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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO. 225 <br />2'~0 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 /> am peHorming work on a ¢roperty I own of'occupy. . .... P'I~ANT <br /> <br /> of a registered builder <br /> The wor~ will be performed by a registered builder <br /> <br /> D~TE: 12/e8/94 TIHE: 9= e8=52 ' <br /> <br />[ SITOS ADDRESS: I CONSTRUCTION TYPE; ; OCCUPANCY; <br /> <br /> le679 STAYTON R1) SE ~T~ <br /> ~UPANT <br /> <br /> __.- ............... ~~.'. <br />"~g~EE' A66~EA~ ................................. ~ suemws~o~: <br /> <br /> ~ SITE ~UH~ER: <br /> PHONE: 7~9-4~17 [ VAL. UATION: <br /> <br />~'L'Sf: i~LbbE~ ~i5~] fSg~A~'~ ~'~X~a~ ~ 2~.. <br />, ~ :17 9S 1g <br /> <br />TYPE: ON-SITE SENAGE <br /> <br />PER~IT OR APPLICATION <br /> <br />CONI'RACTOR~ NO. <br />JIJDD~ WAYNE & DEBRA <br /> <br />PHONE: 769-4~17 <br /> <br />WATER SUPPLY: PW <br />TEST HOLES READY: YES <br />SITE EVALUATIOW NUHBER: <br />EXISTING TANK SIZE: <br />EXIS'rIN§ DRAIN FIELD LINES: <br />8EPTI6 TANK PLIMPED: <br />PREVIOUS NO. BEDROONS: <br /> <br />ITEM QIJAN]'I'fY AMOUNT <br />REF'AIR - NAJOR 1 ~ ] ,~8,, 00 <br /> <br /> TOTAL ASSESSED FEES <br /> PRE~IOUS RECEIPTS <br /> TH~S RECEIPT $:L5¢. <br /> <br />,BALANCE DUE ~0,,00 <br /> <br /> WAYNE & QEBRA RECEIPT NO: 62715 <br /> I:?YEE:RECEiVEDJUDD~By,, js ........................................... TYPE:CK CNECK ~: 1103 <br /> <br /> SEE ATTACNED ~DOUMENT FOR ~EQUIRENENTS QF ON-SITE SEWAGE SYSTEM. <br /> <br /> * THIS IS A VALI~ PERHIT * THiS PERNIT EXPIRES 368 <br />CONSTRUC'rION FAILS TO MEET ALI,,. REQUIREMENTS OF STATE LAWS AND MARION COUNTY BUILI)ING AND <br />ZONIN60RDINANOES~ TI,IlS FF, RNIT .~RAL. L BECOME NULL AND <br /> <br />OFi:~ICE COPY <br /> <br /> <br />