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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 - 4:3o <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />builder. <br /> <br />SIGNATURE OF APPLICANf: <br /> DATE: <br /> <br /> BALE: 02103/92 <br />OWNER~ <br /> <br /> MCPiKE, DEAN <br />SITUS ADDRESS: <br /> <br />liME: 15:40:09 <br /> <br />TAX LOT: <br /> <br />CONSTRUCTION TYPE: <br /> <br /> 8342 8tSHDP ROAD <br />AUIvSVILLE OR 9'7325 <br /> <br />USE OF BUILDING: <br /> <br /> cONTRACT OITY: , UGB: <br /> <br />IcC. RION COUN'I'Y <br /> <br />MAILING ADDRESS: <br /> <br />NO <br /> <br /> RES,t DEN /l At_ <br /> <br />OCCUPANT LOAD' <br /> <br /> PHONE: 749-1366 <br /> <br />LOT: BLOCK: SECTION: <br /> <br />Wf0TH: DEPTH: AREA: <br /> <br />TOWNSHIP: <br /> <br />UNITS: <br /> AC <br /> <br />SiTE NUMBER: 92-00630 <br /> VALUATION: <br /> <br /> 1W EFU <br /> NO NO <br /> <br />48 <br /> <br />TYPE: ON-SiFE SEWAGE <br /> <br />PERMiI OR APPL1CA'IiON NO: <br /> <br />CONf'RAC'f'OR, NO. <br />~OPiKE~ DEAN <br /> <br />PHONE: 749--1368 <br /> <br />3?65? <br /> <br />WAFER SUPPLY: PN <br />'FES'T HOLES READY: <br />SITE EVALUATION NUMBER: <br />EXiSTiNG TANK SIZE: <br />E~iS'T'iNG DRAIN FIELD LINES: <br />SEPTIC 'rANK PUMPED: BRING VERIPY <br />PREVIOUS NO. BEDROOMS: <br /> <br />If'EM QUANFi'f'Y <br />REPAIR - MAJOR 1 $B5_00 <br /> <br />TOI'AL ASSESSED FEES <br />PRE¥1OU5 RECEIPTS <br />THiS RECEIPT <br /> <br />$85.00 <br />$85.0O <br /> $0.00 <br /> <br />BALANCE DUE $0 ,. O0 <br /> <br /> PAYEE: RECEI PF NO: <br /> RECEIVED BY; CL TYPE: CHECK ~.' C) <br /> <br /> SEE. AT'iA~ED ~CUME~'f' FOR RE~iR~EN'f'5 OF ON-SiTE SEWAGE SYSTEM- <br /> <br />* TH15 15 A VALID PE~iT * THiS PE~iT ~PIR~ 36D ~Y8 F~ iTS i~ ~TE. IF <br />~T~CTI~ FAi~ TO MEET ALL RE~IR~TS OF STATE ~ ~D ~RI~ ~NTY BUILDING <br />Z~ING ORDIN~C~. THiS PE~IT ~ALL BEdE NULL ~D VOID. <br /> <br />REMARKS: MAJOR REPAIN /~'~ <br />t%}NAL0 E. ~OODLEY, MARION COUN'i'Y BUiLDiNG OFFICIAL / BY ......................................................~ <br /> <br /> OFFICE COPY <br />FORM # MD 15-56 REV, 4/90 <br /> <br /> <br />