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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 4 30 PM. - 8.00 A M <br /> <br />The work w~ll be porformed by a registered builder <br /> <br />SIGNATURE OF APPLICANT <br /> <br /> DATE <br /> <br /> 03/08/89 TINE.* 2.'22:110 <br /> <br />SITUS ADDbAgHAPELLE, JOAN <br /> <br /> TAX LOT <br /> <br /> CONSTRUCTION TyPF. <br /> <br /> CONTRACT CIT" UGB <br />SE <br /> MARION COUNTY NO <br /> <br /> 6064 SHAW LANE <br />US~ OF BrilLO}lNG OR <br /> <br />CATEGORY <br /> <br />OCCUPA~C~ UNKNOWN CLASS <br /> <br />3 <br /> <br />PHONE: <br />LOT SLOCK SF, CTION <br /> <br />SITE NUMBER: 66?6 <br />YA~E~JAT ION -' zoaE <br /> <br />MAP <br /> <br /> UNITS IRREG ~T 2W SOHNER <br /> 24 8S <br /> <br />A NNNflN ¢~ ~n Nn <br /> <br />AR- <br /> <br />51 <br /> <br />TYPE: ON-SITE SENAGE <br /> <br />PERMIT OR APPLICATION NO: <br /> <br />CONTRACTOR, NO. <br />LACHAPELLE, JOAN <br /> <br />14340 <br /> <br />WATER SUPPLY; PN <br />TEST HOLES READY: <br />SITE EVALUATION NUMBER: <br />EXISTING TANK SIZE; <br />EXISTING DRAIN FIELD LINES: <br />SEPTIC TANK PUMPED: 1/24/89 <br />PREVIOUS NO. BEDROOMS= <br /> <br />ITEM QUANT I TY ANOUNT <br />REPAIR - NAJOR 1 $80.00 <br /> <br /> TOTAL ASSESSED FEES $80.00 <br /> PREVIOUS RECEIPTS $80.00 <br /> THIS RECEIPT $0.00 <br /> <br /> BALANCE DOE $0.00 <br /> <br />PAYEE: RECEIPT NO: <br />RECEIVED BY: CL TYPE; CHECK <br /> <br />SEE ATTACHED DOCUMENT FOR REQUIREMENTS OF ON-SITE SENAGE SYSTF_J~,I. <br />x~ THIS IS A VALID PERMIT * THIS PERMIT EXPIRES 360 DAYS FROIfl ITS I~E DATE. IF <br /> <br />CONSTRUCTION FAILS TO MEET ALL REQUIREMENTS OF STATE ~ AND MARION COUNTY BUILDING AND <br />ZONING ORDINANCES, THIS PERMIT SHALL BECOME NULL AND VOID. <br /> <br />REMARKS: REPAIR ~7244 <br /> <br />DONALD E. NOODLEY, MARION COUNTY BUILDING OFFICIAL / BY <br /> <br />FORUM ¢ MC 15-b6 REV ll'f~ OFFICE COPY <br /> <br /> <br />