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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 8::00 - 4::30 <br />24 HOUR CODE-A-PHONE:: 588-7904 <br /> <br />of a registered builder <br /> <br />this document <br /> <br />SIGNATURE OF APPLICANT <br /> <br />OWN~AYE:: 05/25/90 F£ME: 11:00:09 <br /> <br />STUSADDRES~AMPYON, IiNOTHY <br /> <br />TAX LOT <br /> <br />CONSTRUCTION TYPE <br /> <br />OCCUPANCY <br /> <br />11742 SfE:J. NKAMP RU <br /> <br />OR 9?325 <br /> <br />SE <br /> <br />CONTRACT CITY UGB <br />I~ARI ON COUN1Y NO <br /> <br />SUBDIVISION <br /> <br />SANE <br /> <br /> PHONF-: ?49-2502 <br />LOT BLOCK SECTION TOWNSHIP <br /> <br />Si I E NUMBER: ?002 <br />RANe~ALUAT ION: ZONE <br /> <br />9?99995 <br /> <br />IRREG LOT CORNER <br /> <br />NO NO <br /> <br />lYfmE: ON-Si TI-' SEWAGE <br /> <br />PBRMll OR APPLiCATiON NO: <br /> <br />CON IRAC fOR, NO. <br />HAMPTON, ¥ If'40~HY <br /> <br />PHONE: ?49-2502 <br /> <br />24213 <br /> <br />HOLES REAOY: <br />EVALUAIiON NUMBER: <br />P-5<2STING rANK S~Z~; <br />EXi~IiNG BRAiN FIELD LINES: <br />SEPFiC TANK ~J~P~D: <br />PREViOU~ NO. BgoROOt~o: <br /> <br /> i1EM <br />iAU[HO~i~Af~ON NOTICE - NO V~I'f' <br /> <br />101AL A~ESSED FEE5 <br />PR~¥1OUS RECEIPTS <br />FHiS RECEiPI <br /> <br />QUANIIIY AMOUNI <br /> $80_00 <br /> <br />$60_ <br /> <br />BALANCE OUE <br /> <br /> $~E ATfACHEO LY~MENF FOR RE~JIREMENT~ OF ON-SiTE SEWAGE SYSfE~. <br /> <br />~ THIS IS A VALID PER~IT ~ THIS PERMIT ~XPIRE3 380 0AYS FR~ iTS iSBUE DATE. iF <br />CONSTRUCTION FAILS TO MEET ALL REqUIREMEnTS OF STATE L~ AND MARI~N COJNTy BUILDING AND <br />ZONING ORDINANCES, THIS PF~IT ~HALL BE-~E NULL AND VOID. <br /> <br />R~,~ARKS: AUfH- NO VI~I f <br /> <br />F3OIWALO E- INOOgLBY, MARION COUNIY BUiLDiNG OFFICIAL / BY <br /> <br />OFFICE COPY <br /> <br /> <br />