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MARION COUNTY BUILDING iNSPECTION <br />SENATORSLDG NO 225 <br />220 ~IGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE 588-5147 <br />CODE-A-PHONE 4::30 P M.. - 8 O0 A.M <br /> <br />I am performing work on a property I own or occupy <br />lam aregistered builder CRt ) the authorized representative <br />of 8 registered builder <br />The work wdl be performed by a registered builder <br />Other. <br /> <br /> I have read and agree to the terms stated on the reverse side of <br /> this document <br /> <br />DATE; 09/29/88 TINE*. <br />OWNER <br /> WEST, WALTER <br /> <br /> 12993 EHLEN RD <br />AURORA OR <br /> <br />SIGNATURE OF APPLICANT <br /> <br />DATE <br /> <br /> · i TAX LOT <br /> <br /> NE r CONTSA6T CITY <br />97002 <br /> RioN NO <br /> <br />MAILING ADDRESS <br /> <br />PO BOX 426 <br />WI LSONVI LLE OR <br />PHONE*. 682-3003 <br /> <br />tOT BLOCK <br /> <br />WIOTH DEPTH <br /> <br />g?070 <br /> <br /> 10 4S <br />AREA ! UNITS <br /> 60.0000 AC <br /> <br />SITE NUMBER: 1306 <br />VALUATION: <br /> <br /> lW EFU <br /> I'RREG LOT : CORNE~ <br /> NO ( NO <br /> <br />CATEGORY <br /> RESIDENTIAL <br /> <br />OCCUPANCY <br /> <br />OCDUPAN F LOAD <br /> <br />MAP <br /> <br /> 3 <br /> <br />TYPEt ON-SITE SEWAGE <br /> <br />PERMIT OR APPLICATION NO: 7172 <br /> <br />CONTRACTOR. NO. <br />WEST, WALTER <br />PO BOX 426 <br />WILSONVILLE OR 97070 <br />PHONE: 682-3003 <br /> <br />HATER SUPPLY ~* <br />TEST HOLES READY: <br />SITE EVALUATION NUMBER: <br />EXISTING TANK SIZE: <br />EXISTING DRAIN FIELD LINES: <br />SEPTIC TANK PUMPED: <br />PREVIOUS NO. <br /> <br /> ITEM <br />AUTHORIZATION NOTICE - FLD. VISIT <br /> <br /> TOTAL .A,-%-~E~EO FEES <br /> PREVIOUS RECEIPTS <br /> THIS RECEIPT <br /> <br />BALANCE DUE <br /> <br />~UANTITY <br /> 1 <br /> <br />PAYEE: ~'EECEIPT NO: <br /> <br />AHOUNT <br /> $65.00 <br /> <br /> 365.00 <br /> 65.00 <br /> $o.oo <br /> $o.oo <br /> <br />RECEIVED BY; pb TYPE.- CHECK ~.* <br /> <br />SEE ATTACHED DOCUMENT FOR RE~UIREMEN,T~ OF ON-SITE SEWAGE ,SYSTEM. <br />* THIS IS A VALID PERMIT ~ THIS PERMIT EXPIRES 36.0 D,A~ FROM [TS I~SUE DATE+ IF <br />CONSTRUCTION FAILS TO MEET ALL, RE(~uIREMENTS 0F'~rA~rE.~ EANS ,AND r4ARION COUNTY BUILDING AND <br />ZONING ORDINANCES, THIS PERMIT SHALL BECOD1E 'NULL AND VOID. <br /> <br />REMARKS: R~9301 <br /> <br />DONALD E. NOODLEY, ~RICN COUNTY BUILDING OFFICIAL / BY <br /> <br /> <br />