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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-~147 <br />CODE-A-PHONE 4;;30 RM - 8::00 A M <br /> <br />mvVgA~TE: 01/06/89 TIME: <br /> <br /> FOREIVlAN, THERESA <br /> <br />4:04:21p <br /> <br />RESIDENTIAL <br /> <br /> 562 11TH ST <br /> AuNSVI LLE <br />UCE OF BUILDING <br /> <br />OR 97325 <br /> <br />N <br /> <br /> CONTRACT CITY <br /> <br />t'~RION COUNTY <br /> <br />UGB <br /> <br /> NO <br /> <br /> SA~E <br /> <br /> PHONE: 749-1503 <br />LOT BLOCK <br /> <br />WIDTN DEPTH <br />271 <br /> <br />SECTION <br /> <br />102980. SF <br /> <br />SITE NUIV~ER: 6289 <br />~**N~ALUATION: <br /> <br />iRnEG LOT 2W L~OnN~R AR <br /> NO NO <br /> <br />TYPE: ON-SITE SEWAGE <br /> <br />PERNIT OR APPLICATION NO: <br /> <br />CONTRACTOR, NO. <br />FOR~, THERESA <br />SANE <br /> <br />PHONE** '749-1503 <br /> <br />13282 <br /> <br />hATER SUPPLY: PW <br />TEST HOLES REAOY: <br />SITE EVALUATION NUMBER= <br />EXISTING TANK SIZE** <br />E~ISTING DRAIN FIELD LINES: <br />SEPT'lC TANK PUMPED: 12-26-88 <br />PREVIOUS NO. BEDROOMS: <br /> <br /> I TEIVi WANT I TY <br />ANNUAL EVAL. - TEMP OR HDSHP i',,"H 1 $60.00 <br /> <br /> TOTAL AESE. SSED FEES $60.00 <br /> PREVIOUS f~ECEI PTS SE0.00 <br /> THIS RECEIPT $0- 00 <br /> <br /> BALANCE DUE $0.00 <br /> <br />PAYEE: RECEIPT NO: <br />RECEIVED BY: cl TYPE: CHECK <br /> <br />SEE ATTACHED DOCUMENT FOR RE(;~JIRIEclENT8 OF 0N-SITE SEWAGE <br /> <br />* THIS IS A VALID PERMIT ;¢ THIS PERNIT EXPIRE~ 360 DAYS FR0f4 ITS ISSUE DATE. IF <br />CON~TRUCTION FAILS. TO MEET ALL REQUIRENENTS OF STATE LAHS AND I~tARION COUNTY BUILDING AND <br />ZONING ORDINANCES. THIS PERlUlIT SHALL SECOME NULL AND VOID. <br /> <br />RF_jvIARKS: ANNUAL HARDSHIP SEPTIC INSP FdAtGB68 (~ <br />DONALD E+ NOODLEY, I~¢,RION COUNTY BUILDING OFFICIAL / BY ...................... _~'-__ <br /> <br />OFF{CE COPY <br /> <br /> <br />