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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 />The work will be performed by a registered builde¢. <br />Other <br /> <br />'c, WhEr~, E.__03/10ZStA ........-TI~E B.-~.4~-£8 ...................................... <br /> <br />I H~PTON~ KELLY & VERNON RESII)ENTDZRL <br />~ '~0~ '~D~ES~: ............................................... CONSTRUCTfON TYPE; . <br /> <br /> 8~7~ SHAW SQOARE <br /> AUM~V~LLE OR 972~5 MARION COUNTW NO ' <br /> , <br /> <br /> 4 <br /> <br />SAME ....... <br /> SITE NUMBER= 94-80845 <br />PMONE: 362-0447 VALUATION: <br /> <br /> AR3 ~ 49 <br /> IRA ........................... <br /> NO J NO <br /> <br />TYPE; ON-SITE SEWAge <br /> <br />PERMIT OR APPLICATION <br /> <br />CONI'RACTO~, NO. <br />HAMPTON~ KELLY & VERNON <br />SANE <br /> <br />PNONE: ~62-0447 <br /> <br />532~4 <br /> <br />WATER SUPPLY: PW <br />'rEST HOLES READY: <br />SITE EVALUATION NUMBER: <br />EXISTING TANK SIZE: 1000 <br />EXISTING DRAIN FIEL~ LINES: <br />SEPTIC TANK PUMPED: 2/7/94 <br />PREVIOUS NO. BEDROOMS: 3 <br /> <br /> ITEM QUANTITY AMOUNT <br /> AUTMORIZATION NOTICE - FLD. VISIT i $:1.6~.00 <br /> <br /> TOTAL ASSESSED FEES $160.00 <br /> PREVIOUS RECEIPTS <br /> THIS RECEIPT $0.00 <br /> <br /> BALANCE'FDUE $0.00 <br /> PAYEE: ' ' RECEIPT NO: <br /> RECEIVED BY: PB - TYPE: CHECK ¢: 0 <br /> SEE ATTACHED DOCUflENT FOR RE~UIREflENTS.OFON-S~TE SEWAGE SYSTEM. <br /> <br /> ~ THI~ IS A VALID PERMIT ~ 'THIS'PERMIT EXPIRES ~0 DAYS FROM ~TS ISSUE DAT~. <br />CONSTRUCTIgN FA~LS TO NEET ALL REQUIREMENTS OF STA'TE LAWS AND HARION COUNTY BUILDING AND <br />ZONING ORDINANCES, TNIS PERMIT SMALL BECOME'NULL AND VOID. <br /> <br />REMARKS: AU'tH <br /> <br />DONALD E. WOODL. EY, MARION COUNTY BUDiLOING OFFICIAL / BY <br /> <br />~o~t~ # uc'~-~ r~.,~o OFFICE COPY <br /> <br /> <br />