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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 />of a registered buCder <br /> <br />SIGNATURE OF APPLICANT <br /> <br /> r~ATE <br /> <br />owBC,,TE= 06/22/89 <br /> <br /> HARD, NIKE <br />SITUS ADORESS <br /> <br />TIME: 12:16=54p <br /> <br />TAX LOT <br /> <br />CONSTRUCTION TYPE <br /> <br />90220-120 <br /> <br />DENT t AL <br /> <br />110 PATTON STREET <br />DETROIT <br />USE OF BUILDING <br /> <br />OR 97342 <br /> <br /> CONTI~AC1 CITY <br /> <br />DETROIT <br /> <br />UGB <br /> <br /> NO <br /> <br /> P.O. 80X 455 <br /> DETROIT, OR 973&2 <br /> PHONE: 854-2833 <br />I OT BLOCK <br /> <br />SECTION <br /> <br /> HAMNOND <br /> <br /> SITE NUMBER: <br />PANG~/ALUATION: ZONE <br /> <br />7067 <br /> <br />MAP <br /> <br />50 100 <br /> <br />5000.00 SF <br /> <br />5E co,~s, CON 105 <br />NO NO <br /> <br />TYPE: ON-SITE SEWAGE <br /> <br />PERMIT OR APPLICATION NO: <br /> <br />CONTR.A~TOR, NO. 36421 <br />KEv'IN S BACKHOE SERVICE <br />P.O. BOX 466 <br />DETROIT, OREGON 9?342 <br />PHONE: <br /> <br />16830 <br /> <br />INATER SUPPLY= <br />TEST HOLES READY: <br />SITE EVALUATION NUMBER: <br />EXTSTING TANK SIZE+. <br />EX'rSTING DRAIN FIELD LINES: <br />SEPTIC TANK PUMPED: <br />PREVIOUS NO. 8EDROOIviS: <br /> <br />ITEM QUANT I TY ANOUNT <br />REPAIR - NAJOR 1 $80+00 <br /> <br />TOTAL ASSESSED FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />~80.00 <br /> 80.00 <br /> $o.oo <br /> <br />BALANCE DUE $0.00 <br /> <br />PAYEE: INVOICE NO; <br /> <br />RECEIVED BY: cl TYPE= CHECK <br /> <br />SEE ATTACHED DOCUMENT FOR REQUIRE.~IENTS OF ON-SITE SEI4AGE SYSTEIVi. <br />~ THIS tS A VALID PER~IT ~ 114I$ (~t~;~4IT EXPIRES 360 DAYS FROI~ ITS ISSUE DATE. IF <br />~CTION FAILS TO f4EET ALL~,,RE~UIRI~TS OF,,STATE ~ AND ~IARION COUNTY BUILDING ~J~D <br />ZONING ORDINANCES, THIS PF~IT~J-J- BECOME,NULL AND VOID. <br /> <br />REMARKS: MAJOR REPAIR <br /> <br />DONALD Et N00DLEY, MARION COUNTY BUILDING OFFICIAL / BY <br /> <br />FORM ,MC,~5,56 REV ~'8~ OFF,CE COPY <br /> <br /> <br />