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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 - 4'80 <br />2~4 HOUR CODE-A-PHONE:: 588-7904 <br /> <br /> 0AfG: 12/18/90 <br />OWNER <br /> N ICHOL. GLEN <br />SITUS ADDRESS <br /> <br />TAX LOT <br /> <br />CONSTRUCTION TYPE <br /> <br />56363-000 <br /> <br /> 8420 HOLM(,~JIBf RD <br />AU;Vi~VJLLE <br /> <br /> SE CONTRACT CITY UGB <br />OR 97325 <br /> IYW~R1ON (,X)UNIY NO <br /> <br />9?48 8Af~ RD SE <br />AUf4~VILLG, OR 9?325 <br />PHONE; 585-1782 <br /> <br />LOT BLOCK SECTION TOWNSHIP <br />31 <br /> <br /> 1.77 <br /> <br /> SiTE NUIVE~ER.+ 11405 <br /> VALUAT ION: <br /> RANGE ZONE <br /> <br /> IRREG LOT CORNER <br />AC YES NO <br /> <br />CATEGORY <br /> R~I DEN [ <br />OCCUPANCY <br /> <br />OCCUPANT LOAD <br /> <br />MAP <br /> <br /> 48 <br /> <br />PERMi1 OR APPLICAIlGN NO: <br /> <br />CON'IRAC'roR, NO. <br />NiCHOL, GLEN E. <br />9748 BAIES RD SE <br />NJ~VILLE, OR 97325 <br />PHONE: 585-1782 <br /> <br />28240 <br /> <br />WATER ECJPPLY: <br />I'E~T HOLE.~ READY: <br />SiTE EVALUAI"iON NUIVE3ER: <br />~.~(iSIlNG rANK ~iZE~ <br />~iSIlNG D~iN FIELD LINES: <br />~llC 'f'~K PUMPED~ <br />PREWi~ NO, <br /> <br /> i TF_.~I QUAN ri 'fY ~N1 <br />PRE. RE DiS'l RIBU I ION 1 $165,00 <br /> <br /> 'tOTAL ~Eg'SSgo FEP~ $155.00 <br /> PR~'ViOUS RECEIPTS $165.00 <br /> THIS R~81P'F $0.00 <br /> <br />8AL.a.NCE PtJE $0.00 <br /> <br />PAYEE: RECEIPT NO~ <br />R~CEiVED BY~ ,oN 1YPE.* CHECK ~.' 0 <br /> <br />SEE AIIIAO'HED 0OOUMEN1 FOR REQUIRP3'flENIfIS OF QN-SifE SENAGE Sy~IIEN. <br /> <br />x< ')'HIS IS A VALID PE~4IT :¢ THIS PEC,~41T EXPIRES 360 DAY~ FRO~I ITS I~E DATE. <br /> <br />CONSTRUCTiON FAIL~ TO MEET ALL REQUIRENENTS OF STATE LA~ AND I~tARION COUNTY BUILDING AND <br />ZONING ORDiNANCe,, THIS PEF~4IT E~ALL BP-COf4E NULL AND VOID. <br /> <br />REMARKS: PR~RE OIS'! R~4246 <br /> <br />OONALD E. INOODLEY, MARION CCUNIY BUILDING OFFICIAL / BY <br /> <br /> OFFICE COPY <br />FORM # MC 15-56 REV <br /> <br /> <br />