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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO, 225 <br />220 HIGH BTREET NE <br /> SALEM, OREGON 97301 <br /> <br />~ am performing work on ~ property I own or occupy, <br />I am a registered builder OR ) the author:zee representative <br />of 8 registered builder. <br />The w~rk will be performed by a reglstered builder. <br />Other. <br />r have read and agree tO the teems stated on the reverse side of <br /> <br /> DATE.' <br />OWNER: <br /> <br /> PHONE: 588-5147 8:00 - 4:30 <br />-- '" 24 HOUR CODE-A-PHONE: 588-7904 <br /> <br /> SrGNATURE OF APPLICANT: <br /> <br /> DATS: <br /> <br /> 05/11/92 TirqE: 13:25:37 <br /> TAX LOT: <br /> LADDIE SNOODERLY 40514,000 <br /> CONSTRUCTION TYPE: <br /> <br />SITUS ADDRESS: <br /> <br /> 15233 OT'rAWAY RD NE <br /> AURORA OR 97002 <br /> <br />USE OF BUILDING~ <br /> <br /> ; ObCUPANCY: <br /> <br />!-~A~t 81~r,~¢ : u(2S: ;OCCUPANT LOAD; <br /> <br />: ~ARION COUNfY: YES ~ <br /> <br />MA~LING ADDRESS; SUBDIVISION: <br /> <br />RES i DEN l t Al <br /> <br /> PO BOX 364 ' <br /> AURORA, OR 1'4(,~S I LE-?E4-1890 <br /> PHONE: 288-5985 81'1'8 NUI~BER: 92-01928 <br /> VALUAT1~; <br /> <br />LOT: BLOCR: S~OOJ0~; f0~N~[F: ........ '~d~: <br /> 13 &S lW EFU <br /> <br />WIDTH; DEPTH'. 'AREA: ~.0~ :UNITS: AC ~ <br /> <br />TYPE: ON-SiTE SEWAGE <br /> <br />P~RMiI' OR APPLiCATiON NO: 4,011B <br /> <br />CONTRACTOR, NO. <br />LADDIE SNODDERLY <br />PO BOX 364 <br />AURORA, OR IVlOEiLE-784,-1890 <br />PHONE: 288-5986 <br /> <br />WA'T'ER SUPPLY: PW <br />TEST HOLES READY: YES <br />SITE EYALUAI'iON NUMBER: <br />EXiSTiNG 'rANK SIZE: <br />EXiS'¥'iNG DRAIN FIELD LINES: <br />SEPTIC TANK PUMPED: <br />PREVIOUS NO. BEBROOINrFSz <br /> <br /> iTEM <br />~I'I'E EVALUATION, FIRST LOT <br /> <br />:fOI'AL ~ED FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />,(,(,(,(,(,QUAN'flTY AMOUNT <br /> 1 $220.00 <br /> <br />¢220.00 <br />220-00 <br /> $0.00 <br /> <br />BALANCE 0UE $0.00 <br /> <br />PAYEE: RECEIPT NO: <br /> <br />RECEIVED BY: PB .............................................................................................................. TYPE: CHECK ~: 0 <br /> <br />SEE ATTACHEO DOCUMENT FOR REQUIREMENTS OF ON-SiTE SEWAGE SYS'¥Et4. <br /> <br />NOTE: THIS DOE~ NOT GRANT OR i~PLY PERI,II.ION TO BUILD ON THiS PARCEL+ PLI~NNING AND <br />CONSTRUCTION PER~ITS r~U~T BE OBTAINED BEFORE BUiLDiNG OR ~EPTIC iNSTALLATiON BL~iNS. <br /> <br />REMARKS: SITE EVALUATION ONLY <br /> <br />OONALO E. WOODLEY, MARION COUNTY BUILDING OP'EICIAL / BY <br /> <br /> OFFICE COPY <br />FORM # MC 15~56 REV. 4/90 <br /> <br /> <br />