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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-P tONE: 588-7904 <br /> <br /> I am performing work on a property I own or occupy. <br /> <br /> of a registered builder, <br /> <br /> this document. <br /> <br />OWNeR; 8A F'.,, 041121°4 'f'I HE': <br /> HAS~',:H[. HEr ~, <br /> <br />TAX LOT; <br /> <br /> 75300 ,.~...0 <br /> <br />RESI~EN'f ;AL <br /> <br />LOAm <br /> <br />F'HI%IE ~ <br /> <br /> BLOCK <br /> <br />DEPTH. <br /> <br /> SITE <br /> VALUATION: <br /> <br />SECf~ow: ....... rowhsA'~7 ...... <br /> <br />,/3~ ..... 85 ......... 2W <br />A ~ EA'. U N ~'. ~E~. LOT <br /> <br /> ZONE; <br /> <br /> ~R 5I <br /> OORNER: <br /> <br />No i NO <br /> <br />TYPE: ON-SITE SELVAGE <br />P~R~IT OR APPLICATiOH MO: <br />CONTr?;'rOR,, NO. 3c',:1,78 <br /> ])WAIII ~ETHEL & SSNS EXCAVATION <br />PCi BOX 5e4 <br />TURNER~ ?7?2 <br />PI,,IgNE: 74~-"2343 <br /> <br /> WATER SUPPLY: PW <br /> TEST HOLES READY: YES <br /> SITE EVALUATION IqUMBER~: <br /> EXtS'FING TAI,IK SIZE~ <br /> EXISTING ORAIN FIELD LINES: <br /> SEPTIC TANK PU~PED~ <br />' PREVIOUS NO. BEDROOMS: <br /> <br /> ITEM <br />Al_ ~ L. kATION <br /> <br />TOTAL ASSESSED FEES <br />PREVIOUS RECEIPTS <br />THiS RECEIPT <br />BAIl,NCE DUE <br /> <br />(~UANTITY A~tOUNT <br /> <br /> ,.,^i A <br /> RECEIVEP <br /> BY: <br /> MB <br /> . TYF'E~ CHECK :~,: 1878 <br /> NE;E AI'TAI;HE9 I)OCUHEN~ FOR RE[IUII:EMENTS OF ON-SITE SEWAGE SYSTEM. <br /> THIS IS A vALID PERMIT $ THIi PERHIT EXPIRES ~68 DAYS FROM ITS ISSUE ~ATE. ~F <br />CONSTRUCT~'}N FATe, S TO ~EET ALL ~E~IlIREMgNTS OF STATE LAWS ANO ~ARION COUNT~ BUILi)~'.NG <br />gOqlNG ORg~NAq;~S~ THIS~ PERHIT SH~L BECOHE NULL AN~ VOIB. <br /> / <br /> <br />REHARKS. o,~.,Ak.r OKAY SOILS FOR STA;,Ii)ARO tN,:H'ALLAI.I. ON. <br />i)ONAL?) E~ WCIOPLEt~ HAR;'ON ~l]I. ~ l~t.iJ.L.D,ttq, OFt, I[,.,AL / BY <br /> <br />, OFFICE COPY <br />FORM ,~ MO 15,5~ REV, 4/90 <br /> <br /> <br />