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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 />I have read and agree to the terms stated on the reverse '~ide of <br />this documont <br /> <br />SIGNATURE OF APPLIC&NT <br /> DATE <br /> <br /> t0/09/90 'fINE; 12:05;40 <br /> <br />S~TdS~gDRE~ACKSON, JOE 8. & ~iLDRED <br /> <br />8801 Hor.4QUi,ST RO SE <br /> <br /> PO Br3X t18'[ <br /> AUMSVI LLE DR 97325 <br /> r-)HL)NE: '!49-232'! <br />LOT BLOCK <br /> <br />A~E~, ~ ~ UNITS <br /> 27300. <br /> <br /> TAX LOT <br /> CONSTRUCTION TYp~ <br /> CONTRACT CiTY UCB <br /> <br />MARION COUN fY NO <br />SUBDIVISION <br /> <br /> NUMBER: <br />~a~C, iLUA ¥ ION: <br /> <br />CATEGORY <br /> <br />OCCUI'ANC~ ~E~l DEN ¥ IAi_ <br /> <br />OCCUPANT LOAD <br /> <br />ZONE MAP <br /> <br />8~ IRREG LOt '~,~ CORNER AR 4~ <br /> <br />SF NO NO <br /> <br />l YPb.: ON-S,~ 'I E SE.~AGE <br /> <br />PERMIf OR APPLICAIION NO; 27360 <br /> <br />CONTRACTOR, NO. <br />JACKSON, JOE B. & MILDRED <br />PO B~X 1187 <br />AU~VILLE OR 9'¢325 <br />PHON~: 749-2227 <br /> <br />WAlgR SUPPLY: PW <br />~I~f HOLES R,f~,~,DY: <br />SIIE EYALUAIlON NU~ER: <br />~Xi~llN~ TANK ~IZE: 1000 <br />EXISFING DRAIN FIELD LINES: <br />SEPTIC TANK PUMP~O: 4-27-85 <br />PR~ViOU~ NO. BEDROOm52 <br /> <br />AUIHORIZAIiON NOIiCE - NO ViSJI <br /> <br />"f'O'f'AL A~EO FE[S <br />PREViOU~ RECEiPt5 <br />f'HIS RECEIPT <br /> <br />QUANIifY A~OUN~ <br /> <br />BALANCE DUE $~.OU <br /> <br />PAYEE: RF-,,CEIP! NO: <br /> <br /> R~'CEiVE/) BY: CL .................... IYPE: CHECK ~; 0 <br /> <br /> 5lib Al IACHED ~U~EN[ FOR R~QUIRkMENf5 OF ON-8iTE SE~GE SYSf~. <br /> <br />~ THiS IS A VALID PE~iI * THiS P8~iT ~PIRES ~60 ~ ~R~ ITS i~ OA]E. ~F <br />~ST~ClI~ FAI~ 1'0 MEET ALL RE~IREM~'fS OF STATE ~ AND MARION C~UNIY BUILDING AND <br />Z~IN60RDiN~C~, THIS PE~iT ~ALL B~E NULL AND VOID. <br /> <br />NgI~IARKS: AUIN R~2906 /~ /~ <br />DONALD E_ WOODLEY, I~ARiON COUNIY BUILDING OF~;-iCIAL / BY ......... ~ <br /> <br />OFFICE COPY <br /> <br /> <br />