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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 8::00 - 4'30 <br />24 HOUR CODE-A-PHONE 588-7904 <br /> <br />I am performm9 work on a property I own or occupy <br /> <br />SIGNATURE OF APPLICANT <br /> DATE <br /> <br />°w~fE: 06/ql/90 lIME: 11;49-'47 <br />SITUS A0~)nestsYONS, HANTJLD <br /> <br />CONSTRUCTION /YPE <br /> <br />OCCUPSNC¥ RESIDENTIAL <br /> <br />CONTRACT CITY UGB <br />MARiON COUNI Y NO <br /> <br />4 <br /> <br /> 5Ar~lE <br /> <br /> PHONE.* 749-1047 <br />LOT BLOCK SECTION TOWNSHIP <br /> <br />Si1E NUIV~ER; 10303 <br />RAN~ALUA[ ION.' ZONE <br /> <br />48 <br /> <br />lYPE: ON-SITE SEWAG~ <br /> <br />R~K~I1 OR APPLiCAllON NO: 24476 <br /> <br />CONIRACf'ON, NO. 34936R-2 <br />5TAYFON MILL CiTY 5iLVERI'ON 5EP <br />41155 SlAY'ION ~IO ORIVE, SE <br />SIAYfON, ORgGON 97383 <br />PHON~: 769-2302 <br /> <br />NA1ER ~PPLY: <br />'res! HOL~ READY: <br />SII~ EYALUAIlON NUMBER: <br />P~(ISTiNG rANK <br />EXiSTiNG DRAIN Fi~LO LiNg~: <br />SEP[iC ~ANK PUMPED: <br />PR~VIOCIS NO, BEDROOMS: <br /> <br /> ITEM OUANflTY <br />ALTERAIlON <br /> <br /> FOFAL ~EE,EED <br /> PREVIOUS RECEiP15 <br /> THIS REC~IP'f <br /> <br />BALANCE DUE <br /> <br />PAYEE: RECeiPT NO: <br />REC~IVBD BY: ct TYPE: CHECK <br /> <br />A~OUNf <br /> $t45,00 <br /> <br /> $145.00 <br /> $~45_00 <br /> $o,oo <br /> <br /> $0.oo <br /> o <br /> o <br /> <br /> SEE AIIACH~D 0OCUMbNI FOR REQUIREMENTS OF ON-SIiE 5ENAGE SYSI~M, <br /> <br />~ THIS IS A VALID PER~41T :~ THI$ PEI~IIT EXPIRES 360 OAY~ FRC~I IT~ 1.5SUE DATE. IF <br />CONSTI~UC'TION FAILS TO MEET ALL ;~E~IRE~E~T$ OF STATE LAJ~IS AND P~ARION COUNTY 8UILOING AND <br />ZONING ORDINANCES, THIS PE~IT SHALL 8IECO~IE NULL AND VOID. <br /> <br />RE,lARKS; ALTgRAIiON- EXISllNG ON NglG8ORS NEAR NELL <br /> <br />DY, ANALD E, KOODLEY. MARION COUNFY BUILDING OFFiCiAL / BY <br /> <br />OFFICE COPY <br /> <br /> <br />