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MARION COUNTY BUILDING INSPECTION
<br />SENATOR BLDG. NO. 225
<br />220 HIGH STREET NE
<br /> SALEM, OREGON 97301
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<br />PHONE: E[88-5147 .8 O0 - 4:30
<br />HOUR CODE-A-PHONE: 588-7~4
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<br />I ~m a reg[steCed builde¢ OR ( ) the e uthorized representative
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<br />flU~SVI[.LE~ OR 97325 NAR[ON ~0UNTY ;N0 ; i~
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<br />TYPE= ON-BITE SE~A~E
<br />PERH[T OR APPLICATION NO: 147377
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<br />CON'FRACTOR~ NO. ,
<br />~ODDERN DUII_DIND SYSTEHS~ INQ 1
<br />KENNETH A RASNUSSEN: P.E. 682-1
<br />PO BOX 25~ TUALATIN, OR 97~62 ,
<br />PHONE: 749-4949
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<br />WATER SUPPLY
<br />TE~T HOLES READY:
<br />SITE EVALUATION NUMgER:
<br />EXISTIN~ TANK SIZE:
<br />EXISTING ~RAIN FIE~D LINES:
<br />.SEPTIC T~NK PUMPED.
<br />PREVIOUS NO. BED~OOHS:
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<br /> AUTHORIZATION NOTICE -"FIELD' V,ISIT .... , : i $l&O. 00
<br /> "" j'~ . ' ' TOTAL; '~SSESSED'.'EEES
<br /> $~6~.
<br /> · ' .... ' ,. '..' P~E,~*/'~UD..EE~'IPTS.
<br /> ' ." ,". .... ..' .. · 'THI~:,RECE!PT ' '
<br /> .... T:-.',..:; ~. ~:,,'.',,,,,,, ,, :,. ',: ~E'AHCE.. DUE/',,, ,' $~.
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<br /> PAYEE: '" ' ~:, '""""' ":' RECEIPT NO~
<br /> ~ECE~VE~ ~Y. 9H ...... ,' TYPE~ CHECK J:
<br /> S~E ATTACHED ~OCUNENT FOE',~E~U~RE~NT8 ~. ON;SITE ,SEWAGE
<br /> ~ THiS IS A VAL],~ PERMIT, ~. 'TH~;PER~,~P~ 3~'~YS PEON ~TS ISlE DATE,
<br />CONSTrUCTiON ~A~LS TO NEET..A~E. EEQU~RENE,~TS,',OE.~TA~E'.LAWS,,AND HARION COUNTY 9UZL~ZNG AND
<br />ZON]N~ O~NANCES~ TH~S PERH~T'"S~A~ "~CgNE';NULL. AN~ ,'V, OI'~. ;.
<br /> -: .-.,.,,. ,'~,,,,,;, ',,,..... ,. '........ '., '.~ ,, .... .,
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<br />R£HARKS: AUTH:FIEL~) (OFF,ICE APP~Le~O47372~E~ZCE ~'N':.PLANT
<br /> FUTURE SAi,ID FILTER. SY~TE~ FOR REPAIRS,
<br />I)ON~LD E. WOOI)LEY~ MRRION COUNTY BUILDING OFFICIAL / BY
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<br />~APPL~.~74) PF
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<br />~E COPY
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