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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO. 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97801 <br /> <br /> PHONE: 588-5147 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />Other. <br /> <br /> I have read and agree to the terms stated on the reverse side of <br /> thJ$ document <br /> <br /> OATE: 01/15/93 TIME: 10:24:02 <br />OWNER: <br /> BURLEIGH. JAMES & _ECTA <br /> <br /> DATE <br /> <br /> 56510946 <br /> <br />CONSTRUCTION TYPE <br /> <br />CATEGORY <br /> <br />RESIDENTIAL <br />OCCUPANC~ <br /> <br /> 11982 STEiNKAMP RD SE <br />AUMSVILLE OR 97525 <br /> <br />USE Of BUILDING. <br /> <br />MAILING ADDRESS: <br /> <br /> PO BOX'18102 <br /> SALEM'97~05 <br /> PHONE: ~93-8790 <br /> <br />CONTRACT C~T¥ UGB <br />MARION COUNTY NO <br /> <br /> S~,TE <br /> VALUAT ION E' <br /> <br />OCCUPANT LOAD: <br /> <br />LOT~ BLOCK SECTION <br /> <br />I _ 666 <br /> <br />TOWNSHIP' RANGE <br />ss iw AR. <br />~C NO NO <br /> <br />48 <br /> <br />TYPE: ON-SITE SEWAGE <br /> <br />PERMIT OR APPLICATION NO: <br /> <br />CONTRACTOR~ NO. <br />BURLEIGH, JAMES & LECTA <br />PO BOX 18102 <br />SALEM 97305 <br />PHONE: $95-8790 <br /> <br />44620 <br /> <br />WATER SUPPLY: PW <br />TEST HOLES READY: <br />SITE EVALUATION NUMBER: 79-1909 <br />EXISTING TANK SIZE: <br />EXISTING ORAIN FIELD LINES: <br />SEPTIC TANK PUMPED: <br />PREVIOUS NO. 8EOROONS: <br /> <br /> I TEN QUANT I TY AMOUNT <br /> STANDARD ON-SITE SYSTEM 1 $210.00 <br /> <br /> TOTAL ASSESSED FEES $2i0.00 <br /> PREVIOUS RECEIPTS $210.o0 <br /> THIS RECEIPT $0,00 <br /> <br /> BALANCE DUE $0.00 <br /> PAYEE: RECEIPT NO: <br /> RECEIVED BY: PM TYPE: CHECK F: 0 <br /> SEE ATTAOHEO DOCUMENT FOE REQUIREMENTS OF ON-SITE SEWAGE SYSTEH. <br /> <br />* THIS IS A VALID PERMIT * THIS PERHIT EXPIRES ~60 DAYS FROM ITS ISSUE OATE. IF <br />CONSTRUCTION FAILS TO HEET ALL REQUiREmENTS OF STATE LAWS AND MARION COUNTY BUZLDING ANO <br />ZONING ORDZN~NCES, THIS PER~ZT SHALL BECOHE NULL AND VOID. <br /> <br />REMARKS: STANDARD SYSTEM - CONSTRUCT THE DRAINFIELDS AS FAR UPSLO~EJ AS POSSIBLE. <br />DONALD E. WOOOLEY, MARION COUNTY BUILDING OFFICIAL / 8Y .............................~, <br /> <br />OFFICE COPY <br /> <br /> <br />