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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 />I have read and agree to Ibc torres stated on the reverse s~de of <br /> <br />OWNt¢~ F E: 05/22/.91 f IME: 12: 03: 33 <br /> <br />S~TUS~OunbS~I:11I~' EARNS! M. <br /> <br />TAX LOT <br /> <br />CONSTRUCTION TYPE <br /> <br />RESiDgNfl&L <br /> <br /> 8144 AUrcrsVILLE HWY <br /> AUIV~ViLLE <br />USE OF BUILDINC <br /> <br />OR 97325 <br /> <br />SE <br /> <br />CONTRACT CITY UGS <br />MARION COUN ] Y NO <br /> <br />MA~LING ^DDRESS <br /> <br />3 <br /> <br />LOT <br /> <br />GARY C~LLA~IER-PRUD~NflAL REALF¥ <br />115b-lST ~] STAY]ON 9?383 <br />PHON~: 423~?'740 <br /> <br /> BLOCK SECRON <br /> <br />TOWNSHIP <br /> <br /> ~AN'I LAM MEADOWS <br /> <br />SIrE NUMBER; 1271 <br />R~N~V~LUATION ~ ZONE <br /> <br />WIDTH q 'F DEPTH AREA <br /> <br />~-~ MNITS <br />5.64 <br /> <br />8~ IRREG LOT ~ CORNER AR <br />AC NO NO <br /> <br />'f'YP~: ON-SirE SEWAGE <br /> <br />PERMIf OR APPLiCAI'ION NO: <br /> <br />31511 <br /> <br />CONfRACFOR, NO. <br /> <br />GARY COLLANER-PRUOENIiAL REALLY <br />l'155~lSf Sf S~AY~ON <br />PHON~; <br /> <br />WAFER SUPPLY: CN <br />lES1 HOLES RbADY: YES <br />Sire EVALUATiON NUMBER: <br />EXISTING TANK SiZe: <br />E. XISf'~NG ORA~N FIELD LiNE~: <br />SEPIIC TANK PUMPED: <br />PR~¥1OUS NO+ 8EOROOrv~= <br /> <br />PAYEE: RECEIPf NO: <br /> <br />RECEIV~L BY: CL ............................................................. rYPE: C~ECK ~: 0 <br /> <br />5g~ AtlACHEO LYQCUMEN¥ FOR REqU.LREMENfS OF ON-SirE SEWAGE SYS'f'EJvL <br /> <br />NOTE: THIS IX)ES NOT GRANT OR [~PLY PERI~ISSiON TO BUILD ON THIS PARCEL. PLANNING AND <br />CONSTRUCTION PERr4IT~ t~J~T BE O~TAINED BEFORE BUILDING OR ~EPTIC INSTALLATION BEGINS. <br /> <br />REIVIARKS: SE R~'1432 SfD SYSTEM ~ ~ <br />DONALD E. WOODLgY, MARION COUNTY BUILDING OFFICIAL / ~Y ........ ~ <br /> <br /> OFFICE COPY <br />FORM # MG 15-56 REV 4¢Jo <br /> <br /> <br />