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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 <br />CODE-A-PHONE 4:30 P,M, - 8:00 A,M. <br /> <br />of a registered builder, <br />The work will be performed by a registered builder. <br />Other. <br /> <br />DATE'~ -- !hi'f4°/~.r~/)~7 TIIv~: 9: 34: 3 la <br /> <br />OWNER; <br /> <br />B[GNATURE OF APPLICANT: <br /> DATE; <br /> <br /> TAX LOT; 40580'~O00 <br /> <br />CATEGORY: <br /> <br />SITUS ADDRESS; <br /> :1.5056 PARK AVENUE <br />AURORA <br /> <br />OR 97002 <br /> <br />CONSTRUCTION TYPE <br />CONTRACT CITY:AR <br /> <br />OCCUPANCY: <br /> <br />OCCUPANT LOAD <br /> <br /> RESIDENTIAL ACCESSORY STRUCiT~F~ <br /> <br />MAILING ADDRESS: <br />3674 PACIFIC ~{I(3~4AY <br />I-K,'BI~, OREGON 97032 <br />PHONE: 981-1175 <br /> <br />SITE ~: <br /> VALUATION: <br /> <br />1041 <br /> <br />LOT: , BLOCK: SECTION: 13 $~)w~lP: 4S mANGE 1W ZONE: <br /> <br />WiOTU 130 'DEPTH: 150 ' AREA: 19500.0 UNITS. SS RREG. LOT'. F CORNER N <br /> <br />MA"3 <br /> <br />PE~IT OR APPLICATION NO: <br />CONTRACTOR, NO. <br /> <br /> TEST PK)LES READY: YES <br /> 1518 SITE EVALUATION ~: <br /> EXISTING TANK SIZE: <br /> EXISTING DRAIN FI~r.n LINES: <br /> SEPTIC TANK PUFFED: <br /> HOLDING TANK A~: <br /> <br />PHONE: AFFIDAVIT: <br /> <br /> ITl!~ <br />SITE EVALUATION, FIRST <br /> <br />TOTAL ASSESSED FEES <br />PREVIOUS RECEIPTS <br />TdIS <br /> <br />QUANTITY AMOUNT <br /> 1 $165.00 <br /> <br />$165.00 <br /> $o.oo <br /> <br />BALANCE DUE $0.00 <br /> <br />PAYEE: INVOICE NO: <br />RECEIVED BY: DM TYPE: C~ECK#: <br /> <br />SEE A~'~AC~ED DOCUMENT FOR REX~UTREb~NTS <br />SPECIAL REQUIREMENTS: <br /> <br /> <br />