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MARION COUNTY BUILDING INSPECTION <br />SENATORBLDG NO 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE 588-5147 <br /> CODE-,~.;PHON'E 4::30 P,,M, - 8::00 AM <br /> <br /> I am performing work on 8 property I own or occupy <br /> [A~aregistered builder ORr I the authorized representative <br /> of a registered builder, <br /> The work will be performed by 8 registered builder <br /> Other_ <br /> I have read 8nd agree to the terms stated on the reverse side of <br /> <br /> DATE: 06/08/8? TIME: 4~32:44p <br /> <br />OWNER MAIR. JAM~S TAX LOT <br /> <br />SIGNATURE OF APPLICANT <br /> DATE <br /> <br />CATEGORY <br /> <br />SITUS ADORESS <br /> <br /> 7727 SHERMAN RD <br /> AUM~V Z LLE <br /> <br />SE <br /> <br />CONSTRUCTION TYPE <br /> <br />OR 97325 CONTRACT CiTY <br /> <br />USE OF SUiLDING <br /> <br /> SINGLE F~ILY DNELLINGS <br /> <br /> SAME <br /> <br /> PHONE: 749-1339 <br /> <br />gUBDWISION <br /> <br />UGS <br /> <br />OCCUPANT LOAD <br /> <br />LOt gLOOK SECTION <br />WIDTH DEPTH AREA <br /> <br /> TOWNSHIP RANGE ZONE MAP <br />28 8S 1W AR 48 <br /> <br />~ . 55000UNITS AC IRREG LOT N CORNER N <br /> <br />CONTRACTOR, NO. <br />IWAI R, JAMES <br />SANE <br /> <br />PHONE ~ 749-1339 <br /> <br />WATER SUPPLY: ~ <br />TEST HOLES READY: <br />SITE EVALUATION NUMBER: <br />EXISTING TANK SIZE: 1200 <br />EXISTING DRAIN FIELD LINES.* <br />SEPTIC TANK PUMPED: 3-19-87 <br />PREVIOUS NO. BEDROOF~: <br /> <br />450 <br /> <br /> ITEM <br />AU'PHORIZATION NOTICE - FLB. VISIT <br /> <br />TOTAL ASSESSEO FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />QUANTITY AMOUNT <br /> 1 $65.00 <br /> <br />$G5. O0 <br />$65.00 <br /> $0.00 <br /> <br />BALANCE BUE $0.00 <br /> <br />PAYEE: INVOICE NO: <br />RECEIVED BY: PB TYPE: CHECK <br /> <br />SEE ATTACHED DOCUMENT FOR REQUIREMENTS OF ON-SI'TE SENAGE SYSTEM. <br /> <br />* THIS IS A VALID PEI~4IT ~ THIS PER~II~' EXPIRES 360 0AYS FROM ITS ISSUE DATE. IF <br />CONSTRUCTION FAILS TO lO, ET ALL REQUIRB~E~T$' OF STA,TE, LAMS AND NARION COUNTY BUILDING AND <br />ZONING ORDINANCES. THIS PERMIT ~HALL BEC~E NULL :AND VOID'+ <br /> <br />E. CODLE*. MARION COuNt' .UZLDING O ICIAL / ................... <br /> <br />OFFICE COPY <br /> <br /> <br />