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MARION COUNTY BUILDING INSPECTION <br />SENC,,TOR B~DG, NO. 225 <br />2¢*~"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 /> I am performir~§ work on a property ~ own or occupy. <br />t am a registered builder OR the authorized rep eser~ ave <br />of 8 registered builder· <br />The work will be pedormed by a registered builder· <br />Other <br /> <br />ow~Cc:-!"E ~ 08/8'!/89 TI'ME: <br /> ADAIR, RICHARD <br />glTUS ADDRESS: <br /> <br />10:qT:OSa <br /> <br />TAX LOT: <br /> <br />CONSTRUCTION TYPE: <br /> <br />58272-000 <br /> <br />RES f DEN T ~ A'... <br /> <br /> 9822, MILL CREEl'( RD <br /> AUMSVI LLE <br /> <br />USE OF BUILDING: <br /> <br />MAILING ADDRESS: ........ <br /> <br />OR 97325 <br /> <br />SE <br /> <br />CONTRAO]' CITY: UGB: <br />MARION CODNTY NO <br /> <br /> SUBDIVISION: <br /> <br />9883 MILL CREEK F~D <br />AUMSV!LLE, OR <br />PHONE: 749-299 I <br /> <br />LOT: BLOCK: SECTION: TOWNSHIP: <br /> <br />SITE NUMBER: 8179 <br />VALUAT I ON: <br /> <br />MAP: <br /> <br />WIDTH: DEPTH: AREA: <br /> <br /> 30 88 <br />5_50000 AC NO NO <br /> <br />48 <br /> <br />?'YPE: ON-SITE SEMAGE <br /> <br />PER~4[T' C)F: APPLICATION NO: 1831~ <br /> <br />CONTRACTOR, NO, <br />ADAIR, RICHARD <br />9863 ~]LL CREEK RD SE <br />AUMSVZLLE, OR <br />PHONE: 749-2991 <br /> <br />WATER SUPPLY: P~ <br />TEST HOLES READY: <br />SITE EVALUATION NtJ~BER; <br />"EXISTING TANK SIZE: <br />EXISTING DRAIN FIELD LINES: <br />SEPTIC TANK PUMPED; BEING DONE <br />DREVIOUS NO_ BEDROOMS; 9 <br /> <br /> ITEM QUANT I TY AMOUN'T <br />AUTHORIZA'T!ON NOTICE .- ¢%0_ VISIT ] <br /> <br /> TOTAL. ASSESSED EELS $1 ( u. 0(., <br /> PREVIOUS RECK ~ PTS <br /> TH.~ RECEIPT ¢'¢ .... <br /> <br /> 8, ,LANCE ~E $0 ,,~ <br />PAYEE <br /> RECEZP-r <br /><ECEIVED BY; tx' ': TYPE; CHECK ~: <br />,~mE ~ FAL,HSD OOCUNENT FOR :RE~U'ZRE~EN~S OF ON-SZ'TE SEWAGE S~TEH_ <br />~ ~IS IS A VALID PE~IT ~, ~]~S;',RE~I~:~pIR~ 860 ~ F~ I~S I~E DATE. <br />~ST~CTI~ FAI~ TO NE~, A~E' R~IR~TS OF STATE ~ ~D ~RI~ ~N~ BUILDING <br />Z~ING ORDIN~CES, THIS PE~IT;]~EL:SE~E :NULL ~D VOID. <br /> <br />dAR 1,177,5 <br /> · ',' ¢-v ~,RI')N COLFIgTY 8U~LCIN(~ OFFICIAL / 8Y <br /> <br /> <br />