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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG, NO. 225 <br />.,"220 H'i~GH 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 em performing work on a property I own or occupy, <br />I am a registored builderOR( } the authorized representative <br />of a registered builder, <br />The work will be perforrne¢ by a registered builder, <br />Other__ <br />I I)ave read and agree to the terms stated on the reverse side of <br />this document. <br /> <br /> D~LIN, ~RIS J ~i 90260-000 ~ R~D~IAL <br /> <br /> 270 KINN~ A~ <br />OET~IT OR 97342 <br /> <br /> 3767 ~ER~ NE <br /> KE~ZER <br /> ~E~ 393-4436 ~ S~TE NU~ER~ 5660 <br /> VA~ATZ~; <br /> <br /> 92 100 g200.O0 ~ SF NO NO <br /> <br />TYPE: ON-SITE SENAGE <br /> <br />PERMIT OR APPLICATION NO: 11624 <br /> <br />CONTRACTOR, NO. <br />DEVLIN, ONRIS J <br />3?6? CHERRY NE <br />KEIZER <br />PHONE; 393-4436 <br /> <br />WATER SUPPLY= CH <br />TI~ST HOLEi~ READY= <br />SITE EVALUATION NURSER: <br />EXISTING TANK SIZE= <br />EXISTING DRAIN FIELD LINES: <br />SEPTIC TANK PUMPED: <br />PREVIOUS NO. BEDROOMS= <br /> <br /> ITEN (;~ilJANT I Ty AIv'~UNT <br />STANDARD ON-SITE SYSTEM ,1 $1:65.00 <br /> <br /> ~ $16S.00 <br /> $165.00 <br /> THIS?I $0.00 <br /> <br /> $0.00 <br />PAYEE *. ' <br />RECEIVED BY.* c1 ~; <br /> <br />SEE ATTACHED DOCUI~IENT FOR :REQUIREI~IEN~ <br />~< THIS IS A VALID PiD~ ~ TH,Is DATE. IF <br />C(I~STRUCTION FAILS TO I~EEf 'ALL' ;X;I, JNTY BUILDING AND <br />ZONIN6 ORDINANCES. THi[S PERMIT <br /> <br />REI~RKS; STANDARD SY~TElvl <br />DONALD E. NCODLEY, WARION COUNTY BUILDING / <br /> <br />roR~ ,, MC ~5-5e ney e/87 OFFICE COPY <br /> <br /> <br />