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MARION COUNTY BfJILDING 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 />Other <br /> <br /> I have read and agree to the terms stated on the reverse side of <br /> this document, <br /> <br /> DA'rE: 06/11/90 TIME: 12:42.'24 <br />OWNER; <br /> PERKINS, DAVID G <br /> <br />SIGNATURE OF APPLICANT: <br /> DATE; <br /> <br /> TAX LOT: <br /> <br /> CONStRUCTiON TYPE: <br /> <br /> 20813 FILBERT S'T NE <br />AURORA 9?002 <br /> <br />LJ~E OF BUILDING: <br /> <br /> CONTRACT CITY: : UGB: <br />AURORA NO <br /> <br />SU SD[VISION; <br /> <br />CATEGORY: <br /> RES[ DEN']' .[AL <br /> <br />OCCUPANCY: <br /> <br />OCCUPANT LOAD: <br /> <br /> PHONE: <br /> <br />LOT: BLOCK: SECTION: <br /> <br /> SITE NUf~IER: 10232 <br /> VALUATION: <br /> <br /> RANGE: ZONE: <br /> <br /> ;O~i~S: IRREO LOT: CORNEA: <br />0.' NO ND <br /> <br />MAp: <br /> <br />FYPE: ON-SI'FE SEWAGE <br /> <br />PERMI'r OR APPLICATION NO: <br /> <br />6.X.3N'f'RAC~'OR, NO. <br />PERKINS, DAVID G <br /> <br />24246 <br /> <br />NA'FER SUPPLY: <br />TEST HOLES READY: <br />SITE EYALUAT[ON NU~ER: <br />E~iSI'IN~ TANK SIZE: <br />EXISTING DRAIN FIELD LIN~: <br />SEPTIC TANK PUMPED: <br />PRE~[OUS NO. BED~t <br /> <br /> i I'EM <br />AU'f'RORITA'f'ION NO'FLOE - PLO. VISIT <br /> <br /> QUAN'T'~'T'Y AC4OUN]' <br /> 1 $105.00 <br /> <br /> $105.00 <br /> 100.00 <br /> $5.00 <br /> BALANCE DUE $0.00 <br /> <br /> PAYEE: PERKINS, DAVID G INVOICE NO: 28220 <br /> RECEIVED BY: c'/ TYRE: iN CHECK ~: O <br /> <br /> SEE A'f"f'AC~ED DOCUMENT FOR REQUIRE~4ENTS OF ON-SiTE SEWAGE SYSTEM. <br /> <br />~ THIS IS A VALID PERi,lIT ~ ~HISPERI~IlT EXPIRIE~ 360 OAYS FI;~BI~I ITS iEx~UE BATE. if <br />CONSTRUCTION FAII,~ TO ~EET ALLRIE~iRE~IB~ITS OF STATE ~ AND I~IARiON COUNTY BUILDING ~O <br />ZONING ORDINANCES5, THIS PER~iT~LLBEC~I~IE NULL~DVOIO. <br /> <br />RP3,4ARKS: AU'fR- CiTY HAS APPL FOR REPLACEMENT FOR MOBILE HO~E ~ <br />D~IALD E. ~ODLEY, MARioN CEAJNI'Y BUILDING OFFICIAL / BY ......................................~ ........................................................ <br /> <br /> OFFICE COPY <br />FORM # MC 15-56 REV, 4/90 <br /> <br /> <br />