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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:S88-5147 8:00 - 4:80 <br /> 24 HOUR CODE-A-PHONE: 588-7904 <br /> <br /> DATE: 01/25194 TIME: 14:02:59 <br /> <br /> i' WILSON~ GLENN H & ALICE N 71850-160 RESIDENTIAL <br /> <br /> ~ 116~1 ~TEINKA~P R~ SE <br /> AUMSVILLE OR ~7~25 ~T~i~~ ~ ~66~O~Ydo~6 <br /> <br /> :U~E o¢ ¢Oi'&'~ik~i ~wo o¢ 86onoo~s: , <br /> <br />i 3&~47 6ZLKEY RD <br />I SCIO OR 97~25 SITE NUHBER: <br />I PHONE: 928-37~1 VALUATION: <br /> <br /> ~ LOT'. i BLOCK: i SCOT'ON: ~CWNSHIP: <br /> ie I <br /> ,[ ', 5. ~2 AC J NO ~ ~0 <br /> <br />TYPE: ON-SITE SEWA~E <br /> <br />PERNIT OR APPLICATION <br /> <br />CONTRACTOR, NO. <br />WILSON. GLENN H & ALICE M <br />36&47 GILKEY RD <br />SCIO 0R 97325 <br />PHONE: 928-3761 <br /> <br />52163 <br /> <br />WATER SUPPLY: PW <br />TEST HOLES READY: <br />SITE EVALUATION NUMBER= 85-660 <br />EX~STING TANK SIZE= <br />EXISTING DRAIN FIELD LINES: <br />SEPTIC TANK PUMPED: <br />PREVIOUS NO. BEDROOMS: <br /> <br /> ITEM QUANTITY AHOUNT <br /> STANDARD ON-SITE SYSTEM 1 $255.00 <br /> <br /> TOTAL ASSESSED FEES $255.88 <br /> PREVIOUS RECEIPTS $255.80 <br /> THIS RECEIPT $8.00 <br /> <br /> BALANCE DUE $0.00 <br /> PAYEE: RECEIPT NO= <br /> RECEIVED BY: PB TYPE: CHECK ~: 0 <br /> SEE ATTACHED DOCUMENT FOR REQUIREMENTS OF ON-SITE'SEWAGE SYSTEM. <br /> <br /> $ THIS IS A VALID PERNIT * THIS PERHIT EXPIRES 3&8'DAYS FROH ITS ISSUE DATE. IF <br />CONSTRUCTION FAILS TO MEET ALL REQUIREMENTS OF STATELA'WS AND MARION COIJNTY BUILDING AND <br />ZONING ORDINANCES~ THIS PERMIT SHALL BECOME NULL AND VOID. <br /> <br />REMARKS: <br /> <br />DONALD E. W£)ODI_EY~ <br /> <br />MARION COUNTY BUILDING OFFICIAL / BY <br /> <br />FORM # MC- 1~-56 R~V, 4230 OFFICE COPY <br /> <br /> <br />