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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG, NO, 225 <br />220 HIGH STREET NE <br /> SALEM. OREGQN 97301 <br /> <br /> PHONE; 588-5147 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br /> AU~ OR 9?002 <br />.................................................................................. L'AU~ .................[ ........ NO <br /> <br /> ? <br /> ~E~ 266-213g ~iI'~ NUb/R: 92-0207~ <br /> <br />LOT: ,~ ~: ......... ~ANGE: [ ZONE: ~MAP: <br /> <br />RESI DEN 1 iA <br /> <br />TYPE: ON-SITE SEWAGE <br /> <br />PEFEflI'T' OR APPLICATION NO: 40343 <br /> <br />CONI'RAC'FOR, NO. <br />O'BRIEN, CHARLP~ <br /> 10155 $. /vlACK~:~uRG <br />? <br />PHONE= 266-2139 <br /> <br />WATER ~SUPPLY: CW <br />'rEST HOLES READY: <br />SITE EYALAJA'FiON NUFSER: <br />PD(iSTiNG T/~qK SIZE: <br />~iSTiNG D~iN FIELD L~NES: <br />S~PTiC T~K ~MPED: <br />PREVi~S NO+ BED~: <br /> <br /> i 'f'EM QUANT[ I'Y <br />STANDARD ON-Si'rE SY~'FEN ' 1 $210. O0 <br /> <br /> : ;::' PREVIOU~: RECEI P rS <br /> THIS RECEIPT <br /> BALANCE ~E <br />PAYEE: : iNVOICE <br />RECEIVED BY~ ~ ::: .: :: ::: :- :TYPE: ~ECK ~: <br /> <br />~210.00 <br />210.00 <br /> $0.00 <br /> <br />$0.00 <br /> <br />:* THIS iS A VALID PER~i~: 360 DAY~ FRO~ ITS i,.%.~JE DATE, <br />CONSTRUCTION FAiL~ TO MEET ALL R~E..~. IRE~ENT~:.OI~ STATE L.A~IS AND MARION COUNTY BUILDING AND <br />ZONING ORDINANCES, THIS PEI:~IIT ,E~,.-IALL BECOME NULL .AND VOid; <br /> <br />REMARKS: NEH SEPTIC ~ <br />EX~ALD E. NOODLE'Y,. IV[ARION COUNTY BUiLDiNG ~FFiCiAL / BY <br /> <br />fORM # MC ~5.s~.eV, ,~ OFFICE COPY <br /> <br /> <br />