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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 /> of a registered builder. <br /> <br /> Other <br /> <br /> DATE: 05/30/91 'rIME: 13;58:27 <br /> <br />OWNER'. HAK, MYRON & GE~4E¥iEYE <br /> <br />SIGNATURE OF APPLICANT: <br /> DATE'. <br /> <br /> T&V LO"[ 75301--620 <br /> <br />SITUS ADDRESS: <br /> <br /> 8325 REf,,,~¢20O OR SE <br />AUI~SV i LLE OR 9?325 <br /> <br />USE OF BUILDING <br /> <br /> AN'i'BONY CANNiZTO - BROTHER <br /> SAL P_..?4 BRO'¥HER-378-1570 <br /> PHONE: 818-845-5764 <br /> <br />CONSTRUCTION TYPE~ <br /> <br />CONTRACT CITY UGS <br />I%A,R I ON COUNTY NO <br /> <br />SUBDIVISION <br /> <br />8iI'E NUFFBER: <br /> VALUAT I ON: <br /> <br />9620 <br /> <br />LOT 8LOCK. SECTION <br /> <br />TOWNSHIP <br /> <br />UNITS: <br /> <br /> RANGE <br />8S <br /> <br />AC nn~G LOl <br /> <br />CATEGOR~ RESI OEN'I' iAI, <br />OCCUPANCY: <br />OCCUPANT LOAD <br /> <br /> NO OF BEDROOMS <br /> 4 <br /> <br />2W Ag:J: 49 <br /> <br /> NO CORNS~ES <br /> <br />TYPE: ON-SITE SEWAGE <br /> <br />PER~iT OR APPLiCATiON NO; 32222 <br /> <br />CONI-RACTOR, NO. <br />HAK, MYRON & GEgqEMiEVE <br />ANTHONY CANNIZZO - BROTHER <br />SALEM BAYg'f'B ER-378-1 <br />PHONE: 818-845~5764 <br /> <br />WATER .SUPPLY: F~ <br />'rEs'r HOLE~ READY: <br />SITE EVALUATION NUMBER: <br />P.~IS'[ING TANK SIZE: <br />E×iSTiNG BRAIN EIELO LINES: <br />SEPTIC TANK PUMPED: <br />PREVIOUS NO. BEDROOMS: <br /> <br /> ! 'T'F.~ qUANT 1 TY AI'~'ON'r <br />STANDARD ON~Si I'E SYSTEM 1 $165.00 <br /> <br /> TOTAL AS~ED FEr--"~ $165.00 <br /> PREVIOUS RECEIPTS $165.00 <br /> THiS RECEIPT $0.00 <br /> <br /> BALANCE DUE $0.00 <br /> <br /> PAYEE: RECEIPT NO: <br /> RECEIVED BY: PB TYPE-* CHECK ~: 0 <br /> <br /> SEE ATTACHED DOCUMP3NT FOR REdiReCT8 OF ~4i't'E SEWAGE SYS'T~. <br /> <br />* THIS 18 A VALID ~IT * THIS ~IT ~Pi~ 360 ~ F~ iTS I~E ~TE. iF <br />~ST~CTI~ PAI~ TO ~ ALL R~J~ OF 8TATE ~ ~O ~Ri~ ~NTY BUI~/N~ ~O <br />Z~[NG ~O1~C~, TH[S ~T ~LL B~E ~LL ~O <br /> <br />REMARKS.~ NEW {Ad~ERS - NEW pER~iI[' R~7595 <br />DONALD E. ~,¢.L1OBLE¥, i",N~RION ~N'f'Y BUILDING OFFICIAL / BY .......................... ~ ................................................... <br /> <br />OFFICE COPY <br /> <br /> <br />