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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 />::OWNed'rE': 09/t3/9~ <br /> <br /> HU~SEY. ALAN <br /> SI'f US ADDRESS: <br /> <br /> 250 SOO'ff' AVE <br /> <br />USE OF BUILDING: <br /> <br />'f,~P4E~ 16t15 t 10 , TAX LOT i CATEGORY <br /> , ~ RES f OE~ T ~ AL <br /> : CONSTR~CTION ~¢E'. : OCCUPANCY: <br /> <br /> OR 9?342 [ ; [ <br /> <br />MAILING <br /> <br />LOT: BLOCK: <br />1 <br /> <br />SiTE NUMBERz 2591 <br /> <br />'IYPE: ON--SI'rE SEWAGE <br /> <br />PER~II OR APPLICATION NO: 33501 <br /> <br />CONf'RAC'fOR, NO_ ~$916 <br />SfAYfON MILL CifY SiLVER'f'ON <br />41'/55 S'f'AY'f'ON SC~O DRIVE, <br />$'TAYION, OREGON 9?383 <br />PHONE: '789~2302 <br /> <br />WATER ~",59JPPLY: P~ <br />TEST HOLES READY: <br />SiTE EVALUAFiON NUMBER: <br />EXiSTiNG YANK SIZE: <br />EX[5'FiNG ORAiN FiELD LINES: <br />SEP']'2C TANK PU~PED: <br />PREVIOUS NO. 8EDROONS: <br /> <br /> i 'f'E~ QUAN']',I TY AIvlOBN T <br /> REPAIR ,- ~AJOR / ,$80.0r, J <br /> <br /> TOTAL ASSESSED FEES $80.00 <br /> PRE¥iOUS RECE.(P'FS $80_ (:)(} <br /> 'T'H15 RECEIPT SO, 0(J <br /> <br /> BALANCE DUE $0.o0 <br /> PAYEE: iNVOiCE NO: <br /> ~kECEIVEO BY: c"i TYPE: CHECK ~: O <br /> <br /> 5bE AI~ACHED O~U~ENf FQR RE~tR~'f'S OF ON-~t'f'E ~ENAGE SYSfE~. <br /> <br />~ THiS iS A VALID PE~IT ~ THIS PE~IT ~PI~ 360 ~YS F~ ITS i~E ~TE. IF <br />~ST~CT~ FAi~ TO ~EET ALL R~IR~TS OF STATE ~ ~O ~Ri~ ~NTY BUILDING ~O <br />Z~[NG ORDiN~C~, fHi8 PE~IT ~ALL BEdE NULL ~O ~iO. <br /> <br />REMARKS: ~JOR REPAIR NI'T'H FNASEI"4ENT <br /> <br />©ONALD E. NOODLE:Y, MARION COUNTY SUiLOiNG OFP'iCiAL / BY <br /> <br />~OnM # MC ~S,$" RSV, .~0 OFFICE COPY <br /> <br /> <br />