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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-$147 <br />CODE-A-PHONE 4:30 P.M. - 8:00 A.M. <br /> <br />I am a registered builder OR ( ) the authorized representative <br />Other <br /> <br />I have read and agree to the terms stated on the reverse side of <br /> <br />DATE: 12/29/87 TIME.* <br />OWNE~: NYNN, MARION <br /> <br />11054 MILL CREEK RD <br /> <br /> ! ~ATEGORY <br /> R <br /> ~,~ ~/~ OCCUI:ANCY: <br /> <br /> CONTRACT CITY: <br />OR <br /> ~RI~ COUN~ NO I <br /> <br /> 2 <br /> <br />; TXX <br /> 56427-000 <br />i CON$:FRIJ~IO~ TYPE: <br /> <br />AUr4SVILLE <br /> <br />MAILING ADDRESS: <br /> <br /> S/V4E <br />, HARRIS, ALLEN- LESSEE <br /> PHONE: <br /> <br />WIDTH: DEPTH: <br /> <br /> SITE NUMBER: 3366 <br /> VALUATION .' <br />............................ !~ION; ;TOWNSHIP; ~ RANGE: i ZONE: <br /> <br /> 32 ; 99 '~ 1N ~ EFU 48 <br /> ,J~"E^: 6.00000 i AC NO <br /> '~TO <br /> <br />TYPE: ON-SITE SENAGE <br /> <br />PERHIT OR APPLICATION NO: 6023 <br /> <br />CONTRACTOR, NO. <br />WYNN, ~RION <br />SANE <br />HARRIS, ALLEN- LESSEE <br />PHONE = <br /> <br />NATER SUPPLY: P~ <br />TEST HOLES READY: <br />SITE EVALUATION NUr4BER: <br />E~(ISTING TANK SIZE: 1000 <br />E"XISTING DPJ~IN FIELD LINES: <br />SEPTIC T~K ~MPED: 3-20-86 <br />PRiZeS NO. BED~: 2 <br /> <br /> I TE]vl QUANT I TY AMC)UN T <br />AUTHORIZATION NOTICE - FLD. VISIT · 1 $65.00 <br /> ; ~OZAL ~LSS~ED FEES $65.00 <br /> PREVIOUS: :RECE I PT8 $ 6 5.0 0 <br /> THIS RECEIPT $0.00 <br /> <br /> :,' BALANCE ~UE <br />PAYEE: RECEIPT NO: <br />RECEIVED BY'- JB ......... ;.; ..~. TYPE: CHECK ~: <br /> <br /> IREMENT S:ZTE S'rSTe <br />SEE ATTACHED DOCUMENT FOR REOU, ;OF T · <br /> <br />~< 1HIS IS A VALID PERMIT ~<. THIS PEI~'~IiT ~P[RE~=,360 ~FRCt'I ;[-rs I.%-~JE DATE. IF <br />CONST~CT'fON FAILS TO I~ET=ALL REq~.II~: OF ,s:r~,-TE,?,t~ /~ID MARION COUNTY BUiLDiNG AND <br />ZONIN~ ORDINANCES. ~rl-118 PERMIT ,SHALE;BEC(~E ' <br /> <br />REMARKS; AUTH R~8545 <br />DONALD E. ,WOODLEY, ["4ARION COUNTY 8UILO1'Ne O~F~CI:AL ,/ BY <br /> <br />FORM ~ MC 15-56 REV 6/~'~ OFFICE COPY <br /> <br /> <br />