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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 O0 AM <br /> <br />I am performing ¢~ork on a property I ocvn Or o0cupy <br />lam aregistered buiiderORt ItheButhorizedrepresentative <br /> <br />DATE.- 12/08/89 TIME: 12:42:40 <br /> <br /> SO+PACIFIC RR (MEEKER FERTILIZER) <br /> <br />SIGNATURE OF APPLICANT <br /> <br /> DATE <br /> <br /> 'fAX LOT <br /> <br /> CONSTRUCTION TYPE <br /> <br /> 11598 MCCLELLAN RD SE <br />AUMSVILLE OR 97325 <br /> <br />USE OI- BUILDING <br /> <br />MARION COUNTY NO <br /> <br />SUBDIVISION <br /> <br />CONTACT: ART GRO~E <br />1795 - 16.TH ST SE <br />PHONE: 769-2330 <br /> <br />SALEM 9?302 <br /> <br /> SITE NUMBER: 8499 <br /> VALUATION: <br /> <br /> TOWNSHIP RANGE ZONE <br /> 9S 2W AR <br /> UNITS IRREG LOT CORNER <br />1. AC YES NO <br /> <br />CATEGORY <br /> CO~IERC IAL <br /> <br />OCCUPANT lOAD <br /> <br /> 0 <br /> <br />MAP <br /> <br /> 62 <br /> <br />TYPE: ON-SITE SENAGE <br /> <br />PERNIT OR APPLICATION NO: 20196 <br /> <br />CONTRACTOR, NO. 51352 <br />REA CONST. INC. <br />P.O. BOX 617 <br />STAYTON. OR 97383 <br />PHONE: 769-6566 <br /> <br />NATER SUPPLY: PN <br />TE~T HOLE~ READY: <br />SITE EVALUATION NU~ER: 19311 <br />EXISTING TANK SIZE: <br />EXISTING DRAIN FIELD LINES: <br />SEPTIC TANK PUNPED: <br />PREVIOUS NO+ BEDROOf4S: <br /> <br /> ITEN ~4JANTITY /~4OUNT <br />STD ONSITE SYS < 1000 GAL 1 $165.00 <br /> <br /> TOTAL ASSESSED FEES <br /> PREVIOUS RECEIPTS <br /> THIS RECEIPT <br /> <br /> BALANCE DUE <br /> <br />PAYEE: RECEIPT NO: <br />RECEIVED BY: P8 TYPE~ CHECK <br /> <br />SEE ATTACHED DOCUMENT FOR REQUIREMENTS OF ON-SITE SE1NAGE SYSTEM. <br /> <br />2165.00 <br />165.00 <br /> $o.oo <br /> <br />$0.00 <br /> <br />O <br /> <br /> THIS I$ A VALID PER~IT * THIS PER~IT EXPIRES 360 DAYS FR01sl ITS ISECJE ~TE. If <br />~Ti~ FAIG TO ~ A~ ~i~8T8 OF ~ATE ~ ~D ~RI~ ~ BUILDI~ ~D <br />~IN8 ~IN~C~, ~IS PE~IT ~ALL 8~ NULL ~D ~ID. <br /> <br />REMARKS: STD SYSTEM R~t?946 <br /> <br />DONALD E. NOODLEY, MARION COUNTY BUILDING OFFICIAL /BY <br /> <br />OFFICE COPY <br /> <br /> <br />