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MARION COUNTY BUILDING INSPECTION <br />SENATORBLDG 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 />Other <br /> <br /> DATE: ll/2~/92 TIME." 8:59:08 <br />NATIONAL WOOD INDUSTRY <br />ADDR~ES~ , ,~'~ PORTER RO SE CoNTR~tT City U68 <br /> AUMSVILLE, OR ~7525 MARION COUNTY. NO <br /> <br />TAX LOT <br /> 60518-000 <br /> <br />WERTZLER, LIN : OWNER <br />PHONE: <br /> <br />COMMERCIAL <br /> <br />OCCUPANT LOAD <br /> <br />NO Of BEDROOMS <br /> <br />SUBDIVISION <br /> <br /> SITE NUMBER: ~ <br /> VALUATION: <br /> <br />!BLOCK :SECflON .... TOW:~'§~i~ ~r~GE ' .... "~ ' MAP <br /> 6 98 1~_ _ ~ IL 60 <br /> ~5. : AC NO NO <br /> <br />TYPE: ON-SITE SEWAGE <br /> <br />PERHIT OR APPLICATION NO: <br /> <br />CONTRACTOR, NO, 04164 <br />Adolph H 8ch~rff <br />150 Cordon Rd NE <br />Salem, 97501-0000 <br />PHONE: 000-0000 <br /> <br />44018 <br /> <br />WATER SUPPLY: PW <br />TEST HOLES REAOY: <br />SITE EVALUATION NUMBER: <br />EXISTING TANK SIZE: <br />EXISTING DRAIN FIELD LINES: <br />SEPTIC TANK PUMPED: <br />PREVIOUS NO. BEOROONS: <br /> <br /> ITEM <br />STD ONSITE SYS ( lO00 GAL <br /> <br />TOTAL ASSESSED FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />QUANTITY AMOUNT <br /> 1 $210.00 <br /> <br />$210.00 <br />$210.00 <br /> $0,00 <br /> <br />BALANCE DUE $0~00 <br /> <br />PAYEE: RECEIPT NO: <br /> TYPE: CHECK <br /> <br /> RECEIVED BY: PB ............................. 0 <br /> SEE ATTACHED OOCUMENT FOR REQUIREMENTS OF ON-SITE 8EWASE SYSTEM. <br /> <br />* THIS IS A YALIO PERMIT m THIS' PERMIT EXPIRES 560 DAYS FROM IT$ ISSUE DATE. IF <br />CONSTRUCTION FAILS TO NEET ALL REQUI. REMENTS OF STATE LAWS AND MARION COUNTY BUILDING AND <br />ZONING OROINANCES, THIS PERMIT SHALL BECOME NULL AND VOID. <br /> <br />REMARKS: TANK REPLACEMENT <br /> <br />DONALD E. WOOOLEY, MARION COUNTY BUILDING OFFICIAL / BY <br /> <br />OFFICEOOP¥ <br /> <br /> <br />