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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 />of a registered builder, <br /> <br />Other <br /> <br />I have read 8nd 8gree to the terms stated on the reverse side of <br />this document, <br /> <br />i OWN6~ATE. :L0/1~./94 TIME: :1.4.: 4S: :~8 %~ L0f: i ~ATEGOHY: <br /> MIEBACI"I~ COR]:E ~ CHA~ 58291-~ RESIDENTIAL <br /> <br /> ~176 ~ATES ROAQ SE ,OONTRACT CITY; ) UGB: )OCCUPANT LOAD: <br /> AUNSVILLE OR 97325 ~ARION COUNTY ~NO <br /> <br /> ~AY PHONE ~ CHA~ 749-1822 <br /> S~TE NUHBER: 94-~345~ <br /> PHONE: 74~-I~26 VALUATION: <br /> <br /> DEPTH; f AR~A: UNITS; IRREg. ~T'. <br /> J 4 6~ AC NO ~NO <br /> <br />TYPE: OH-SITE SEWAGE <br /> <br />PERMIT OR APPLICATION <br /> <br />CONTRACTOr, NO. <br />HIEBACH, CORIE & CHAD <br />DAY PHONE : CHAB 74~-1822 <br /> <br />PI-lONE: 749-102~ <br /> <br />57885 <br /> <br />WATER SUPPLY: PW <br />TEST HOLES READY: <br />SITE EVALUATION HUMBER: <br />EXISTING TANK SIZE: <br />EXISTING DRAIN FIELD LINES: <br />SEPTIC TANK PUMPEB: <br />PREVIOUS NO. BEDROOMS: 2 <br /> <br /> ITE~ QUANTITY AMOUNT <br /> AUTHORIZATION NOTICE - Ft.D. VISIT 1 $160.00 <br /> TDTAL ASSESSED FEES $160.00 <br /> ~REVIOUS RECEIPTS $160.00 <br /> 'HIS RECEIPT <br /> <br /> BALANCE DUE <br /> <br /> PAYEE: RECEIPT NO: <br /> RECEIVEQ BY: dm . TYPE: CHECK ~: <br /> SEE ATTACHED DOCUMENT FOR R~QUIREHENTS OF OH-~ITE SEWAGE SYSTEM. <br /> <br /> ~ THiS IS A VALID PERHIT ~ THIS PERHIT EXPIRES 3&8 ~AYS FROH ITS ISSUE DATE. iF <br />CONSTRUCTION FAILS TO MEET ALL REQUIREMENTS OF STATE LAW8 AND MARION COUNTY BUILDING ANI) <br />ZONIHG ORDINANCES, THIS PERMIT SHALL BECOME NULL AND VOID. <br /> <br />REMARKS: <br /> <br />~)OIqALI) E, WOOI)LEY~ HARIOH COUNTY" BUILBINI:; OFFICIAL / BY <br /> <br />OFFICE COPY <br /> <br /> <br />