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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 ~88-5147 <br />CODE-A-PHONE 4:30 P.M. - 8:00 A,M, <br /> <br />I am performJn¢¢ work on a property I own or o¢cudy, <br />I am a degister~d builder OR ( ) the authorized representative <br />of a registered builder. <br /> <br />I have read and agree to the terms stated on the rovetSe side <br />this documenf <br /> <br />DATE: 09/21/B8 TI~E; <br /> STEELE <br /> <br />2:03;35p <br /> <br /> 13132 8ROOKSIDE DR <br /> ~DRORA OR 97002 <br /> <br />USE O~ BUILDINGZ <br /> <br />2495 N N ~:::ODEREST <br />,ALBANY. OR 97321 <br />PHONE¢ 928-5018 <br /> <br />5/6 <br /> <br />1 ? 2 <br /> <br />118 20296,0 <br /> <br /> 71580-130 i RESI DEN'ClAL <br /> CONSTRUCTION TYPE: ~ OCCUPANCY; <br /> <br />' CONTRACT CITY: ,, UGB: i OCCUr'ANT LOAD; <br /> <br /> GRI~ ESTATES , <br /> <br /> SITE NU~ER: 5460 <br /> VA~AT I~ t <br /> <br /> SF NO ~ NO <br /> <br />TYPE: ON-SITE SEWAGE <br /> <br />PEA*NIT OR APPLICATION NO: 11098 <br /> <br />CONTRACTOR. NO. <br />S'TEELE <br />~495 N N WOODEREST <br />ALBANY, OR 97321 <br />PHONE: g~8-5018 <br /> <br />WATER SUPPLY~ CN <br />TEST HOLES READY: <br />SITE ~¥ALUATION NUMBER: <br />EXISTING TANK SIZE= 1000 <br />EXISTING DRAIN FIELD LINES: <br />SEPTIC TANK PUMPED: 9-1~-88 <br />PREVIOUS NO. 8EDROONS: <br /> <br /> ITEM qUANTITY AMOUNT <br />EXISTING SYSTEM EVAL. RPT. 1 $100.00 <br /> TOTAL ASSESSED: ~EES $100.00 <br /> PREVIOUS RECEIPTS $100.00 <br /> THiS RECEIPT , $0.00 <br /> <br /> BALANCE 'DUE $0. O0 <br /> <br />PAYEE: NO: <br />RECEIVED ~Y: c] .............................. ~PE: <br />SEE ATTACHED DOCUMENT FOR RE, QLIIR~4ENTS OF:ON-SITE SE~AeE'sYSTB~. <br />· THIS IS A VALID PER~IT * this PER,lIT !IT~ ISSUE DATE. IF <br />CONSTRtJOTION FAILS TO MEET ALL REOUJ~RI~,IENT$ OF ',STATE L~ AND ~MARION COUNTY BUI'LDING AND <br />ZONING ORDINANCES, THIS PERMIT 'SbLALL BECOME NULL'AND VOID,, ,,'j <br /> <br />RFJ~ARKS: ESR FOR LOAN Rg4828 <br /> <br />DONALD E. WOODLEY, MARION COUNTY BUILDING OFFICZ~L ~/ BY <br /> <br />MC: ,o~ n~v 6/.~ OFFICE COPY <br /> <br /> <br />