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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 <br />CODE-A-PHONE 4:30 P,M, - 8:00 A.M. <br /> <br />of a registered builder. <br />The work will be performed by a registered buiIder. <br />Other <br /> <br />I have read and agree to the terms stated on the reverse side of <br />this document, <br /> <br />I~E~. 12~07/89 TINE= 12:28:29 <br /> <br />'SIT'US AD~LEY* RODNEY & NARZA <br /> <br />TAX LOT <br /> <br />CONSTRUCTION ry~055-000 <br /> <br />CATEGORY <br /> <br />OCCUPANCY RESIDENTIAL <br /> <br /> ~'~ CO~TRACT CITY: JGB: OCCUPANT LOAD: <br />5785 <br />AUtO'VI LLE OR. <br />USE Of BUILDING ~JC~ION COUNTY NO .n OF BEDROOMS <br /> <br />SUBOIVtS~ON: <br /> <br />"PHONE: 581-1872 SITE NUNBER: 3193 <br />LOT. BLOCK. SECTION: TOWNSHIF ~i~,~4~,~T I ON ~. ZONE. ~IAF <br /> <br />AREA 1~ UNITS 8S nREG. L O~:J~ CORNERAR <br /> <br />TYPE: ON-SITE SE-I~AGE <br /> <br />PERMIT Or APPLICATION I~K~: <br /> <br />CONTRACTOR, NO. <br />~KL~, ~ & ~RIA <br />~E <br /> <br />~E~ 581-1872 <br /> <br /> ~T~ <br />~NUAL ~AL~ - T~P OR H,~P ~ <br /> <br />20378 <br /> <br />PAYEEs <br />RECEIVED BY: cl <br /> <br />WATER SUPPLY: PIN <br />TEST HOLES READY= <br />SITE EVALUATION NU~ER: <br />EXISTING TANK SIZE: 1000 <br />EXISTING DRAIN FIELD LINES: <br />SEPTIC TANK:PUI~PED: 4-11-88 <br />PREVIO(J$ NO. 8EDROONS: <br /> <br />TOTAL ~ED: FEES <br />PEEViO. fS RFCE! PT8 <br />THIS :RECEIPT <br /> <br />BALANCE DUE <br /> <br />QUN~TITY AI~IOUNT <br /> 1 $60.00 <br /> <br /> ~60.00 <br /> 60~00 <br /> $o.oo <br /> <br />RECEIPT NO: <br />:CHECK <br /> <br />$0.00 <br /> <br /> TYPE: 0 <br /> SEE ATTACHED DOCUMENT FOR P~IRE~TS OF' (~'-~[TE .V4~E~t~E ~T~ - <br /> <br /> * ~IS IS A VALID P~IT ~: ~IS ~IT ~I~ 360 F~ i~ I~E ~TE. IF <br />~$I$ FAIB ~ ~ ~'~I$ ~ ~AE ~ ~D ~I~ ~ ~I~ING ~D <br />~ ~IN~C~, ~IS ~IT~ 8~ ~ ~D ~ID. <br /> <br />REd'lARKS: HD~ RENENAL I~t7967 <br /> <br />DONALD E. NOOOLEY, NARION COUNTY BUILDING OFFICIAL / BY <br /> <br />r'OnM *' MC ~:~-n¢, "~V e/87 OFFICE COPY <br /> <br /> <br />