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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 430 PM - 800 A M <br /> <br />I ~m performing work on 8 propody I own or occupy <br />I &m & rog~stered builder OR ( I the 8uthorrzed representative <br /> <br />ow~}L4~TE: 05/02/89 TIME: 'l 1; 5'1; 32a <br /> <br /> ~'~YTH l AN BUILDTNG <br />SITUS ADDRESS <br /> <br />TAX LOt <br /> <br />CONSTRUCI iON TYPE <br /> <br /> 49?9 SECOND <br />AL ROR,~ <br /> <br />OR 97002 <br /> <br />4 U RD RA N G <br /> <br />SUBDIVISION <br /> <br />CATEGORY <br /> <br /> CS('¢!ME RC ~ ~L <br />OCCUPANCY <br /> <br />OCCUPANT LOAD <br /> <br /> PHONE- <br /> <br />LOT <br /> <br />$(OCK SECTION TOWNSHIP <br />DEPTH AREA 1 3 UNITS <br /> <br />SiTE NUMBER; o8,_5 <br />RAN~/ALUAT ION; ZONE <br /> <br />4S IRREG LOT { ~ GORNEH <br />AC NO NO <br /> <br />TYPE: ON--SITE SEWAGE <br /> <br />PERMI-r OR APPLICATION NO~ <br /> <br />CONTRACTOR, NO, <br />PYTHIAN BUILDING <br /> <br />PHONE :: <br /> <br />9015592 <br /> <br />NATER SUPPLY; CH <br />TEST HOLES READY: <br />SITE EVALUATION NUMBER <br />EXISTING TANK SIZE; <br />EXISTING DRAIN FIELD LINES:; <br />SEPTIC TANK PUMPED: <br />PREVIOUS NO_ BEDROOMS; <br /> <br /> ;TEM <br />S'1'00NSITE SYS < 1000 GAL.~\ <br /> <br />F~YEE: PYTHIA,N BUILDING <br />RECEIVED BY: CL <br /> <br /> QUANTITY aMOUNT <br /> ! $1650O <br /> <br />TOTAL ASSESSED FEES $165,00 <br />PREVIOUS RECEIPTS $0.0C <br /> <br />;NVOICE NO; 16553 <br />TYPE: IN CHECK ~: 0 <br /> <br />SEE ATTACHED DOCUMENT FOR REQUIRENENTS OF ON-SITE SENAGE SYSTEM, <br /> <br />* THIS IS NOT A PER~IIT. THIS APPLICATION I~LIST GO THROUGH A REVIEW PROCESS NHERE THE <br />FOLLDNING I~JST BE COf4PLETEO. IT IS THE RE~I:~3NSIBILITY OF THE A~F'LIOANT TO A,..%SURE THAT <br />ALL NECE~;~RY INFORMATION HAS BE~N PROVIDED. <br /> <br />REMARKS: r'4AJOR REPAIR/DRAINFIELD <br /> <br />FOR~ # MC mae ~Ev 1,,88 Of?iCE CO::'Y <br /> <br /> <br />