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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 />~bwNER:I)~TE,'; 07113194 TIME-'{: 1~'5~"~'~37 TAX t. bT: <br /> <br />r CONSTRUCT ON TYPE: <br /> <br /> 1,.793 EI"ILEN RD NE <br /> AURORA OP. 97002 <br />iU§E OF §blLBi'N~,. ................................. <br /> <br />, CONTRACT CITY: <br />,MARION COUNTY iNO <br /> <br /> CATEGORY; <br /> <br />~ RE.II)El'IT1 AL. <br /> OCCUPANCY: <br /> <br /> OCCUPANT LOAD: <br /> <br />NO 0F 8EOROOMS <br /> <br />MAILING ADDRESS: , SUBDIVISION; <br /> <br />CONTACT:: JIM ARLETH 645-2230 <br /> SITE NUMBER: ~4-~1777 <br />PHONE: VALUATION: <br /> <br /> , ~0 A,~ NO NO <br /> <br />TYPE: ON-SITE SEWAGE <br /> <br />PERMIT OR APPI. ICATION NO: <br /> <br />CONTRAC~OR~ 1,18, <br />GHI GL,.~EI'~I ,~ LORENZO <br />CON-fACT: JIM ARLETH 6~5-223~ <br /> <br />PNOI,IE: <br /> <br />54784 <br /> <br /> WA'TEE SUPPLY: PW <br /> TEST HOLES READY: <br /> SITE EVALUATION NUMBER: 442:[2 <br /> EXISTING TANK SIZE: <br /> EXISTING DRAIN FIEL~ LINES: <br />'SEPTIC TANK PUMPED: <br /> PREVIOUS NO. BEDROOMS: <br /> <br /> ITEM QOANTII'Y AMOONT <br /> S'rAN~ARB ON-SITE SYSTEM 1 <br /> <br /> TOTAL ASSESSED FEES $255,,00 <br /> PRE¥ZOUSRECEIPTS $255,,00 <br /> THIS RECEIPT $0,,00 <br /> <br /> BALANCE DUE <br /> PAYEE: ,^ if') RE6EIPT H~- <br /> RE~EIVI~.D Bf~ MB ....... , 'TYPE: CHFCK ~,: 1176 <br /> ..................... ========================== ......................... :: ........:: ................... <br /> SEE ATTACHEB ~0COMENT FOR REQUIREMENTS OF' 0N-SITE SEWAGE SYSTEM. <br /> <br />CONSTRUCTION [:'AILS TO MEET ALL REQUIREMENTS OF STATE LAWS AND MARION COONTY BUIL. D~NC AND <br />ZOWING ORD~NANCES~ THIS PERMIT SHALL BECOME NULL AND VOID. <br /> <br />REt4 AI:;:KS :: STD <br /> <br />DONALD 1(,. WOODLEY~ <br /> <br />,AR],ON O01JN'rY BUILOIMG OFFICIAL / BY <br /> <br /> OFFICE COPY <br />FORM # MC 1 ~-§$ REV, 4/~0 <br /> <br /> <br />