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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 />Other ,, <br /> <br />SIGNATURE OF APPLICANT <br /> DATE <br /> <br />OWNE.~fE: 04/04/91 fINE= <br /> <br /> HAiFIBLD, SIEYEN <br /> <br />13:35:29 <br /> <br />TAX LOT <br /> <br />CONSTRUCTION TYPE <br /> <br />RESI D~-N f <br /> <br /> ?932 IERRANCE LANE <br /> AUM~VI LLE <br />USE OF BUILDING <br /> <br />OR 9?325 <br /> <br />fc~Rt ON CtXJN1 Y NO <br /> <br />OCCUPANT LOAD <br /> <br /> NO OF BEDROOM5 <br /> <br />SUBDIVISION <br /> <br />2269 SALEM DALLA~ HWY <br />SALf;~l OR 97304 <br />F,14ONE2 362w8335 <br /> <br />Si1E NUM~ER: <br /> VALUAT.ION: <br /> <br />82 230 <br /> <br />188~0, <br /> <br />UNITS <br /> <br />~F NO NO <br /> <br />AR 51 <br /> <br />iYPE: ON-BIlE SEWAGE <br /> <br />PE~lll OR APPLiCAtiON NO: $0803 <br /> <br />CONfRACfOR, NO. <br />HAFFIELD, <br />2269 SALEM DALLA.5 HWY <br />SALEt,'I OR 9'?304 <br />PHONE: 382~6335 <br /> <br />NA1ER SUPPLY: P~ <br />IRES[ HOL~ READY: <br />SIlL ~VALUAIIiON NU~ER: <br />E)<i~TiNG f'ANK SIZE: <br />~l~llN6 DRAIN FIELD LINE~: <br />SEPTIC f'~K ~MPED: <br />PREVi~S NO. BEDRid: <br /> <br /> ITE~4 <br />RgPAiR - MAJOR <br />AU[HORi£A¥ION NOtiCE - FLO. visit <br /> <br />TOTAL ~ED FEES <br />PR~NIOUS RECEIPTS <br />IHiS RECEIP1 <br /> <br />BALANCE DUE <br /> <br />f,~.lANf'if'Y A~K~JN¥' <br />~ $80.oo <br />1 $~95_00 <br /> <br />PAYEE: RECEiP f NO: <br />RECEIVED BY: Of~42 TYPE.* CHECK <br /> <br />SEE AI'¥AONED OO(.,'UMENF FOR REqUlRr~IF~4FS OF ON-SirE SEWAGE <br /> <br />$185.00 <br /> <br />33106 <br /> 0 <br /> <br />* THI~ i$ A VALID PEI~IlT * THIS PEF~IlT EXPIRE~ 380 DAYS FRO~I ITS ISSUE DATE. iF <br />CONSTRUCTION FAIL~ TO ~EET ALL RE(~JiRiB~IE~TS OF STATE ~ AND lvtARION COUNTY BUILDING AND <br />ZONING ORDINANCES, THIS P~IT ~HALL DECOf4E NULL AND VOID. <br /> <br />R~4ARKS; MINOR REPAIR/ADf'H FIELD VlSif' CHG TO MAJOR REPAIR R~7983~ <br />DONALD E+ WOODLEY, MARION COUNiY BUILDING OFFICIAL / BY k./ <br /> <br />FORM ~ MC 15,56 REV 4/90 OFFICE COPY <br /> <br /> <br />