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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 am a reglsteeed builder OR the authorized representative <br />of e registered builder, <br />The work will be performed by a registered builder, ' <br />Other <br /> <br />°WN~ATE: b4/30/92 YII",IE: 8:44:o2 <br />'SITUS ADDR~S~BETHEb, ' DARRELL <br /> <br />T'~Y LOT <br /> <br />CONSTRUCTION TYPE: <br /> <br /> 9550 BA'¥E~S ROAD <br />AUMSVJLLE <br /> <br />.OR._. 9.1.32 <br /> <br />CONTRACT CITY: UGB. <br />~&RiON crjuI~'I:Y NO <br /> <br />MAIUNG ADDRESS; <br /> <br />SUSDIV~StO~. <br /> <br />CATEGORY: <br />OCCUPANCY: RESt Dfl~4'l' IAL <br /> <br />OCCUPANT LOAD <br /> <br />NO OF 8EDR00MS <br /> <br />3 <br /> <br />PO BOX 523 <br />S'FAYTON 9?383 <br />PHONE: <br /> <br />SITE NU~ER: 92-01502 <br />RANE'~ALUATIONkzOSE: <br /> <br />DEPTH: AREA ~t'[ JNITS: ~, IRREG. LOT '~1~ CORNER AR <br /> <br />s8 <br /> <br />TYPE: ON-SiTE SENAGE <br /> <br />PER,liT OR APPLICATION NO= 39389 <br /> <br />CON'tRAC'FO~; NO. <br />BETHEL, DARRELL <br />PO BOX 623 <br />STAY'rCS 97383 <br />PHONE: 769-2874 <br /> <br />~ATERSUPPLY: P~/ <br />TP...~I' HOLES READY: <br />SiTE EVALUATION NUMBER: 83-1948 <br />E~ISTING TANK SIZE: <br />~ISTiNG D~.AIN FIELD <br />~PTIC T~ <br />PREVI~S NO. BEDR~: <br /> <br /> I'rEt,1 QUANFiTY AIVK]UNT <br />SAND FILTER 1 $365.00 <br /> <br />TOTAL AS~ED FEES <br />PRE¥i CYOS RECEIPTS <br />'tH iE~ RECEIPT <br /> <br />BALANCE DUE <br /> <br />365.00 <br /> So.go <br /> <br />$0.00 <br /> <br /> PAYEE: ~ -, ~/")c RECEIPT NO: <br /> RECEIVED BY: M6 ;-:~:.:~ ................................. :r: ............. ~ TYPE: CHECK ~: 0 <br /> <br /> SEE ATTACHED r.X~UMEN'I' FOR REQUiRF..~ENTS OF ON-SiTE SEW~E <br /> <br />* THIS IS A VALID P~iT ~ THI~ PE~IT ~PIR~ 360 ~Y5 F~ IT~ I~E ~TE. IF <br />~T~CTi~ FAI~ TO ~T A~ R~IR~ OF ~TATE ~D~RI~ ~NTY BUILDING ~O <br />Z~INGO~IN~C~, THI~ P~iT ~B~E~LL ~D VOID+ <br /> <br /> REMARKS: SAND FILTER <br /> <br />BONALD E. [,¢OODLEY, MARION CC~JNTY BUiLDiNG OFFICIAL / BY <br /> <br />OFFICECOPY <br /> <br /> <br />