ~PLETED+ IT 1S THE R~SIBILI~ OF THE APPLI~T TO ~RE THAT <br />ALL fl~ INFO~TI~ H~ B~ P~IOED. <br /> <br /> R~RKS.- D~iNP1E~D~'~C~'REPA1R R~B480 <br /> <br /> OFFICE COPY <br />FORM # MC 15-56 REV 4/90 <br /> <br /> <br />