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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 RM. - 8:00 A,M, <br /> <br />owl~eT'E: 06/22/89 TIME: 12.'26.'35p <br /> <br />S,TUS ADOR~S¢ALLOAIAY' KENT <br /> <br />TAX LOT: <br />CONSTRUCTION TYPE: <br />CONTRACT CJTY: UG0: <br />MAR[ON COUNTY NO <br />SU BDIV~SION; <br /> <br /> 10364 PORTER RD <br />AUNSVILLE <br /> <br />OR 97325 <br /> <br />SE <br /> <br />MAILING ADDRESS; <br /> <br />CATEGORY: <br /> <br /> RESIDENTIAL <br /> <br /> 4 <br /> <br />PHONE: 749-1699 <br /> <br />AREA: 06 UNITS: g~ <br /> 2 +00000 AC <br /> <br /> SITE NUF~ER.' <br />R~,~.~ALUAT ION ~ ZONE, <br /> <br />3039 <br /> <br />IRREG LOT: 1 W CORNEH: <br /> <br />NO NO <br /> <br />TYPE: ON-SITE SEWAGE <br /> <br />PERMIT OR APPLICATION NO: <br /> <br />CONTRACTOR, NO. <br />GALLOWAY, KENT <br /> <br />PHONE: 749-1899 <br /> <br />16840 <br /> <br />WATER,SUPPLY: PW <br />TEST HOLES READy: <br />SITE EVALUATION NUNBER: <br />'EXISTING,TANK'$IZE: <br />~XISTING DRAIN FIELD LINES: <br />SEPTIC TANK PUMPED: <br />PREVIOUS NO. 8ED~= <br /> <br />ITEM QUANTITY AMOUNT <br />REPAIR - ~AJOR 1 $80.00 <br /> <br />TOTAL, AE~ES,SED FEES <br />PREVIOUS RECEIPTS <br />~H, IS RECEIPT <br /> <br />$80.00 <br /> 80.00 <br /> $0.00 <br /> <br />BALANCE DUE $0.00 <br /> <br />PAYEE: RECEIPT NO: <br />RECEIVED BY: c] TYPE~ 'CHECK <br /> <br />SEE ATTACHED DOCUMENT FOR :R~T~..O~, ON-$TTE'~ENAGE SYs~cEN. <br />* ~IS IS A VALID PE~~IS':~T ,~I~,,360 ~F~' [~ I~E ~TE. iF <br />Z~l~ O~I~C~. ~IS :" <br /> <br />R~R~: ~OR REPAIR T~K &, D~INFI~D ~ ~~ <br />~ALD E. ~DLEY, ~R[~ ~NTY BUILDING OFFICIAL / 8Y ............... <br /> <br />FORM # MC 15-56 REV ll/8C~ OFFICE COPY <br /> <br /> <br />