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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG, NO. 225 <br />220 HIGH STI~EET 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 />I have read and agree to the terms stated on tho reverse side of <br /> <br />°W"~A'f'E: 05/18/92 'f' i1'4E: <br /> <br />SITUS ADDRESS:I'UCKER, WILLIAM <br /> <br />TAX LOT <br />CONSTRUCTION TYPE. 9022'1--2 t 0 <br /> <br />[)E'1 ~(DJ. I NO <br /> <br />2?(.} ,'~AN'f [AM AVE: <br />DEl ROI T <br /> <br />CATEGORY' <br />CE :UPANC'~ .~'~.51 DEN T [ A <br />OCCUPANT LOAD <br /> <br /> :J <br /> <br /> 3095 FIR TREE DR SE <br /> SALEJVl, OR 9730q <br /> PHONE: 3~4'-8251 <br />LOT: BLOCK: SECTION~ TOWNSHIP <br /> <br /> SiTE NUMBER: <br />RANm~ALUA~fION:zoNE: <br /> <br />MAP' <br /> <br />5E CORNER RS <br />N(') NU <br /> <br />'TYPE: ON-SI'TE SEWAGE <br /> <br />PERM1']' OR APPLiCA','iON BIO; <br /> <br />CON'T'RAC'f'OR, NO. <br />TUCKER, WILLI~ <br />3095 FiR I'REE OR SE <br />~ALEM, OR <br />PHONE: <br /> <br />WATER SUPPLY: CW <br />'T'g~1 HOLES READY: YES <br />SITE EVALUATION NUMBER: <br />EXIS'fiNG TANK SIZE; <br />EXISTiNG.ORAIN FIELD LINES: <br />SEPTIC TANK f--%JMPEO: <br />PREVIOUS NO. BEORoorq~: <br /> <br /> ~lE~ (~:~"Z....~ ©UANfI'fY AMOUN'f <br /> <br /> BALANCE DUE $0.00 <br /> <br />PAYEE: iNVOICE NO: <br />RECEIVE0 BY: CL TYPE: CHECK ~: <br /> <br />SEE ATTACHED DOCUMENT FOR REQUIREMENTS OF ON-~I'l'£ SEWAGE SYSTEM. <br /> <br />NOTE: THIS DOES NOT GR~4~T OR II~IPLY PERMISSiDN TO BUILD ON THIS PARCEL. PLANNING AND <br />CONSTRUCTION PER~4ITS NUST BE O~STAINED BEFORE BUILDING OR SEPTIC iNSTALLATiON f~E. GINS. <br /> <br /> PLAN REVIEW: BY ...................................... DATE ................................................... CiTY JURISDiCTiON: BY <br /> REMARKS: SE <br /> <br />DA l' E .............. <br /> <br /> OFFICE COPY <br />FORM # MO 15-56 REV. 4/90 <br /> <br /> <br />