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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 WHI be performed by a reoistered b¢lder. <br />Other <br /> <br /> CAIIGHMAN~ El IZABETF i [ RFSIDENTIAL <br /> ~' I CONSTRUCTION TYPE: <br /> <br /> .562 '[ I TH ST N J'~'f'~×Ef ~t~V:' i"0~i§i <br /> AUHSVILL~' OR 97725 ~ MARION COUNT~ NO <br /> <br />AOBR~'. ~'~ SUBDIVISION: <br /> <br /> SAME SITE NUMBER: 94-~755 <br /> PHBNE= 749'"15¢~ V~LURTZON~ <br /> <br />TYPE= OH-SITE <br /> <br />PERHIT OR APPLICATION NO: <br /> <br />CONTRAC?R, <br />CAUGHMAII~ ELIZABETH <br />SAME <br /> <br />PHONE: 749--1~0~ <br /> <br />WATER SUPPI. Y: PW <br />TEST HOLES READY: <br />SITE EVALUATION NUMBER: <br />EXISTING TANK SIZE: 758 <br />EXISTING DRAIN FIELD LINES: <br /> · ' -"' <br />SEPTIC lANK PUMPE~. <br />PREVIOUS NO. BEDROOMS: <br /> <br /> il'EH <br />ANNUAL EVAL. - TEMP OR NDSHP MH <br /> <br />TOTAL ASSESSEB FEES <br />PRE~i[OUS RE[;EIPTS <br />THIS RECEIPT <br /> <br />QUANTITY AMOUNT <br /> 1. $90.00 <br /> <br />$90,.80 <br /> <br /> $0.00 <br /> <br />BALANCE DUE $0.00 <br /> <br />PAYEE: RECEIPT NO:: <br /> TYPE: CHEI;K <br /> <br /> RECEIVED BY: PB ....................................... 0 <br /> SEE ATTACHED DSCUMENT FO~ REQUIREMENTS OF OH-SITE SEWAGE SYSTEM. <br /> <br /> * THIS IS A VALIB PE~HIT * THIS PERHIT EXPIEES 368 DAYS FROH ITS ISSUE BATE. IF <br />CONSTRWCTIOI~ FAILS TO MEET ALL ~EBUIEEM~NTS OF STATE LAWS AND MARION COUNTY BUI[.,DIN~ AND <br />ZObl,~ ]RDIbAbCES~ '~IS PERMIT SHALL BECOME NULL AMD VSI~, <br /> <br /> DONAI,,.~ E. wOODLEY,~ HARION COUNTY ~UILDING OFFICIAL / BY ............................. ~ ........................................... <br /> <br />FORM # MC 15,5S ~EV. 4m OFFICE COPY <br /> <br /> <br />