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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: 888-7904 <br /> <br />I am performing work on a property I own or occupy. <br />i am a registered buirPer OR the authorized representative <br /> of 8 registered builder, <br />The work will be performed by a registered bLfilder. <br />Other <br /> <br />I have read and 8gree to the terms sta~ed or~ the reverse side of <br />this document, <br /> <br />°wt~E: 09/12/90 'riME.· 13:01=15 <br /> <br />s,fus Auo~E~RAF'f', JOYCE & TERR'Y <br /> <br /> 18425 BUTTEVlLLE ROAD <br />US~ING ' OR '-'-9?002 <br /> <br />~I~INO ADDRESS: <br /> <br />NE <br /> <br /> TAX LOT <br /> CONSTRUCTION 'rYmE <br /> CONTRACT CITY: <br /> <br />rC~.R I ON 6rJJNTY <br /> <br /> SUBDIVISION: <br /> <br />UGB. <br /> <br /> NO <br /> <br />CATEGOmY: <br /> <br />OCCUPANCY: RESI DffNT IAL <br /> <br />OCCUPANI LOAD: <br /> <br /> PHC1NE: 981-0934 <br />LOT BLOCK ~ECTION; TOWNSHIP' <br /> <br />SITE NUIVlBER *. 10984 <br />RAA~ALUATION: ZONE <br /> <br />MAP: <br /> <br />EFU 9 <br /> <br />TYPE: ON-SiTE SEWAGE <br /> <br />PERC4IT or APPLiCATiON NO: <br /> <br />CONTRACTOR, NOt <br />KRAFT, JOYCE & TERRY <br /> <br />PHOebE: 981-0934 <br /> <br />26542 <br /> <br />9~ATER ~UPPLY; <br />TEST HOLE~ REAOY: <br />SITE EVALUAI'ION NurvIBER: <br />EXISTING TANK SIZE: 500 <br />EXiSTiNB DRAIN FIELD llNES: <br />SEPTIC TANK F~JMPED: 8/18/90 <br />PREVIC~S NO. BEDR12OIV~: <br /> <br /> (~AN T I TY <br />AUTHORIZA'flON NOTICE - FLO. viSiT 1 <br /> <br /> ~OTALASSE,~.~E~ FEES <br /> PRE'VIOU~ RECEIPT3 <br /> THIS RE. CE[PT <br /> <br />Afflr~JN'f' <br /> $~05_00 <br /> <br />$105.00 <br />$~05.00 <br /> $o.oo <br /> <br />BALC~NCE :DUE $0.00 <br /> <br />PAYEE: RECEIPT NO: <br /> <br /> RECEIVED BY: Cl ......... si .... "'""' .... .... ~,~,~,~i~i- ....... TYPE¢ CHECK ~: 0 <br /> SEE ATTACHED DOCUt4E_N'[' FOR REqUIREI~IE?4T$ OF ON-SiTE 3ENAGE SY~TE.~I. <br /> <br />~ THIS 1~ A VALID PEf~IT ~ THIS"I:~B~:T i~JXP[RE~ 360 DAYS FROf4 ITS I~SUE I~AT£. IF <br />C~NSTRLICTION FAIL*.~ TO I~EET AIJ.: RB~UIREI~ENTS Of= $7/ATE ~ AND I~ARION CO.~TY BUILD[N6 AND <br />Z~NIN6 ORDINANCES, THIS PEI~IT: ~HALL B~ NULL AND VOl0. <br /> <br />RBViARKS: AUTH - FIELD VISIT R~¢3761 <br /> <br />LYONALD E. VCC~ODLEY, fAARION COUNTY BUiLDiNG OFFICIAL / BY <br /> <br /> OFFICE COPY <br /> <br /> <br />