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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 8::00 - 4::30 <br /> 24 HOUR CODE-A-PHONE:: 588-7904 <br /> <br />] Am a ro~istored bddder OR f ) the authorized representative SIGNATURE OF <br /> <br />09/19/90 TIME: <br /> <br />JACK,5ON, ,JOE <br /> <br />CONSTRUCTION TYPE <br /> <br />©CCtJPANCY <br /> <br />RESiDENtiAL <br /> <br /> 8801HOMF,,~UiSf RD <br /> AU~VILLE <br />USE OF BUILDING <br /> <br />OR 97325 <br /> <br />SE <br /> <br />CONTRACT CITY UGB OCCUPANT i OAO <br />MARl'ON COUNTY NO No ~r u~m!uu'cs <br /> <br />MAILING ADDRESS SUBDIVISION <br /> <br /> PO BOX 1 187 <br /> AUMSViLL6 OR 9?325 <br /> PHCNE: 'Z49~2227 SllE NUMBER: 42f~4 <br /> <br />LOT BLOCK SECTION }OWNSHIP RANG~LUA'I[~I *~ ~ ~ ; ZONE MAP <br /> <br />W~DTH DEPTH AREA ~ J UNITS 8S IRREG LO1 ~W CORNER A~ ~8 <br /> <br /> 2?2 100 27200. 5F NO NO <br /> <br /> T'YPL: ON~5iIE 5EWAGb I WA'TER~gPPLY: <br /> · . J TEST HOLE~ READY: <br /> PERNIf OR APPLiCA/iON NO: 9027360 [SITE EVALUATION NUIVlSER: <br /> <br /> ~[~CfOR, NO. ~E~iSTiNG O~IN FiELO LiNE5~ <br /> JACK~. JO~ B. ~ NiLDRbD ~T~ SEPTIC TANK ~NPED= 4-2?-86 <br /> ~ BOX 1187 ,, ~ j PREVI~S NO_ BEDR~MS; <br /> AU~VILL~ OR 9 ~325 ~ ~ <br /> <br /> t~ QUANFI~Y A~N~ <br /> AUTHORIZAIiON NOTICE ~ PLO+ VlSil 1 <br /> <br /> TOTAL ~ED F;EES $105_00 <br /> PREV~S RECEIPTS <br /> THI~ RECEIPT <br /> <br /> BA~C~ DUg $0.00 <br /> <br /> PAYEE: JACK~, JO~ B. & ~UDREO ~ R~C~tPf NO: 28951 <br /> ~CEIVED BY: ~ <br /> fYPE::CK CHECK ~: <br /> <br /> SEE AfIACHED ~CUNEN/ FOR RE~1R~EN'fS OF ON-SJf'E S~NAEE 5YSfE~. <br /> <br />* THIS i~ NOT A P~IT. THiS APPLI~TI~ ~T ~ ~ A *~I~ P~ ~E~ THE <br />~LL~I~ ~T BE ~P~T~. iT IS THE R~iBILITY OF THE APPLI~T TO ~RE 'THAT <br />~L NE~RY IN~Ti~ H~SE~ P~IOED. <br /> <br />PLAN REVIEW: BY <br /> <br />RLNARKS: AUfH R~2906 <br /> <br />0A T E <br /> <br />CITY JURiSDICtION: BY DAlE <br /> <br />OFFICE COPY <br /> <br /> <br />