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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 P.M. - 8:00 A.M. <br /> <br />I am performing work on 8 property I own or OOCUpy. <br />lanlaregisteredbuirderOR( ) the authorized representative <br />of a registered builder. <br />The work will be performed by a registered builder. <br />Other. <br /> <br />I have read and agree to fhe terms stated on the reverse side of <br /> <br />b~TRE: 0?/26/88 TINE: 3:51 <br /> ~ CATEGORY; <br /> <br /> LINDL~, ~A~E ........... ~01,9~000 ........ ~ RESIDENTZAL- <br />S~TUS ADDRESS; ; CONSTRUCTION TYPE; ~ OCCUPANCY: <br /> <br /> 5912 V[L~GE VI~ CT SE ~ ..[ ~ <br /> <br />-V~I,L LAC-.~2C-IE~ ..................... <br /> <br />SAME <br /> <br />PHONE: <br />LOT: SLOCR: <br /> <br /> 14. <br />WIDTH: DEPTH: <br /> <br /> SITE NUMBER= <br /> _V.A LU A_"[ .T, Ol~l: ..... ~_ <br />SECTION; TOWNSHIP: i RANGE: ~ ;~ON~: MAP <br /> <br />AREA: : . . . <br /> <br /> C ' <br /> 2,50000 ..~ A i NO BE) ........................... <br /> <br />TYPE: ON-SITE SEN.AGE <br /> <br />PERMIT OR APPLICATION NO: <br /> <br />CONTRACTOR, NO. 38238 <br />SANTIAIVt VALLEY HOMES <br />11373 MILLCREEK RD SE <br />AUMSVILLE OR 9?325 <br />PHONE: 6 <br /> <br />~/kTER ,SUPPLY.+ F~ <br />TEST HOLES READY; <br />SITE EVALUATION NUMBER: <br />EXISTING TANK SIZE: 900 <br />EXISTING DRAIN FIELD LINES: <br />SEPTIC TANK PUMPED~. 7/13/88 <br />PREVIOUS NOt BEDROOMS: 3 <br /> <br />450 <br /> <br /> ITEM QUANTITY AMOUNT <br />AUTHORIZATION NOTICE - FLD. VISIT 1 $105+00 <br /> <br /> $105.00 <br /> THIS RECEIPT $0.00 <br /> <br /> 8ALANOEBUE $0.00 <br /> <br />PAYEE: RECEIPT NO: <br /> <br />RECEIVED BY: J8 ,:..';. . .:': TYPE:. CHECK ~¢; <br />SEE _ATTACH~ED DOCUMENT FOR ;REQUIRE~IEN:~:::O~.7~=$'];TB :=SEHAGE 'SYSTE1vl. <br />:~ THIS IS A VALID PERMIT * THIS, PEI:U~iIT ,EXPIRES 360 BAYS FROM ITS I,.%,.SUE DATE. IF <br />CONSTRUCTION FA[I..~THSPERM BE <br />TOI"EETALL RE'~U¥:EENENTS OF ST*~EI ~ ~ ~R~ ~N~ "U ~ L~N~ ~ <br />zONm oRDmANoES, rr CO, NU- _ AND ID. <br /> <br />REMARKS: REPLACING EXISTING MO HOME-AUTH FIELD VISIT R~4011 <br />DONALD E. NOODLEY, MARION COUNTY BUILDING OFFICIAL/BY ............ ~~__~ <br /> <br />¢:(~RM er MO 15'56 REV ~/S7 OFFICE COPY <br /> <br /> <br />