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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:S0 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />i am pertormlng work on ~property I own or occupy, <br />~ am a reOstered builder OR ( ) the authorized representative <br />of a registered builder, <br />The work will be performed by a reSistered builder, <br />Other <br />I have read and agree to the terms stated on the reverse side of <br /> <br /> ~A~E':~ ~[/24/94 T~HE: 16:38:45 <br /> CHRISTIE~ DAVID <br /> <br /> 13367 DONALD RD NE <br /> AURORA OR 97~e2 <br /> <br />MAILING ADDRESS; <br /> <br />TAX LOT; <br /> 4~709~00 <br /> <br />CONSTRUCTION TYPE; <br /> <br />t~Tf~ ~UNTY <br /> <br />SUBDIVISION: <br /> <br />CATEGORY'. <br /> RESIDENTIAL <br /> <br />OCCUPANCY; <br /> <br />OCCUPANT LOAD: <br /> <br />SAME <br /> <br />PHONE: 678-5724 <br /> <br />SITE N§I{~L~R: <br />VALUATION: <br /> <br />94-~Z58 <br /> <br />LOT: ELOCK; I 1$ 4S 1W EFU <br />WIDTH: AREA'. '~6= UNIT~;~ IIRREG'NO LOT; COnNER,.NO <br /> <br />MAP: <br /> <br />TYPE: ON-SITE SEI~GE WATER SUPPLY: <br /> TEST HOLES READY: <br />PERNIT OR APPLICATION I~: 51874 SITE EVALUATION NUMBER: <br /> EXISTING TANK SIZE: <br />CONTRACTOR, NO. ~9~7 EXISTING DRAIN FIELD LINES: <br /> SEPTIC TANK PUMPED: <br />SAME <br />~HONE: ~78-5724 <br /> <br /> ITEM <br />STANDARD ON-SITE <br />SITE EVALUATION, <br /> <br />PAYEE: <br />RECEIVED ~Y: DM2 <br /> <br />SEE ATTACHED <br /> <br />QUANTITY <br /> <br />RECEIPT NO: <br />TYPE: CHECK ~: 0 <br /> <br />AMOUNT <br /> $255.00 <br /> $265.00 <br /> <br />$520.00 <br />$520.00 <br /> $0.00 <br /> <br />NOTE: THIS DOES NOT ,CEi~NT,.OR.:,,I,MP,LY.,PERM:ISSION...TO..BU,'rLD:,,,ON THIS PARCEL. PLANHIN~ AND <br />ONSTRUCTION PERMITS MUST 'DE OBTA'I'NE])' ]~EFORE~'~UIE]~.NG' ORSEPTIC INSTALLATION I~EGINS. <br /> <br />DONALD E. WOODLEY, MARI[~N couNTY ]~UT~DTNG OFFTcTAL /,~ _ <br /> <br />FORM # MC 1E-~ REV. <br /> <br />OFFICE COPY <br /> <br /> <br />