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MARION COUNTY BUILDING INSPECTION <br />SENATOR IBL~)G. 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 />lamareglsteredbullderOR( ) the authorized representative <br />of a registered builder. <br /> <br />Other ..... <br /> <br /> MODI)E;RN BUZL~;[NG S~STE~S,, lng 685~8::'88~ COM~ERCIRL <br /> <br /> ~4~3 PORTER R~ SE ; CO~RAC~ O~; ~UGB; ~ ocauPANf LO~B <br />~ AtJ~SVII,,,LE~ O[~ 97325 ~ARION COUNTY ~NO , 18 <br /> <br />MAILING ADDRESS; , SUBDIVISION: <br /> <br /> KEHHIETH A RASNOoSEIq. <br /> SITE NUI4BER: 94-92749 <br /> YALUATION: <br /> <br />-OT: J SECTION; q~'~" OWN~HIP: ,I RANGE; ,J ZONe: <br /> <br />TYPE: ON-SITE SEal,GE <br />PERMIT OR APPLICATIOH NO: 47~77 <br /> <br />CONTR¢.CTOR. NO. <br />NOI)~)ERN [~UILDiNG SYSTE~S~ INB , <br />K4~NNETH A RASMUSSEN~ P.E. 6871 <br />PO BOX 258 TUALA'rlN~ OR 9~862 , <br />PHONE: 74~.,-4~49 <br /> <br />WATER SUPPLY <br />TEST HOLES READY: <br />SITE EVALUATION NUMBER: <br />EXISTING TAHK SIZE: <br />EXISTING BRAIN FIELD LINES: <br />SEPTIC TANK PUHPED: <br />PRE¥IOUS NO. BEDROONS: <br /> <br /> ITEM QUANTITY AMOUNT <br />A1JTHORIZATION NOTICE - FIELD VISIT i $160.00 <br /> <br /> TOTAL ASSESSED FEES $1~0.00 <br /> PREVIOUS RECEIPTS $160.00 <br /> TNIS RECEIPT $0.00 <br /> <br /> BALANCE DUE $0,, 00 <br /> <br /> PAYS:E: RECEIPT NO',: <br /> RECEIVE;l) I~Y,*, I)N ....................................................... TYPE: CHECK ~: 0 <br /> <br /> SEE ATTACNEQ DOCIJMEMT FOR REt_IUIREMEi. ITS O~ ON-SITE SEWAGE SYSTEN. <br /> <br /> ~ THIS IS A VALI~) PERHIT ~ THIS PER~TT EXPIRES 3~ DAYS FROH ITS ISSUE DATE. IF <br />COI~STRUCTIBI,I FAIt S TO MEET ALL REQUIREMENTS:OF STATE LAWS AND MARION COUNTY BU;[LDING AND <br />ZONIHG ORDINANCES¢ THIS PERMIT SEIALL BECOME ;'lULL AN]) VOID, <br /> <br />REMARKS: AU'IfIH:F'IEL]O (OF'FICE APPL.~C7047;~72/QFF'iCE 'tN PLANT :APPL~9047~74) PF <br /> FtJFI.I~<E oAH~) FIcL, TER SYSTEM FOR REPAI;RS. <br />I)ONALD E. WOOBLEY~ MARION COUNTY BUILDING OFFICIAL / BY ......................................................................... ~,, <br /> <br />OFFICE COPY <br /> <br /> <br />