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COUNT~ 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 4:3,0 P.M. - 8:00 A.M. <br /> <br />05/19/88 TIME: 2:80:2~D <br /> <br />;dAZBLWOOD , LEE <br /> <br /> 9413 GOLF CLUB RD SE <br />AUMSVILLE OR 97825 <br /> <br />USE OF BUILDING: <br /> <br /> fax ~fl ~001 : h(E~ T DENTIAL <br /> <br /> OO"~"'~ud~iON +YPE; i OCCUPANOY; <br /> <br />~RION COUNTY ~ NO ! <br /> <br /> REAL ESTATE PROF <br /> PHONE: <br /> <br />WIDTH: DE~H: <br /> <br />?69-3448 <br /> <br /> SITE NUMBER: 4432 <br /> VALUATION: <br /> <br /> 4 9S 1W EFU <br />2.00000 ! u,,~s: AC : <br /> <br />, MAP: <br /> 60 <br /> <br />TYPE; ON-SITE SEWAGE <br /> <br />PERMIT OR .APPLICATION NO; 8514 <br /> <br />CONTRACTOR, NO_ 34916P-2 <br />STAYTON SEPTIC SERVICE: <br />4'1155 STAYTON SCIO DRIVE, SE <br />STAYTON, OREGON 97~88 <br />PHCNE: 7~9~2302 <br /> <br />WATER SUPPLY: <br />T~T HOLES READY: <br />SITE EVALUATION NUMBER: <br />E×ISTING TANK SIZE: <br />EXISTING DRA;N FIELD LINES: <br />SEPTIC TANK PUMPED= <br />~REVIOU8 NO. BEDROOMS: <br /> <br />I TEN QUANT I TY AMOUNT <br />REPAIR ~ M~NOR $55_ <br /> <br />-OTAL A,~SESSED FEES <br />PREVIOUS RECEIPTS <br /> RECEIPT <br /> <br />$55.00 <br />$55.00 <br /> So_co <br /> <br />BALANCE DUE <br /> <br />PAYEE: RECEIPT NO: <br />RECEIVED BY: XXX ................................ -YPE: CHECK ~: <br /> <br />SEE .ATTACHE0 DOCUMENT FOR REOUIRE24ENT5 OF ON-S~TE SEWAGE SYSTE~. <br /> <br />C,E~STRUCTION FAILS TO ~EE'f ALL REQUIREMENTS OF STATE LAWS ANB I~ARION COLINTY BUILDING AND <br />ZONING ORDINANCe, THIS PERNIT SHALL BEOOf4E NULL ~J~D VOID. <br /> <br />REMARKS: SEPTIC TANK REPAIR R~8079 ~ ~ <br />DONALD E. WOODLEY, MARION COUNTY 8UIbOING OFFICIAL / BY .......................... ~'~__ <br /> <br />¢'ORM. ~c l,~.~l~ .~v 6~'~ OFFICE COPY <br /> <br /> <br />