|
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 />[OWNER; I TAX LOT:
<br />i (,,ASbAI)E INTLFd,h"ITIOI,! SF. ED COl'iF'ANY ,58,:.&"'~-4;7~8 RESiIDENT]'.AL
<br />
<br /> 8487 k~EST STAYTON RI) SE '~'~J~h: 16~CU~ANT LOAD'.
<br />
<br />,, AUflSVJ:[,.LE OR 77~585 ~AF~tON COUNTY ~0: ~ 4
<br />
<br /> S'rTE NUNBERa ?5-eO3:t7
<br /> PHO. Nt~',: 747,,-iL822 YALUAI'I'ON:
<br />
<br />TYPE: ON-SITE SEWAGE WATER SUPPLY
<br />
<br />PHO['4E." -'7-4 c...? '.i. 8~_,.
<br />
<br />TF. ST HOLES READY:
<br />SITE EVALUATION
<br />EX]~STING TANK STZE: 1000
<br />EXISTING DRAIN F'IELD
<br />SEPTIC 'FANI~ PLJMF'F'D: NO
<br />PREiVIOLIS )iQ; BEDROOMEi:
<br />
<br />3(?)9
<br />
<br /> ITE~ QUAI,IT:ilT Y AI'tOUNT
<br />AiJ'rHI:IRIZATION NgTICE -- FL.D, V.tOIT 1 ¢1(~1.5..¢,,;)I!)
<br />
<br />TO FAI., AS,S.F.,~.'~ED FEEa
<br />PREVIOU,:~ RECEIPTS
<br />THIS R ,F. CEI F'T
<br />
<br />B'ALANtlE DUE $~,T¢,, ~tv
<br />
<br />CAYE ..... R.F,'.CEIF ¥ NO:
<br /> TYPE:C HI.'-'.'CI,~" :,~."
<br />
<br /> RI,(,L]VED BY," MB ............................................... 0
<br /> SEE A"I'TACHE~D bOCllhlEl,IT FOR REtIU~F(EHE~)TS DF OI~,,.SZ~E SEWAGE SYS'FE~.
<br />
<br /> ~ THIS IS A VALI~ P~IT ~ THIS PERmiT EXPIRES ~ ~AY~ FRO~ ITS IB~UE ~ATE. IF
<br />CONSTRUC'¢:~:ON FA)iI...S TO HEET AL.~ REQUIREMENTS OF STATE LAWS AN~ HARION COUhI'FY ~'.~u]:r,,,DFNG AN~)
<br />7. DN;[NF, fJI:~D:~HANCES~ THIS PERMI .' SHALL BECOHE NULL AhlB vO:t:D,
<br />
<br />Fd,:HARKS; SS: AUTH ~/ V:[S}:"[: PF,,12/23/74,
<br />
<br />)>~.;1!,)¢,~...):) i::., kI(}(:)DLEY,¢ MFIRI'FJH .¢,0UN')'¥ BUi'LDIN(; OF. I(..IAL/ BY
<br />
<br /> OFFtCE COPY
<br />~ORM # MC: ~ $~S6 REV, 4/9O
<br />
<br />
<br />
|