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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 />,' 749;~ PORTE'R RD SE ~;'60N'~RAO~- CITY; ,] UdB: ,OCCUPANTI LOAD; <br /> AtJHSVI[.L.E, OF( ~)73~5 MARION COUNTY ~NO r 78 <br />id'cmA O~ A0i'L~f~': ........................................ ~ ........................................................................ ~6~oF ~ED~OOUS: <br /> <br /> KENNETH A RASMU$SEN~. P.E. 682-1422 <br /> PO BOX 258 TUA[.ATIN~ OR 978,52 SITE NUNDER-' 94-02749 <br /> PI,,IONE: 74~?-4~47 VAL, UAT~ON: <br /> <br /> BLOCK'. ' SCOT ON ~ TOWNSH P RANGE ' ZON~ ~ACJ <br /> <br />.......................................... B8 ; ,BO <br /> <br />TYPE: ON-STTE SE~AI;E <br />PERHfT 01~ APPLICATION HO-- 46582 <br /> <br />CONTRACTOR,, NO. , . <br />HODDERN BI,JILDIN~ SYSTEHS~ <br />KENNETH A RASMUSSEN.¢ P.,E. 682-~ <br />PO BOX 258 TUALATIN~ OR 97862 <br />F'MONE: 74~-494~ <br /> <br />WATER SUPPLY <br />TEST HOLES READY: <br />SITE EVALUATI'ON NUMBER: <br />EXISTING TANK SIZE,: <br />EXISTING 9RAIN FIELD LINES: <br />SEPTIC TANK PUMPED: <br />PREVIOUS NO. BEDROOMS: <br /> <br /> ITEM QUANTITY AMOUNT <br /> AUTHORIZAI'iON NOTICE - FIELD VISIT I $160.00 <br /> <br /> TOTAL. ASSESSED FEES $160.00 <br /> PREVIOUS RECEIPTS $160.00 <br /> THIS RECEIPT $0.00 <br /> <br /> BALANCE DUE $0.00 <br /> PAYEE: RECEIPT NO: <br /> RECEIVED BY: BM TYPE: CMESK :~: 0 <br /> SEE: ATTACHED DOCUMENT FOR REOUIREHENTS UF UN-SITE SEWAGE SYSTEM. <br /> <br /> * TN~ I~A VALID PERHIT * THZ~ ,PERHZT EXPIRE~ ~6~ DAYS FROH ITS ISSUE DATE. IF <br />CONSTRUCTION FALLS TO NEET ALL REqUIREmENTS OF STATE LAWS AND MARION COUNTY BUZL. DIN6 AWE <br />ZONING OROINANCES~ THIS PERMIT S~A.L BECOHE MULL AND VOID. <br /> <br />REMARKS;; AIITHORIZAI'ION FOR BUI[iDING PERMIT ~ 44721. FUTURE SEPTIC RE, E~AIRS WI,L[,, ;[NCLtJDE <br /> AI_TERMA'f':[VE Sflh~D FILTER !SYSTEM. ~ ~ _ <br /> OO LEY, .A ON' / .................... ................................. <br /> <br /> OFFICE COPY <br />FORM ~ MC 15,~6 REV. ~ <br /> <br /> <br />