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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 />The work will 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 /> ow~TE: t2/06/90 <br /> <br /> RI ESTERER, BERNARD <br />'SITUS ADDRESS; <br /> <br /> 58381-815 <br />: C0NsT~Ub'nON TYPE: <br /> <br />8521 HOLMf~JiST RD SE : CONTRACT CITY; : UGg: <br />AU~Vi LLE OR 97325 <br />FUSE O¢ 13UILDING: ~RIGN '6~OUN~f:Y NO <br /> <br />MAILfNG AC*DRESS: <br /> <br />P.O 8OX 255 <br />SUBLIMITY, OR 9'/385 <br /> <br />t, OT: ! BLOCK: SECTION: <br /> <br />WIDTH: DEPTH: , AREA: <br /> <br />: SUBDIVISION: <br /> <br /> S,~TE NUIVfB~'R; q909 <br /> VALUAT <br /> ~bW~Hi,i RANGE; ZONE: <br /> <br /> 8S. 1 N AR <br />UNITS: IRREG. LOT; <br /> <br />~A~EGOnV: <br /> <br /> RE.~ ] DEN'f' J AL <br /> OCCUPANCY: <br /> <br />MAP: <br /> <br /> 48 <br /> <br />TYPE; ON-SI'f'E SE~AAGE <br /> <br />PERMiI' OR APPLICAI'iC¢4 NO~ 2?508 <br /> <br />OONTRACI'OR, NO. 35916 <br />STAY'rON MILL CITY SILVER':ON SEP <br />41155 STAYTON SCIO DRIVE, SE <br />S'rAYTr.~, OR~('~ON 9738~ <br />PHONE: ?59-2302 <br /> <br />HATER ~IJPPLY: PiN <br />'rEST HOLE.~ READY: <br />SITE EYALUAI'iON NUlVfaER: SE82~1950 <br />EXI~'f'ING 'rANK SIZE= <br />EXiSTiNG DRAIN F/gLO LINES: <br />~gPl'IC TANK PUMPED: <br />pREYtC~JS NO. 8EDROOI~i5: <br /> <br /> l'f'F,~l QUANTITY AIvlOUN'f' <br /> PRESSURE DiSTRiBU'f'iON 1 <br /> <br /> TO'rAL .g~Cc~ED FE~ $165.00 <br /> PREViOU~RECEiPTS $165.00 <br /> THIS R~E~'r $0.00 <br /> <br /> BALANCE IOUE $0.00 <br /> <br /> RECEIVED BY: CL TYPE; CHgCK ~: 0 <br /> <br /> SEE ATTACHED 0OCUMENT FOR REQUiRE2NENI'S O¢ ON-S~'fE SEINA6E SYSI'E~. <br /> <br />~ THiS IS A VALi0 PERfVltT * THIS PERI~4~T EXP~RE~ 960 DAY~ FROt~ iTS l,~E OATE~ <br />CONBTRUOT~ON FAILS TO MEET ALLRP.:T,~iRIBVlENT80¢ STATE ~ AND f~tARiON COUNTY BU~LBING AND <br />ZONING ORDINANCES, THIS PERNUTS'tALL B~E NULL ANB <br /> <br />REMARKSt PR~RE DiSTRiBU'fiON 1:~!~3311 ~¢,) <br />f.7,JNALO E, ~¢-..~OOLEY, ~R~ON COLIN'¥'Y BUILDING OFFICIAL / BY ................................................................................~ <br /> <br />OFFICE COPY <br /> <br /> <br />