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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 /> CA'f E: 12/18/90 TIME: 13:53t54 <br />oWNCnH ERR~t~C4N, ROY <br /> <br />TAX LOT CATEGOHY RESIDEN I IAL <br /> <br />SITUS ADDRESS <br /> <br /> 92?3 SHAN 50UARE RD <br /> AUf'~V I LLF~ OR <br /> <br />9'1325 <br /> <br />USS OF UUtLDtNQ <br /> <br /> DE.5IREE HERf~WI, NN ~ MOBILE <br /> 9254 ~AW ~ARE RD ~E AU~VlLLE <br /> <br />LOT ~LOCK SSCT~ON <br /> <br /> CONSTRUCTION TYPE OCCUPANCY <br /> <br /> CONTRACT CITY UOB OCCUPANT LOAD <br />1~4¢.RION COtJN I'Y ~ NO <br /> <br /> SITE NUIV~ER: 11610 <br /> VALUA [' I ON: <br /> <br />AC IRREO LOT NO CORN~ <br /> <br />['YPE: ON-SI f~ SENAGE <br /> <br />PE~'MI1 OR APPLICAIlON NO: 9029399 <br /> <br />CONTRACTOR. NO. <br />HER~;~tANN, ROY <br />O~iREE HER~ANN - Iv~3BiLE OWNER <br />9254 ~HAN ~UARE RD ~E ~VILL <br /> <br />[~TER ,SUPPLY: <br />"r~r HOLP-~ RF_.AOY: <br />SITE EVALUATION NUI~ER: <br />EXIST lNG T~K <br />~[S[iN~ D~IN FIELD LINES: <br />SEP]iC T~K ~MPED: WILL HAVE PUMP <br />PRiZeS NO. <br /> <br /> i F~B~1 (~JAN r I FY A~ION i <br /> AU1HORIZA'IiON NOIlCE - FLD, ViSII ~.r-., 1 $105.00 <br /> °'ky <br /> THIS RECEIPT $'105.00 <br /> ~ DANCE ~E $0+ O0 <br /> <br /> PAYEE: NE~rY J~N~'r~ ,R~C~[P~, NO: 31063 <br /> RECE[V~ ~Y= PR ~ TYPE: CK CHECK ~: 1464 <br /> <br /> ~EE A~ fACH~D ~NEN'I FOR R~JR~ENrS OF ~-SJTE 8E~CE 5Ys"rE~. <br /> <br />~ THiS IS NOT A PE~IT. THIS APPLI~TI~ ~Sf ~ TH~ A ~I~ P~ ~ERE THE <br />FOLDING ~ST BE ~ETED, IT IS THE ~IBtLITY OF THE ~PLI~ ~0 ~RE THAT <br />ALL N~RY INFO~TI~ H~ BE~ P~IDED. <br /> <br />PLAN RFVIE'N.' BY <br />REMARKS: SEP! IC <br /> <br />CITY JURISDICrlON: BY ....... DAIE <br /> <br />OFFICE COPY <br /> <br /> <br />