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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 />of a registered builder. <br />The work will De performed by a registered builder, <br />Other ........ <br /> <br /> le~22 LEVER~N RD BE ~ OONTRAOT CITY: UGB: ~' OCCUPANT LOAD: <br />OR 9~LIMSVZLL, E 7~25 ~RZ)N COUNTY ~N[ <br /> <br />562 N &J, TH ...... <br />AUMSVILLE '~ SITE HUMBER: <br />PNONE: 749~15~ i VALUATION: <br /> <br />TYPE: ON-SITE SEWAGE <br /> <br />PERMIT OR APPLICATION HO= <br /> <br />C~NTRACTOR. NO. ~4916 <br /> STAYTON SEPTIC <br />411~S STAYTON SCIO gR SE <br />STAYTON~ 97~8~ <br />F'HOWE: 7~9-2~02 <br /> <br />54619 <br /> <br /> WATER SUPPLY: PW <br /> TEST HOLES READY: <br /> SITE EVALUATION NUMBER: 81-~54 <br /> EXISTING TANK $~ZE: <br /> EXISTING DRAIN FIELD LINES: <br />J SEPTtC TANK PUMPED: <br /> PREVIOUS NO. BEDROOMS~ <br /> <br /> ITEM OIJANTZTY AMOUNT <br />STANDARD ON-SITE SYSTEM i $255.00 <br /> <br /> TOTAL ASSESSED FEES $255.00 <br /> PREVIOUS RECEIPTS $255.00 <br /> THIS RECEIPT $0.00 <br /> <br /> BALANCE DUE $0,,00 <br /> PAYEL,, ^ ^ Y~) RECEIPT un. <br /> R BY: MB .... :.___L ................... TYPE: CHECK ¢: 0 <br /> SEE ATTACHED DOCUMENT FOR REQUIREMENTS OF ON-SITE SEWAGE SYSTEM. <br /> <br /> * THIS IS A VALID PERHIT $ THZS PERHIT EXPIRES 368 DAYS FRON ITS ISSUE DATE. IF <br />CONSTRUCTION FALLS TO MEET ALL REQUiB£MENTS OF STATE LAWS AND MARION COUNTY BUILDING AN~) <br />ZONING ORDINANCES, THIS PERMIT SHALL BECOME NULL AND VOID, <br /> <br />DONALD E~ WO.ODLEY, MARION COUNTY BUILDING OFFICIAl.. / BY <br /> <br />FOR~,~ ~C tsse R~V, 4~eo OF FICE COPY <br /> <br /> <br />