|
MARION COUN'I-Y BUILDING INSPECTION
<br />SENATOR 8LEG. NO, 225
<br />220 HIGH STREET NE
<br /> SALEM, OREGON 97301
<br />
<br /> PHONE: 588-514,7 8:00 - 4:30
<br />24 HOUR CODE-A-PHONE: 508-7904
<br />
<br /> am pet o¢~ ng woEk on a R?operty I OWn Dr occupy.
<br />I am a regtsle~'e¢ builder OR { ) I he ~tthorized representative
<br />of e registered bt~ilder,
<br />
<br />DATE; ...........................
<br />
<br />gR 97~25
<br />
<br />ARiON COUNTY NO
<br />
<br /> 4
<br />
<br />WALDO HILLS FDUIT FARHS 8~
<br />
<br />]WIDTH: ¢DE;~TH: ~ J AREA; ! gNl'i'¢: ! IRRE{~. LOT: CORNER:
<br /> " 6. AC NO NO
<br />
<br />TYPE; ~N-~Ill~
<br />PERMIT OR APPLICATISN NO3 54487
<br />CONI'~ACTOR. NO. 71161
<br />PO ~OX 5241
<br />Sa],em~ 97307-0000
<br />PHONE~ 508-t115 "
<br />
<br />WATER SUPPLY: PW.
<br />TEST HOLES READY. YES
<br />SITE EVALUATION NL, MBER.
<br />EXISTIN5 TANK,SIZE:
<br />~XISTIN~ BRAIN F~ELB LINES~
<br />SEPTIC lANK PUMPED~
<br />PREVIOUS NO, ~EDROOMS:
<br />
<br /> ITEM ' ' ',.: " ~UANTITY AMOUNT
<br /> · " 1
<br />SITE EVALUATION~ FIRCT. Lb~' ,.," : .
<br />
<br /> ..... ' .... R~OE~PT NO:
<br />
<br />,~ ~E ATTACHED ~OOUHEHT FORT'~EQUZ~,f'S O~, ON-S'ITE 5EWE~E SYSTEM.
<br />
<br />,IJ~,~.. rH,[.~ 'O?.~S,NOT GRANT ,OR iHPLY PER~TIS$iDN TO 8UIL]) O~ THIS PA,',,C,,,.L, PJ.A.I,.,,,,',IC A ....
<br />G!'~ISrI~UCT~O;,~ PE!.,.M;/TS MUST 8~, (;~TAI{~ED. BEFORE BU~,L1)ZNG OR SuP IC
<br />
<br /> ': 0
<br />· ..,.'~:; ~..~, r,,~,,..,,~, ,. ..... ,, _ ~,.,~.~-'r, LOT. 6 ACR~.~,~ 01~ ~AY ~0~ ~TAN~A~ W/I AREA 0~' P%TS~
<br />,,(,, ,A D :' W~, P,._ ~ K6RIOH ~GU,~,Y BU)~Li~N~'OFF'ZdlAL / SY
<br />
<br /> OFFICE COPY ~
<br />
<br />
<br />
|