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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 />The work will be performed by a regislered Dull,4et. <br />t h~¥~ lead and agree to ~he terms stated o~'¥he rever~e side of DAT~: .... <br /> <br />, 9493 PORTER RD ;~25~E , , . , ~ <br /> AUHSVILLE, OR ~7 . , <br /> ~ARION COUNTY tHO 78 <br /> <br /> ' <br /> <br /> KENNETH A RASMUSSEN, P.E. 682-1422 <br /> PO BOX 258 TUALATIN~ OR 978~2 SITE NUMBER= 94-1B2749 <br /> PHONE: 749-4949 VALUATION: <br /> <br />LOT ~ BLUE: , ~0~ ON ~ ~WN~HIP: , RANG~ ZONe: '.' ~X~' ' <br /> <br />....................... ................ L ............ ...... .............. j..wo ........................... <br /> <br /> TYPE: ON-SiTE SEWAGE WATER SUPPLY <br /> TEST HOLES READY: <br /> PEEliIT OR APPLICATION NO: 14&582 SITE EVALUATION NUMB£~= <br /> EXISTIN6 TANK <br /> CONTRACTOR. NO. : EXISTIN~ DRAIN FIELD LINES: <br /> MODDERN DUILDING SYSTEHS~=.INC...~ ..,., m,.,,L SE~T, IC, T,ANK.,PUHPED: <br /> KENNETH A RASMUSSEN~ P.jE."682:! "~ PREVIOUS NO. BEDROOMS: <br /> PO BOX 258 TUALATIN~ OR <br /> PHONE: <br /> <br /> ITEM '.'. QUANTITY AMOUNT <br /> AUTHORIZATION NOTICE - FtEL~ V.iSIT i $1~0,80 <br /> "':I." '"':'"' TOTAL ESSESHED'FEEs $~69.00 <br /> <br /> SEE ATTACHED DOCUMENT FoR:'RE~u~REMENTS .OF'ON~S~T~ .S~W.A~E .SYSTEM. <br /> * THIS IS A VALI~ PERHZT ,', THIS.~ERflIT'EXPIRES ~&B DAYS FEott ITS ISSUE DATE. IF <br />CONSTRUCTION FAILS TO HEET.'.ACE: REQUIRE~ENTS..OF STATE LAWS AND MARION COUNTY BUILDING AND <br />ZONING ORDINANCES, THIS PERMIT SqAL'E BECOME-NULL.AND VOID. <br /> <br /> REMARKS: AUTHORIZATION FOR'BUIlDING PERMIT'~ 44721. FUTURE SEPTIC RE.J~AIRS WILL INCLUDE <br /> .... Al TERIqAI'[VE SAN~ FILTER ISyBTEH. , ,', ,( \ <br /> t)ONALD E: ~OODLEY, MARI~N COUNTY BUILDING OFFICIAL / BY <br /> <br />OFFICE COPY <br /> <br /> <br />