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MARION COUNTY BUILDING INSPECTION <br />SEN~OR B¢.~G. NO, 225 <br />220 :NIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE 588-5147 <br />CODE-A-PHONE 4:30 RM. - 8:00 A,M. <br /> <br />I am performing work on a property I own or occupy. <br /> <br />10/16/89 TINE: <br /> <br />GALLAGHER, KEN <br /> <br />1:57:09p <br /> <br />40010-O00 <br /> <br />CATEGOHY <br /> <br />OCCUPANCY: <br /> <br />RES I DENT IAL <br /> <br /> 23721 SCHULTZ ROAD NE <br />AURORA OR 97002 <br /> <br />CONTRACT CITY: U~B: <br />N[ARION CC~JNTY NO <br /> <br />7457 ACORN HILL CT SE <br />SALEM OR 97301 WK 585-0040 <br />PHONE: 585-8274 <br /> <br /> 32 <br /> <br /> 5.21000 <br /> <br /> SITE NUM8ER: 8226 <br /> VALUAT I ON: <br /> <br />3S 1W AR <br />AC NO NO <br /> <br />TYPE: ON-SITE SEWAGE <br /> <br />PERMIT OR APPLICATION NO: 19073 <br /> <br />CONTRACTOR, NO. 21950 <br />FAMILY HONES OF AMERICA <br />PO BOX 189 <br />AURORA OR 97002 <br />PHONE: 678-1'139 <br /> <br />WATER SUPPLY: PW <br />TEST HOLES READY: <br />SITE EVALUATION NUI~ER: <br />EXISTING TANK SIZE: <br />EXISTING DRAIN FIELD LINES: <br />SEPTIC TANK PUMPED: <br />PREVIOUS NO. BEDROOMS: <br /> <br /> I TFJ',I <br />SE < 8 IVE)NTHS OLD <br /> <br />PAYEE= <br />RECEIVED BY: PR <br /> <br />QUANT I'FY AleE)UN T <br /> 1 $1 '10,00 <br /> <br />TOTAL ASSEE~ED =RES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />~110,00 <br />110,90 <br /> <br />BALANCE DUE $0.00 <br /> <br /> RECEIPT NO: <br />TYPE': CHECK <br /> <br />SEE ATTACHED DOCUMENT FOR RE(~JIREMENTS OF ON-SITE SEWAGE SYSTEM. <br /> <br />* THIS IS A VALID PEENIT ~ THIS',~PEF~IIT,EXPIRES 360 DAYSFRO~ ITS ISSUE DATE. IF <br />CONSTI~JCTION FAILS TO NEET ALL,REtIREMENTS OF STATE bANS AND ~RION COUNTY BUILDING AND <br />ZONING ORDINANCES, THIS PEf:~ITE~HALL,BECONENULLANDVOID. <br /> <br />RENARKS: SYTEM INSTALLATION ROi:2389 y%N/~. <br />DONALD E. WOODLEY, NARION COUNTY BUILDING OFFICIAL / <br /> <br />FO.,~ # MC ~-5~ r~Ev -/se OFF]CF COPY <br /> <br /> <br />