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MARION COUNTY BUILDING INSPECTION
<br />SENATOR BLDG. NO. 225
<br />220 HIGH STREET NE
<br /> SALEM, ORF~GON 97301
<br />
<br /> PHONE: 588-5147 8:00 - 4:30
<br />24 HOUR CODE-A-PHONE: 588-7904
<br />
<br />The work will be performed bY a resi. ered bu der,
<br />
<br /> SAME
<br /> SITE MU14BER: 93-01265
<br /> PHONE:; 769-77~4 VAI...UATI]ON:
<br /> ; ~O~K: ~ ¢~¢fi6~ ~'fdW'E~i~i ..... ............ ~-~'~ ~ ........I "~:
<br />} ....... .... ,
<br />
<br />TYPE: 0N-SITE SEWAGE
<br />
<br />PERi,fIT OR APPLICATION
<br />
<br />C ONTFIA{]'i"[%,~l
<br />
<br />SA~E
<br />
<br />PI-.IDNE ~: 769-7734
<br />
<br />46392
<br />
<br />WATER SUPF'L,Y; PW
<br />]"EST HOLES READY:
<br />SITE EVALUATION NUHt~SR:
<br />EXISTIN[; 'rANK SIZE:
<br />EXISTINI; ;DRAIN FI~:~L;O LINES0
<br />SEPTIC TANK PU~i::'EQ;
<br />PREV~:OUS NO. BEDROOMS: 4
<br />
<br />Ad FI,OE.I. ZAI ION t,tOTl, uE -'- F'L.D. V: SIT
<br />
<br />TOTAL A,,S, SESSEI) F'EFZS
<br />PREVIOUS RECEIPTS
<br />THIS RECE):PT
<br />
<br />i) U ANT ): 'I'Y A HOI.INT
<br />
<br />]~A_A,Nu,~ DUE'
<br />
<br />P AYF-'E',: FiECI:-:'I PT 1,10:
<br /> 'f'YF'E: OHECI'~ ~,".
<br />
<br /> REC.--].VE;O pY: Pr:,, ................................................................................... 0
<br />
<br /> t'~ ............... ~" ~ 0 ....
<br /> ,~EE A FMLHI::.D DO(.;UHEN-F F'O~ RM.~U,,~ENEI~T~ OF ON'-SZTE oEWAE, E SYSI'EM,,
<br />
<br /> * THIS IS A VALI~ PE~IT * THIS PERmiT EXPIRES 368 ~AYS FROM ITS tSSUE DATE. iF
<br /> ,.c ...... ~ ,~- v '~, ~.),~..~ lNG
<br />(;ONSTRUCTI:Oi,i FA'i'.LS 'r(I ME,_.r ALL, R~. X, ,R~MLN S OF STATE LAWS AND ~iARION COU~fl'Y ~ ' .....
<br />ZON~N[; Oi~D,I,,~ANCE~,¢ TH!:~; f ~I,H,,.T oHALL BE~.,(~HE NULL AND VOID,,
<br />
<br /> ..... ~IA R,x,:¢ ,. AUI'H
<br />~OI'IAI..D F,. I^iOOC, LEYt~ ?/¢d;;II:)i'~ ,COilN'TY BUtLDi]i,lf;- OFF][CZI;Ai,,. / BY ................................................................................y
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