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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 />Other_ <br /> <br />SIGNATURE OF APPLICANT: <br /> CATE: <br /> <br />OWN~A'f'E: 04/12/91 <br /> <br />SITUS ~COSSS~¢)OD1;OCK <br /> <br /> 13037 MAPLE LEaF C'f <br /> AU RORA <br />USE OF BUILDINGz <br /> <br />OR <br /> <br />NE <br /> <br />CONTRACT CiTY USS <br />"~4A R :[ OlqJ C£)UNTY ND <br /> <br />SUBDIVISION <br /> <br />15550 NW PERIMEf'ER DR <br />~AVERTON, OREGON 97005 <br />PHONE: 629-5633 <br /> <br />( CT' BLOCK. SECTION <br /> <br />w DTH. ~ DEPTH: AREA <br /> <br />2~ UNr"S: 4~ <br />~. AC <br /> <br /> MAPLELEAP ESTATES <br /> <br />~II~ NUfV~ER: 3179 <br />RANGV~LUA'i'' ][ ON: ZONE <br /> <br /> RREG LOT ~ CORNER ~'P[:~ <br /> <br /> NC <br /> <br />OCCUPANCY: <br /> <br />OCCUPANT LOAD <br /> <br />RE~iDEN 1 l~.lL <br /> <br />'fYPE: ON'-Si'f'E SEWAGE <br /> <br />PERMIT OR APPLiCA'f'[©N NO: <br /> <br />CON'f'RAC'~OR, NO. <br />WOODCOCK , ROBERT <br />15560 NW PERIME'[ER DR <br />BEAVER'f'ON, OREGON 97006 <br />PHONE: 629~5633 <br /> <br /> iTEM <br />EXISTING SYSTEM EVAL. RP'f'. <br /> <br />9031504 <br /> <br /> WATER SUPPLY: <br /> TE$'f' HOLES READY: <br /> SITE EYALUA'FION <br /> EX~ST[NG TANK <br />~E.XISTiNG DRAIN FIELD LINGS: <br /> SEPTIC TANK PUMPED: 4-1-90 <br /> PREVIOUS NO. BEORYgOMS: <br /> <br />PAYEE: WOODCOCK , RO~ER'I' <br /> <br />QUANTITY A~OUN~ <br /> 1 $ 0~ ~0 <br /> <br />TOTAL ASSE~EDEEES $100.00 <br />PRE¥1OUSRECE~P'rs <br />'T'HI~ RECE~P:f' $100.00 <br /> <br />BALANCE 0UE $0.00 <br /> <br />RECEIP'I NO: 33283 <br /> <br /> RECEIVED BY; CL f'YPE: OK CHECK ~: 0 <br /> SEE A'i'f'ACHEO DOCUMENT FOR REQUIREMENTS OF <br /> <br />~ THIS 15 NOT A PE~iT. THiS APPLI~TI~ ~ST ~ TH~ A R~i~ P~ ~ERE THE <br />FOLL~iNG ~ST BE ~PLETEO~ iT I~ THE R~SiBiLiTY OF THE APPLt~T TO ~RE THAT <br />ALL NEC~RY INFO~T[~ H~ BE~ P~VIDED; <br /> <br /> REMARKS: LOAN RE.PT R~5113 <br /> <br />CORM ~ ~C ~5-5~ REV, 4~ OFFICE COPY <br /> <br /> <br />