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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO. 225 <br />220 HIGH STREET NE <br /> SALEM1 OREGON 97301 <br /> <br /> PHONE: 588-5147 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />OWN~'~ 10/25/9~ <br /> <br /> KU~'f'A, PEARL <br /> <br />f'IME: 12:46:58 <br /> <br />TAX LOT: CATEGORY: <br />CONSTRUCTION TYPE: OCCUPANCY: <br /> <br />RESi DEN T' IAL. <br /> <br />10791 ARNOT ROAD NE CONTRACT CfTY; UGB: <br />AURORA OR 9?002 <br />USE OF BUILDING: 1~4ARiON {~NI'Y <br /> <br />OCCUPANT LOAD: <br /> <br />MAILING ADDRESS: .... SUBDIVISIONI <br /> <br /> RNONE: 578'-5965 ~iTE NUIV~ER'- <br /> VALUATION <br />LOT: 8~ OCK: SECTION. TOWNSHIP: RANGE; <br /> <br />WiDfH: <br /> <br /> AREA: 32': ONItS: 3~ iR~AG COT: IW <br />12,0 ] ~0.0 Sf:' NO <br /> <br /> 14524 <br /> <br />ZONE; <br /> <br />¢O~NE~: AR <br /> NO <br /> <br />MAP: <br /> <br /> 1 <br /> <br />lYRE: ON-SITE SEWAGE <br />PL-';RIvIiI 0N APPLICATiON NO: 9035242 <br /> <br />CON',',~C I OR, NO. ~¢X <br />KC~IA, PEARL <br /> <br />PHONE: 878-59~5 ~ <br /> <br />WATER SUPPLY: PW <br />'f'E.5'f' HOLES REAOY: <br />SiTE EYALUA'f'ION NUMBER: <br />PD(1S'f'ING TANK ~iZE: <br />EXiSTiNG DRAIN FIELD <br />~EP'TiC TANK PUMPED: <br />PREVIOUS NO, BEOROONS; <br /> <br />?50 <br /> <br /> 11'EM QUAN l' I TY AIVIGLIN <br /> REPA i R ~- I~fA,JOR 1 $85.00 <br /> <br /> TOTAL A~E~SEO FEES $85.00 <br /> PREVIOUS RECE i P'f'~ .~_ &l.~.~ <br /> !'H 15 RECE i PT %._~.~$ 25_ <br /> <br /> BALANCE DUE $0,00 <br /> PAYEE; KO'~'fA, ~EARL ~ RECEiPI NO; 38'28q <br /> RECEIVED BY: P" TYPE: CK {;NECK :~: <br /> SEE A'f"f'ACNED D(;)CUM¢:Nf FOR REQUIREMENTS DE ON-SITE SEWAGE SYSTEM. <br /> <br />* THIS iS NOT A P£C~IiT. THIS APPLICATION I~IMST GO THROUGH A REViE~ PROCESS ~ER6 TH~ <br />~:OLLOWlNO iv~JST 8E f..'O~PLETEDi iT IS THE R~PONSIBiLiTY OF THE APPLICANT TO AS.SURE THAT <br />ALL NFCE'S~C~RY £NP"O~TiON HAS BEEN PROVIDED. <br /> <br /> BY.,, ,,,,.,:~,~ <br /> I,>LAN <br /> REVIEW <br /> ........... OA'~E..]~:~..~.'._[ ......... CITY JURISOiC'fION: SY .............................. 0A'fb, <br /> <br /> REIVlARK~: 3EPT'iC REPAIR TANK & DRAiNF.[ELD R~3'Z7~ <br /> <br />OFFICE COPY <br /> <br /> <br />