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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG, NO, 225 <br />220 HIGH STREET NE <br /> SALEM, ORF_.GON 97301 <br /> <br /> PHONE 588-5147 <br /> CODE-A-PHONE 4:30 P.M. - $:00 A.M. <br /> <br />of ~ register'ed builder, <br /> <br />08/0?/87 <br /> <br />RAND. LORA <br /> <br />TIME.' 2:05':03p <br /> <br />11954 NEST STAYTON RD <br />, AUP~VI LLE <br />USE OF BU~LB'~NG: <br /> <br />MAILING ADDRESS: <br /> <br />SUBDIVISION: <br /> <br />3 <br /> <br /> SA,ME <br /> <br /> PHONE: ?69-5;944 <br /> <br />LOT'. SLOCK: <br /> <br />WIDTh: <br /> <br />DEPTH: <br /> <br /> 5..J300.0.0 AC NO ~ NO <br /> <br /> sITE NUr4BER: 2076: <br /> i :VALUATION= <br />SECTION: TOWNSHIP; ' RANGE: I ZONe: : MAP; <br /> <br />TYPE: ON-SITE SENAGE <br /> <br />PERMIT OR APPLICATION <br /> <br />CONTRACTOR, NO. 34916P-2 <br />STAYTON SEPTIC SERVICE <br />41155 STAYTON SCIO DRIVE, SE <br />STAYTON, OREGON 9?383 <br />PHONE: 769-2302 <br /> <br />"3542 , <br /> <br />WATER SUPPLY= PN <br />TEST HOLES READY= <br />S~TE EVALUATZON NUMBERt <br />EXISTING T~NK SIZE: <br />EXISTING DRAIN FIELD LINES: <br />SEPTIC TANK PUMPED~ <br />PREVIOUS NO. BEDROOMS: <br /> <br /> ITEN <br />REPAIR <br /> <br />(~JANTITY AMOUNT <br /> 1 $35.00 <br /> <br />PAYEE z rECEI PT NO ~ <br />RECEIVED BY: DM . ~ : ::: :: ; T~l~E,. :,CHECK ~+ <br />SEE ATTACHED DOCUMENT FOR RE(~IRENENTS OF' CH~IT:BiSE~E,:'~Y'S'TEM-~ <br />* THis zs A VALID PE~ZT * THIS ITS ISSUE BATE. <br />CONSTRUCTION FAIL.S TO :I~RION COJNTY 8UILOiNG <br />ZONING ORDIII~ICES. THIS PERNIT S~LIL [Di <br /> <br />REMARK,S~ REPAIR <br /> <br />DONALD E. NOODLEY, MARION COUNTY BUILDING OFFICIAL / BY <br /> <br />-o~ ~ ~c ,~.s~ ~v ~l/~r OFFICE COPY <br /> <br /> <br />