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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 />I mm e registered builder OR ( ) the authorized representative <br />Other <br /> <br />..... Al( BI:NEKOEE,j JOHN I [(ESID IAi_ <br />AURORA OR ~78~2 ~AEIQN COUNTY ~0 , <br /> <br />PO BOX 848 <br />CANBY OR 97~1,~ I SITE NUMBER: ?4-84112 <br />PHONE: 266-2792 i VALUATION: <br /> <br />~---CR+M ............................................... <br /> <br />TYPE: ON-SITE SEWAGE <br /> <br />PERMIT OR APPLICATION MO: <br /> <br />£ONTRACTOR~ NO,, 33966 <br /> BOB~$ BACKHOE . <br />17884 ARBOR GROVE RD NE <br />WOODBURN~ 97871 <br />PHONE: 781-1200 <br /> <br />57091 <br /> <br />WATER SUPPLY: PW <br />TEST HOLES READY: <br />SITE EVALUATION NUMBER: <br />EXISTING TANK SIZE: <br />EXISTING DRAIN FIELD LINES: <br />SEPTIC TANK,PUMPED: <br />PREVIOUS NOi BEBROOMS: <br /> <br /> ITEM QUANTITY ~MOUNT <br /> REPAIR - MAJOR i $125.00 <br /> <br /> TOTAL ASSESSEd FEES $125.00 <br /> PREVIOUS RECEIPTSr' $125.00 <br /> THIS RECEIPT $0.00 <br /> <br /> BALANCE DUE $8.00 <br /> <br /> PAYEE.- RECEIPT NO: <br /> RECEIVED BY: CL TYPE: CHECK ~: <br /> <br /> SEE ~TTA~HE~ DOCUMENT FOR ~E~UI~EMENT~ OF ON-~TE ~EWAGE ~Y~TEM~ <br /> <br /> ~ THIS IS A V~LI~ PERMIT ~ ~]S PERH~T EXPIRES 3~ DAYS FROM ITS ISSUE DAT[ if <br />CONSTRUCI'ION FAILS TO MEET ALL.REQUIREflENT~ OF STATE L~WS AND MARION COUNTY Bt )lNG AND <br />ZONING ORDINANCES, THIS PERMIT SHALL BECOME NULL AND .VOID. <br /> <br /> REMARKS: SS. MJR:REPA:R RENEWAL <br /> <br /> 1)ONA[_D E- WOO~LEY,~ MAR).ON COUJJTY BU:[LQ~:NG OFFICIAL / ~Y <br /> <br />ror, u ~ uc ~-~ ~v, ~./9o OF F ICE COPY <br /> <br /> <br />