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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 />O[her <br /> <br /> ~ have rea(~ and agree to ~he terms stated on the reverse side of <br /> this document. <br /> <br /> DATE: 07/]8/90 I'iME: 15:97:4-8 <br />OWNER: <br /> E,;NGLAND.. JAJ'"4ES IN. <br /> <br /> ??42 'I"ERRANCE LN <br />AUtVFE, V i LLE OR 9?325 <br /> <br />USE OF BUILDIN~ <br /> <br />MAILING ADDRESS: <br /> <br />SAME <br /> <br />Pi'tONE:" ' ';~ .... <br /> 749-~51 ? <br /> <br />DATE: <br /> <br />TAX LOT; <br /> <br />f~qARiON CC~JN ]'Y NO <br /> <br />: SU~DIVtS~ON: <br /> 'T'ERRANCE <br /> <br /> ? 2 26 <br />WIDTH: 165 :DEPTH: 228 AREA: 37820. UNITS: <br /> <br />CATEGOHY: <br /> RESi DEN'I IAL <br /> <br />OCCUEANCY: <br /> <br />OCCUPANT LOAD: <br /> <br /> NO OF 8EDRO0,~S <br /> <br /> 3 <br /> <br />MAP: <br /> <br />TYPE: ON-~i'I'E SENAGE <br /> <br />PER~I'f' OR APPLICATION NO: <br /> <br />CONTRACTOR, NO. <br />ENGLAND, JACaES W. <br />S.aeaE <br /> <br />PHONE: 7~9-251 ? <br /> <br />25610 <br /> <br />IAA'FER SUPPLY: PW <br />TEST HOLE~ READY.+ <br />SiTE EVALUA'FJON NUI~:~tER: <br />~S'T'ING '~'~K SIZE: 1000 <br />~is'rING B~iN FIELD LiNE~ <br />SEPTIC 'T'~K PUMPED: <br />PRB~i~ NO, 8EDR~: <br /> <br />RE:PAiR .-- IVtAJOR <br /> <br />i 'f' EIv1 r,J,,%JAN '1' i 'T'Y <br /> l <br /> <br />TOTAL AS.SP_.~SED FEES <br />PRE¥iOUS RE%EiPTS <br />THIS RECEiP'¥' <br /> <br />BALANCE OUE <br /> <br />AMOUN'I <br /> $so.oo <br /> <br /> $80.00 <br /> <br /> $o_oo <br /> $o_oo <br /> <br /> PAYEE= RECEIPT NO: <br /> RECEiVEO DY: CL TYPE: CHECK ~; 0 <br /> ................ ~~.~---:~:2--~ .... 7~-: .... ~%. ............................... <br /> <br /> SEE ATTACHED DOCUNEN'f FOR RE,(.~UiREtflENTS OF:ON-SiTEDEWAGE SYSTEM. <br /> <br />* THIS 15 A VALID PE~IT * THIS ~IT ~PIRB 360 ~ F~ IT8 i~E DATE. IF <br />~ST~CTI~ FAI~ TO ~T ALL R~IR~T8 ~ STATE ~ ~D ~RI~ ~NTY BUILDING ~0 <br />Z~ING OROIN~C~, THiS PE~I'T ~ALL B~E NULL ~D VOID. <br /> <br />REMARKS: REPLAC~ DRAINFiELD R~2620 <br /> <br />[YONALO E. WO©DLEY, MARION CQUN'1'Y BUILDING OFFICIAL / BY ...................................................................... <br /> <br /> OFFICECOPY <br />FORM # MC ~-~6 REV, 4~ <br /> <br /> <br />