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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 />lamare9isteredbuilderOR( )theauthorizedrepresentat~ve <br /> <br />The work will be performed bY a registered builder. <br />Other <br /> <br />SIGNATURE OF APPLIOANT: <br /> <br /> DATE: <br /> <br /> OWN~I'E; 09/18/90 I'tM~'~ 11:29:'5'8 ?AXLO¥: :CATEGORY: <br /> <br /> f'~'NROE, MICHAEL R : 90390-B~0 ,, <br /> SITUS AD~RE~S~ ~ ~ONSTROC~ION TYPE: OCCUPANCYr <br /> <br /> ~ ~5~'~i~ ; OccuPANT LOAD: <br /> 120 3RD s'r <br /> OE'f'~ l' OR 97342 <br />USE OF 801LdlNG: 'DETail ~ NO <br /> <br />............ .,' PATTON <br /> <br /> PHONE: 854-3465 SI'f'E NUMBER: 1'1153 <br /> <br /> I <br />LO'F: BLOCK: ; SECTIONi +O~VN~N IP; RANGE: : : <br /> <br /> 9 4 ' 5S IRREg. LOT: 2W ' <br />WIDTH: DEPTH: A~EA; i 0NIT¢: :CORNER; <br /> <br />: NO 0F 860AOOM$ <br /> <br />MAP: <br /> <br />'f'YPE~ ON-SITE SEWAGE <br /> <br />PERMIT OR APPLiCATiON NO: <br /> <br />6Y.~'FRA(:;'f'OR, NO. 36421 <br />KEVIN'S BACKHOE SERVICE <br />P.O. BOX 455 <br />DE[ROil', OREGON 97342 <br />PHONE: <br /> <br />27060 <br /> <br /> HATER ~JPPLY~C~ <br /> TEST HOLES REAOYt <br />SITE E~C'ALUATION NUI',~ER: <br />EXISTING TANK SIZE; <br />~Is'rING DF~AIN~FiEL¢ <br />SEPTIC 'rANK PUMPED: <br />~REViOUS NO. BED~: <br /> <br /> ll'E~ <br />REPAIR - MINOR <br /> <br />QuANT i T Y AMOUN'T' <br /> $55_ 00 <br /> <br /> TOI'AL A,%S~ED FEES <br /> PREVIOUSRECEiPTS <br /> THiS RECEIPT <br /> BALANCE DUE <br /> <br />PAYEE; · INVOICE NO; <br />R~EIVEO BY: CL TYPE: CHECK ~: 0 <br /> <br />$55.00 <br />$55.00 <br /> $o.oo <br /> <br />$0.00 <br /> <br /> SEE Af"rACHEO ¢OCUC4EN'F FOR REQUiRBViENI'S OF ON--'8iTE SEWAGE SYS'i"~I. <br /> <br /> THIS IS A VALID PEF~iT ~, THiS PEI~IIT E)(~IRES 360 OAY~ FRQ~I IT~ I.SSUE DATE. IF <br />CON~TRUCTION FAILS TO I~mET AU.. ~IR~IENlr~ OF STATE ~ AND NIARiON COUNTY BUILDING AND <br />ZONiN~ OROiNANCE~,. THIS PER~IT ,~-IALL 8E~3~lE NULL ANO VOIO. <br /> <br />RBVlARKS: NINOR REPAIR <br />£~NALO E. NOODLEY, MARION f.,%~N'I'Y BUILDING OFFICIAL / BY ........................ L!....U.. ....................................................... <br /> <br />OFF~EGOgY <br /> <br /> <br />