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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 />of a registered builder. · <br />The work will be performed by a registered builder. <br /> <br /> DATE: 08/19/92 TINE: <br /> <br /> AUHSVZLLE OR 97325 ,MARION COUNTY NO <br /> ~8~6m~si6~ <br /> <br />LOT: <br /> <br />WIDTH: <br /> <br />SAHE <br /> SITE MUHBER: 92-025~4 <br />PHONE: 749-1782 VALUATION: <br /> <br /> , 51 , 8S I 1W EFU : 48 <br /> 2. ~C ~ YES , NO <br /> <br />TYPE: ON-SITE SEWAGE <br />PERMIT OR APPLICATION NO: 4~790 <br /> <br />CONTRACTOR, MO, <br />BARLOW, THOMAS J <br />SAME <br /> <br />PHONE; 749-1782 I <br /> <br />WATER SUPPLY: PW <br />TEST HOLES READY: <br />SITE EVALUATION NUMBER: <br />EXISTING TANK SIZE: :2DO <br />EXISTING DRAIN FIELD LINES: <br />SEPTIC "rANK PUMPED: <br />PREVIOUS NO. BEDROOMS: 2 <br /> <br /> ITEM QUANTITY AMOUNT <br /> AUTHORIZATION NOTICE - FLD. VISIT 1 $150.00 <br /> <br /> TOTAL ASSESSED FEES $1S0.00 <br /> PREVIOUS RECEIPTS $150,,00 <br /> THIS RECEIPT $0.00 <br /> BALANCE DUE $0.00 <br /> <br />PAYEE: RECEIPT ND:0 <br />RECEIVEO BY: PB .............................. '2']: TYPE: ONEO 0 <br /> <br /> SEE ATTACHEO DOCUMENT FOR REQUIREMENTS OF ON-SITE SEWAGE SYSTEM. <br /> <br />* THIS Is A VALID PERMIT · THIS PERMIT EXPIRES ~60 DAYS FROM ITS ISSUE DATE. IF <br />CONSTRUCTION FAILS TO NEET ALL REQUIREMENTS OF STATE LAWS AND MARION CDUNTY BUILDING AND <br />ZONING OROINANCES, THIS PERMIT SHALL BECOME NULL ANO VOIO. <br /> <br />REMARKS: AUTH - FIELD CHECK <br /> <br />OONALO E. WOOOLEY, MARION COUNTY BUILOIHG OFFICIAL / BY <br /> <br />OFFICE COPY <br /> <br /> <br />