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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO, ;?5 <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 />ow4~C, TE.· 01,/07/91 FI:RE: 14158.'2,¢ <br /> <br /> COAKLEY, RODNEY & MARIA <br />SIfUS ADDRESS' <br /> <br />TAX LOT <br /> <br />CONSTRUCTION TYPE <br /> <br />56055-000 <br /> <br /> 5785 D4AW HNY <br /> AUMSVILLE <br />USE Of BUILDING: <br /> <br />OR 9?325 <br /> <br />CONTRACT CITY: ~ UGB: <br />MAR,tON 'COUNTY ...... NO <br /> <br />MAILING <br /> <br />CATEGORY <br /> RF..51 DEN 1' i ~L <br />' OCCUPANCY <br /> <br /> OCCUPANT LOAD <br /> <br /> NO OP BEDROOMS <br /> <br /> SAME <br /> PHONE: 581-1872 <br />LOT:BLOCK: <br /> <br />WIDTH: :DEPTH: <br /> <br />SECT[ON TOWNSH P <br />AREA l~ UNITS: <br /> 4.9 <br /> <br />SITE NUIV~IER: <br /> VALUAI ! ON: <br />RANGE. <br /> <br /> RREG. LOT l~ <br /> <br /> NO <br /> <br /> 3193 <br /> <br />ZONE <br /> <br />:ORNE~: AR <br />ND <br /> <br />MAP <br /> <br />TYPE: ON-SiTE SEWAGE <br /> <br />PE~'4iI' OR APPLiCAI'ION NO: <br /> <br />CONTRACTOR, NO. <br />CO. AKLE¥, ROONFY & MARia <br />E~,IE <br /> <br />PH(~IE: 581-1872 <br /> <br />29654 <br /> <br />WATER f~JPPLY= <br />Tb~'[ HOLES READY: <br />SITE EYALUATION NUMBER: <br />EXISTING TANK SIZE: <br />EXISTING DRAIN FIELD LINF~: <br />SEPTIC TANK PUMPED: <br />pREViOUS NO. BEDROOm: <br /> <br /> il, I'EI~ <br />ANNUAL E'VAL. - TS~IP OR HDE~HP ~H <br /> <br />TOTALAE~F__~ED FEES <br />PREVIOUS RECEIP'rS <br />THIS RECEIPT <br /> <br />8ALANCE DOE <br /> <br />f]JANTiTY <br /> <br />PAYEE= COAKLEY, RODNEY & MARIA <br />RECEIVED BY: cr TYPE.* RF CHECK <br /> <br />SEE ATTACHED OOOUMEN'[ FO~ RE(~UIRENE,~iTS.OE: ON--~[TE $~-~,~AGE SYS'rF-.M. <br />THI~ I~5'~? A PI~IT - TNI8 I~. A R~RJND ~XXI~I'qT. <br /> <br /> .,~IOUN'I' <br /> -$60.00 <br /> <br /> -$50.00 $o.oo <br /> -$50.00 <br /> $o.oo <br /> <br />31326 <br /> <br />REMARKS: 'REP"UNO OF PERM,IT 29480 <br /> <br />~ORM # mc ~s-,~ R~v. 4~9o OFFICE COPY <br /> <br /> <br />