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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 />DAiE: 06/17/91 riME: 14:01:35 <br /> <br /> 1HC~VlF~QN , MICHAEL <br /> <br /> 10024 WISEACRE LANE NE <br />AURORA OR 97001 <br /> <br />USE OF BUILDING <br /> <br /> CONTRACT CITY <br /> <br />f4ARION COLINIY . <br /> <br />UGS <br /> <br />SAME <br /> <br />PHONE: 6?8~2?66 <br /> <br />SECTION TOWNSHIP <br /> <br />NO <br /> <br />WIDTH <br /> <br />140 <br /> <br /> ARFA UNITS <br />147 20580. <br /> <br />RESi DENI IAL. <br /> 3 <br /> <br />SiIE NUMBER; 13074 <br />VALUATION: <br />RANGE ZONE MAP <br /> <br /> 6 <br /> <br /> NO NO <br /> <br />32776 <br /> <br />WAFER ~UPPLY: PW <br />F~T HOLES READY: <br />SllE EVALUA1 ION NUMBER: <br />EXiSfiNG FANK SIZE*. <br />EXiS'flNG DRAIN FIELD LINES: <br />~EPFiC ~K PU~PED: <br />PREV[~S NO. BED~: <br /> <br />REPAIR - Fc~NdOR <br /> <br />C,~JANTiIY AIvIOUN1 <br /> $80.00 <br /> <br />'FO1AL ~E~ED FEES <br />PREVIOUS RECEiPFS <br />IHiS RECE~P')' <br /> <br />BALANCE ~UE <br /> <br />80.00 <br />80.00 <br />$0.00 <br /> <br />$0.00 <br /> <br /> PAYgg: REC~IPF NO: <br /> RECEIVED NY: mi FYPE: G~ECK ~: 0 <br /> <br /> SEE AIIACHED OC,Y,~UME!~4F FOR REQUiREI~IENTS OF ON-sirE SEWAGE SYSI'EM. <br /> <br />* THIS ~5 A VALID PE~IT * THIS PE~IT ~PIR~ 360 ~ ~ iTS I~E DATE. IF <br />~8T~OfI~ FA~ TO ~EET ALL RE~RBBT$ OF STATE ~ ~B ~RI~ ~NfY 8U~LBIN6 ~D <br />Z~IN60R¢iN~C~. fHI8 PE~IT ~ALL BEdE NULL ~8 ~ID. <br /> <br />RE'lARKS: DRAINFiELD REPAIR R~5580 /~ <br />DONALD E. WOODLEY, MARION CONJN)Y BUILDING OFFICIAL / BY .................~ <br /> <br />~ORM t~ MC 1~-,~6 ney 4/~o OFFICE COPY <br /> <br /> <br />