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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO. 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97801 <br /> <br /> PHONE 588-5147 <br />CODE-A-PHONE 4:30 P.M. - 8:00 A.M. <br /> <br />I 8m 0erforming work on a property I own or occupy, <br />I am a registered builder OR ( ) the authorized representative <br />of a registered builder, <br />The work will be performed by 8 registered builder. <br />Other_ <br /> <br /> I have read and agree to the terms stated on the reverse side of <br /> P~is document. <br /> <br /> DATE.- 04/06/88 TIME: 1~;35;10~ <br />OWNER: <br /> BEACH, MERLE <br /> <br />SITUS ADDRESS: <br /> <br /> 8673 NEST STAYTON RD <br />AUNSVILLE OR 97325 <br /> <br />SE <br /> <br />CATE; <br /> <br />TA'X LOT: <br /> 58288-000 <br />CONSTRUCTION TYPE; <br /> <br />CONTRACT C~TY; i UGB: <br /> <br /> SANE <br /> <br /> PHONE: ?49-265? <br /> <br />LOT: BLOCK: <br /> <br />CA'fEGORY; <br /> RESIDENTIAL <br />occUPANCY; <br /> <br />OCCUPANT LOAD: <br /> <br /> ! SITE NUMBER: 4028 <br /> VALUAT l ON: <br /> <br /> 38 8S 2N i EFU <br />AREA: <br /> ?.00000 ~ AC {~ NO NO <br /> <br />TYPE: ON-SITE SENAGE <br /> <br />PERMIT' OR APPLICATION NO: <br /> <br />CONTRACTOR, NO. <br />BEACH, MERLE <br />SANE <br /> <br />PHONE: ?49-2657 <br /> <br />7547 <br /> <br />WATER SUPPLY: PN <br />TEST HOLES READY: <br />SITE EVALUATION NUMBER: <br />E)(iSTING TANK SIZE: <br />EXISTING BRAIN FIELD LINES: <br />SEPTIC TANK PUMPED: <br />PREVIOUS NO. BEDROOi'&S: <br /> <br />ITEM QUANT I TY AMOUNT <br /> <br />REPAIR 1 <br /> <br />PAYEE: <br />RECEIVED BY: CL <br /> <br />TOTAL ASSESSED'FEES <br />PREV I CUB: RECEIPTS <br />THIS 'RECEIPT <br /> <br />BALANCE DUE <br /> <br /> TYPE: <br /> <br />RECEIPT NO: <br /> CHECK <br /> <br />$35.00 <br /> <br /> 35.00 <br /> $o_0o <br /> <br /> $0.00 <br /> <br />SEE ATTACHED DOCUMENT FOR REOU:IRENENTS OF :,ON-SITE SE'WAGE SYSTEM. <br />................................. ,,,,__~ ~,~-,,..--...~.-=---.,~ .......................... <br />* THIS IS A VALID PE~IT ~ THIS PER,lIT ITS ISSUE DATE. IF <br />CONSTRUCTION FAILS TO MEET: ALL RE~JIRE~E~4TS OF STATE':LA~ AND rflARION C~JNTY BUILDING AND <br />ZONING ORDZNANCI~S, THIS PERi,lIT SHALL BEO2fflE :NULL: AND VOID. <br /> <br />REMARKS: REPAIR R~9523 <br /> <br />DONALD E. NOODLEY, MARION COUNTY BUILDING OFFICIAL / BY ......... <br /> <br />FO"M # MC 15'58 REV 6/8'! OFFICE COPY <br /> <br /> <br />