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MARION COUNTY BUILDING INSPECTION <br /> SENATOR BLDG. NO. 225 <br /> 220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> O(her <br /> <br />0AI~: 08/09/91 TIME: 10t0'/':48 <br /> KO'T T R~, RAY <br /> <br /> PHONE: 588-5147 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />DATE: <br /> <br />, TAX I. OT: <br /> <br />SITUS ADDRESS: : CONSTRUCTION TYp~: <br /> <br /> 8612 SHAW SQUARE RD SE <br /> AL MSV[LLE OR 9?325 CONTRACT CITY; , UGS: <br /> MAR10N COUNTY i <br />USE QF BUILDING: <br /> <br />8613 ~HAW SQUARE RD SE <br />AUIVlSV I t_LE, OR 9?'325 <br />RHONE: 364--23 !8 <br /> <br />LOP SLOCK: <br /> <br />WIDTII: DEPTH: <br /> <br />; SUBDIVISION'. <br /> <br />· 04- AC <br /> <br />NO <br /> <br />, OCCUPANT LOAD: <br /> <br /> SiT'E NUIVl8 ER: <br /> VALUAT I ON; <br /> <br />i R~NGE: zoN6: <br /> 2N <br /> <br /> AR3 <br />NC) CORNE R'~E'S <br /> <br />TYPE: ON-SiTE SEWAGE <br /> <br />T*f.'~RMiT OR APPLiCAT'IC)N NO: 9034363 <br /> <br />CON I'RAC fOR, NO. <br />KOI IRE:, RAY <br />8(~'13 ~:'SHAW SQUARE, RI) SE <br />AUN(,SV 1LLE, OR 9/325 <br />PHONE: 364--'23 18 <br /> <br />WATER SUPPLY: PW <br />'f~'r HOLES REAOY: YE5 <br />SiTE EVALUA'I'IO~ NUMBER; <br />E×iS'FiNG 'rANK SIZE: <br />EXISTING DRAIN FIELD LINES: <br />~ERI'IG 'TANK PUMPED: <br />PREVIOUS NO. BEDROOMS: <br /> <br /> 1 'f'c-lvl QUANr I )'Y AMOUN'f <br />SITE EVALUArLC)N, P'IRS1 LOT 1 ~:~/75.00 <br /> <br /> '[:O'I'AL ~ES,~ED FEES <br /> PREVIOUS REcE/rP'I'S $~), 00 <br /> :'tH iS RECEIP'I' $ <br /> <br /> 8,&LANCE ~E $0, <br />PA~68: KOff~E, RAY ~ RECEIPT NO: "~5~3]"?"' <br />RECEIVE0 ElY: P~ TYPE: OK CHECK ~: 2504 <br /> <br />· ),,:~: ATTACHED DOCUMENT FOR REQUIREMENTS OF' ON-SITE ~ENAGE SYSTEM. <br /> <br />NOTE: THIS 0OE.~ NOT GR/~4T OR IMPLYPE~II,~SION TO BUILD ON THIS PARCEL. PLANNING AND <br />OONS'rRUC¥10N PER~IITS ivLIST ~E OBTAINED ~EFORE BU[LO[NG OR SEPTIC INSTALLA'FiCN ~EGINS. <br /> <br /> PLAN REVIEW: BY .............................. OAYE ............................................. CITY JURISOIC'!'[ON: BY ............................. DA~E <br /> REMARKS: SII'E' ~VAL. R~250~ <br /> <br />FORM ~ MC 15-58 R~V. 4t90 OFFICE COPY <br /> <br /> <br />