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MARION COUNTY BUILDING INSPECTION <br /> SENATOR BLDG, NO, <br /> 220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE 588-5147 <br />CODE-A-PHONE 4:30 RM. - 8:00 A.M. <br /> <br /> &m performing wed( on 8 property I own or Occupy. <br />I am a registered builder OR ( the authorized represen a ~ve <br />of a registered builder. <br />Tile work will be pedormed by a registered builder. <br />Other <br />~ have resd and agree to the terms stated on the reverse side of <br /> <br />OWNER: <br /> <br /> DATE: 04/04./90 TIME.' 12:10~07 <br />SITUS ADDRESS: <br /> SENEY, STEVE / BLAIN, JOEL-BUYER <br /> <br />TAX LOT: <br /> <br />CONSTRUCTION TYPE: <br /> <br />CONTRACT CITY: <br /> <br />UGS: <br /> <br /> .7243 B~AIN HINT <br />use o ~A~ [ LLE <br /> <br />MAILING ADDRESS. <br /> <br />OR 9?325 <br /> <br />MARION COUNTY NO <br /> <br />CO~IMERC I AL <br />0 <br /> <br /> P.O. BOX 2go / REX LUCAS <br /> AUMSILLE, OR 97325 <br />LOT: PH~E: ?/~(576 SECTION: <br /> <br /> RANe~ITE NUMBER?NE; 8598 MAP: <br /> VALUATION: <br /> ~RREG. LOT: CORNER: <br />8S 2W RA <br /> <br />51 <br /> <br />1.79999995 <br /> <br />AC NO NO <br /> <br />TYPE: ON-SITE S~E <br /> <br />PERMIT OR APPLICATION NO:,,:' '2043? <br /> <br />OONTI:~TOR, NO. <br />SE~IEY, STEVE / 8LAIN, JOEL~UYE <br />P.O, BOX 290 / REX LuCAS <br />AUIV~I~LE, OR 9?325 <br />PHONE. 749-2576 <br /> <br />NATERSUPPLY: P~ <br />TEST HOLES READY: <br />SITE'EVALUATION'NUMBER: <br />EXISTING T/~C4K SIZE: 1000 <br />EXISTING BRAIN FIELD LINES,* <br />SEPTIC TANK PUMPED: <br />PREVIOUS NO. BEDROOMS: <br /> <br />225 <br /> <br /> ITEM QUANTITY AFOJNT <br />ALTERATIONS 1 $145.00 <br /> <br /> .TOTAL A,.'~O FEES $145.00 <br /> PREVIOUS RECEIPTS $60.00 <br /> THIS'RECEIPT $85.00 <br /> <br />8AL/t~OE, DUE $0.00 <br /> <br />PAYEE,* SENEY, STEVE / BLAIN; ~OEL=BUYER RECEIPT NO: 24342 <br />RECEIVED BY: CL ...................... ~:.;...'..¢.._';...'_ . ...................... TYPE= .OK ~ECK ~: 2682 <br /> <br />SEE ATTACHED ~MENT FOR R~'~REM~TS OF ~'SITE S~E SYST~. <br />* ~-~ VALID ~IT *'.', .~ISi'~[~..;~Z~;'~50 ~.~ I~ I~E DATE. I~.._ <br /> <br />REfCC~RKS: /~UTH FOR MEAT ~OP !0 EXISTINe RES SYSTEM / ALTERATION <br />DONALD E. NOODLEY, MARION COUNTY BUILDING OFFICIAL / BY . ......................................................................................... <br /> <br />OFFICE COPY <br /> <br /> <br />