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MARION COUNTY BUILDING INSPECTION <br />SENATORBLQG 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 per'fOrmin9 work on a Property I own or OCCUpy <br /> <br /> Other~ . <br /> <br />OAf ~.: I 1/26/90 <br /> <br /> I'~}~EY, ~ARK <br /> <br /> ?494 ~HERMAN RD <br />AUM~Vi LL~ <br /> ~ARJON COUN rY NO <br /> <br /> OCCUPANT LOAD <br /> <br />4013 S.CALAR~A Cf <br />WE~'f LiNN, OR 9'f068 <br />~ONE: 8~5-26~0 S~TE NUmBeR: 11427 <br /> VALUA7 i~: <br /> <br /> 28 gPU <br /> <br />fYPE: ON-SIIE SEWA(CE <br /> <br />P~.R~lll OR APPLiCAf ION NO: 2?900 <br /> <br />CON~P, ACfOR, NO. 65359 <br />fOOZE OONSrDcriON Co <br /> <br />~ALEM, OR 97309 <br />PHONE: 581-4886 <br /> <br />IA~ATER SUPPLY: PW <br />lEST HOLES READY: <br />SITE EVALUA f l~ <br />~llNG lANK SIZE: <br />~l~flNG D~iN FIELD <br />~PIIC lANK PU~PEO; <br />PRE~i~S NO. <br /> <br /> ~TANDARD ON-SII8 SYSfE~ 1 $185.00 <br /> <br /> PR~VlOU~ RE~IPf~ $185.00 <br /> tHIS RECEIPT $0.00 <br /> <br /> BALANCE DUE $0.00 <br /> PAYee: RECEIPT NO: <br /> <br /> THIS IS A VALID PERI~IiT * THIS PEI:~4IT ,~..~<PIRES ~80 OAYr¢ FRO¢4 iTS i~E ~lE. IF <br />~T~C~i~ FAi~ TO ~EBT ALL RS~IR~TS O¢ STATE ~ ~D ~RI~ ~N~ BUILDING ~B <br />Z~ZNG OROiN~CES. THIS PE~IT ~ALL BEde NULL ~B ~I¢. <br /> <br />RE~ARKS: SEP'~iC INSfALL - SIND R~2338 <br /> <br />DOT4ALD 5. ~¢30DLEY, MARION C'GUNIY BUILDING OFFICIAL / BY <br /> <br />FORM # MC ls-~e REV 4/90 OFFICE COPY <br /> <br /> <br />