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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 /> OA'fE: 08/31/90 TIME: 10:13;59 <br />,QWNER: TAX LOT: <br /> MiLLER, JERRY - RENTAL HOUSE <br /> <br /> 5555 H~EL P~R~E RD SE 88NTRACTCi~Y: ~, U~: <br /> AU~VI LLE OR 9?325 <br />use o~ aU~LO~NG: .... ~RZ~ ~NT~ ~ NO <br /> <br />CATEGORY: <br /> R~ 1DEN'I'I AL <br />OCCUPANCY: <br /> <br />OCCU RANT LOAD: <br /> <br /> 435 N MACY ST <br /> I~,'NfNNVILLE, OR 97128 <br /> ~>HONE: 472-7618 S~TE NU~ER: 11092 <br /> VA LUA'r <br />:LOT: BLOCKZ SECTION: ' T~WNSH~: ~G~: ~ ~N~; MAP: <br /> <br /> ~ ............ 8 ~", 2~ , EFU 49 <br /> WIDTH: DEPTH: ~ AREA'. ~ UNIT8~ i IRREG. LOT: : CORNER; <br /> ?8 1~2 , 8136. i SF NO ; NO <br /> <br /> I'YPE: ~-~I'I'E SEWAGE ~ ~ ~]~ER ~PPLY* <br /> , ~ ................ ~ T~T HOLES <br /> PE~IT OR APPLiCATi~ NO~ 9026902 ) SITE EVALUA'f'I~ NU~ER= <br /> I / ~iS'rZNG T~K <br /> ~T~C'rOR, NO. N% ~ EXiS'f?G D~ZN FIELD ,LINES: <br /> ~ILLER, ~ERRY - R~'FAL ~~/ SEPTIC 'r~K <br /> 4~5 N ~CY ~'T' , , _~~ ) PRE~I~S NO. BED~ 1 <br /> ~tNNVI,~NE,, OR 9~128 (% N~ ~ ~ <br /> <br /> ~ '['E~ ~'r ~ TY ~N'f' <br /> AU'~'HOR~ZA'f'J~ N01'iC6 ~ F~D. V~SIT 1 $105.00 <br /> <br /> TOTAL ~ED FE~ $105.00 <br /> PREV[~S RECE[PT~ $0.0~ <br /> THZS RECEIPT <br /> <br /> PAYEE: ,JERRY N[LLER l%~ RE%E[P'r NO: <br /> ~E~VE%~Y: CL ........................... 2 ......... ~ .......... TYPE: CK O~ECK ~: 28457393? <br /> SEE ATT~ED ~UM~'i' FOR RE~R~EN:TS OF ~-8~TE S~E SYSTEM. <br /> <br /> ~ THiS ~ ~T A PE~T. THIS ~I~T1~ ~T ~ ~ A R~ P~ ~ERE THE <br /> ~LL~1~ ~T BE ~. IT ~8 ~IL~ ~ THE AP~L~T TO ~RB THAT <br /> <br /> PLAN REVIEW: BY .................................... DATE ................................................. CITY JURf~DJ, CTION: BY 0ATE <br /> RF-.NARK~: AUTH R~4009 <br /> <br /> OFFICE COPY <br />FORM ~ MC 15,56 REV. <br /> <br /> <br />