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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 />I hard read add agree to the terms stated on the reverse 81de of <br />this document <br /> <br />SIC=NATURE OF APPLICANT ',-~f~i~,,~ <br /> <br /> Z <br /> DATE <br /> <br />ow~hrE ~t/ 1/3o/9o FINE.* 8~41 = 18 <br /> ~'V4,1EKUDA, RANDY & ANNA <br /> <br />TAX LOT <br /> <br />CONSTRUCTION TYPE <br /> <br /> 892? SILVER FALLS HWY <br />AUr4SViLLE OR <br /> <br />894? SILVER FALLS HNY SE <br />AUIvCSV1LLE 9?325 <br />PHONE: 264-4500 <br /> <br />LOt BLOCK <br /> <br /> 9?325 <br />'SECTION <br /> <br />t~"~RiON -6~JUNTY- 'NO <br /> <br /> SIIE NO'ER: <br /> VALUAr'I~: <br /> <br />WIDTH DEPTII AREA <br /> <br />UNITS IRREG LOT <br /> AC YES <br /> <br /> 11818 <br /> <br />ZONE <br /> <br /> AR~ <br />CORNER <br /> <br /> Y~ <br /> <br />RE~iDEN¥iAL <br /> <br />3 <br /> <br />ON-Si I E S~WA(~E <br /> <br />P~-R¢41 f OR APPLICAIlON NO: <br /> <br />CON FRAC fOR, NO. <br />~4EKUOA, R.~IOY ~ ANNA <br />894? 51LVkR FALLS HNY <br />AU~W LLE 97325 <br />PH~E: 364~4500 <br /> <br />9029022 <br /> <br />NAIER SUPPLY: PW <br />rESt HOLE~ READY: <br />S~IE EVALUAIiON NUI~f~ERt <br /> <br />EXiSTiNG DRAIN FIELD LINES: <br />SEPTIC TANK PUMPED: <br />PREVIOUS NO. 8EDROOI~5; <br /> <br /> I FE~4 <br />REPAIR - IviAJOR <br /> <br />TOTAL AS~E:SSEO <br />PRE¥IOUS RECEIPTS <br />THIS RECEIPT <br /> <br />8A L./'-~CE [AJE <br /> <br />QUANtiTY AMOUNT <br /> 1 $80.00 <br /> <br /> $80.00 <br /> $0.00 <br /> <br /> tO.OD <br /> PAYEE: ~6KUOA, RANDY & ANNA '~'~ R~C~iP~ NO* ~0555 <br /> <br /> SEE AIIAGH~g DOCU~ENI FOR R~IR~ENJ~ OP ~-SiTE ~E~A~ ~I~. <br /> <br />* THiS iS Nor A PE~iT~ THI~ APPLIOATi~ ~8"r ~ TH~ A RE~I~ P~E~ ~ERE THE <br />~LLONING ~ST BE ~PLETED. IT IS THE R~$IBiLITY OF THE APPLi~"r TO ~RE THAf <br />ALL NEO~ INFO~TI~ H~ 8E~ P~DED. <br /> <br /> PLAN REVIEW: BY ..~ DAlE ,~.,.~_~ OilY JURISDICtiON= BY DAIE <br /> R~ARKS: ~OR R6PAIR - I~K ~ D~INLINE~ R~4687 <br /> <br />FORM ~ MC 15-56 REV 4/90 OFFICE COPY <br /> <br /> <br />