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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; B88-5147 8.00 - 4::30 <br />24 HOUR CODE-A-PHONE:: 588-7904 <br /> <br />DARE: 06/07/91 riME: 14:34:45 <br /> Of W HOMES <br /> <br />SIGNATURE OF ApPglCANT <br /> DATE <br /> <br /> TAX LOT <br /> <br /> CONSTRUCTION fYDE <br /> <br />RES,[/3gN T 1AL <br /> <br /> 14737 ALBErt' WAY NE <br />ALIRrJRA UR 97002 <br /> <br />24'755 5N 65~H <br />fUALi TAN, OR <br />PHONE: 638-8291 <br /> <br />4 1 12 <br /> <br /> CONTRACT CITY <br /> <br />AU N~JRA <br /> <br />SUBDI¢ISION <br /> <br />UGB <br /> <br /> NO <br /> <br />A L8 ~ k-T'd CRESf <br /> <br />Si¥~ NU~ER: 13213 <br />VALUA I ION: <br /> <br />I~R~G LOT CORNER <br /> YES NO <br /> <br />tYPE; UN-Si fE S~WAGE <br /> <br />PERM[[ OR APPLJ. CAfiON NO: 32803 <br /> <br />~ IRAC fOR, NO. <br />D ] W HC~E~ <br />24755 SN 65fH <br />IUALi lAN, OR <br />PHUN,E ~ 638-8291 <br /> <br />WATER 5~JPPLY: <br />TE$~ HOLES READY: <br />sire EYALUAFiON NUKSER: ALBEK'~ <br />EXISlJNG TANK 8I~: <br />EXLSFING OP, AIN FIELO LINESt <br />SEPTIC TANK PUMPED: <br />PR~¥1OU3 NO. BEOR~t <br /> <br />~ANDARD ON-SIrE SY~IEN <br /> <br />PAYEE: DIN HOM~ <br /> <br />'TOTAL ~E~ED PE~ <br />'1'HI5 RECEiPI <br /> <br />1 <br /> <br /> $165,00 <br /> $o,oo <br /> $165_00 <br /> <br />DANCE DUE $0_00 <br /> <br />iNVUlCE NO: 34596 <br /> <br /> RECEIVED BY: CL FYPE: IN CHECK ~: 0 <br /> <br /> SE:g A fFAC~EO DOCUMENr FOR RE(~JiREM~Nf'~ OF ON-SiTE SEWAGE SYSFE~. <br /> <br />~ THIS iS A YALiD PEI~qlT ~ ~HIS PER~IT EXPIRES 360 DAYS FRON ITS 1,5SUE DATE. 1P <br />COI~TRUCTION FAILS TO ~EET ~¢._L REi~UIRI~T~ OF STATE L/~ AND NtARII:~I COUNTY BUILD[i~r.¢ ¢¢40 <br />ZONIN~ ORDINANCES, THI~ PERMIT SHALL BECOI~E NULL AND VOID. <br /> <br />SEPTIC: BY /~ <br />REMARK,.~: PER741f <br /> <br />~}NALD E. WOODLEY, MARION COUNIY BUILDING OFFiCiAL / DY <br /> <br />FOnM ~ MC ~ 5Sf~ REV ~O OFFICE COPY <br /> <br /> <br />