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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 l am a registered builder OR ( ) the authorized representative <br /> <br />LOT: <br /> <br />,1.9,~7 EASE RD <br />ALIRORA~ OR 970r~2 ~ SITE NUHBERt. 9:~-88842 ' <br />P"[ gE:. e~ocxi678--,$588 ~ s~c~,o~ i .... i"TG~,is:, ~V~T~t-BN:. [ ~a'~i~ .................... / raA'~,i '. <br /> <br />TYPE: ON-SITE SEWAGE <br /> <br />PERMIT OR APPLICATION NOc <br /> <br />CONTRACTOR~ NO,, <br />~LtAM~ON~ ROBERT t~ EL'IZABEI'~ <br />;I, 9,:~27 CASE RD <br /> <br /> :'HONE;; 678.-J.~88 <br /> <br />45705 <br /> <br /> WATER SUPPLY: PW <br />' 'I'EgT HOLES READY: <br /> SITE EVALUATION NUMBER: <br /> EXISTING TANK SIZE: ,~,7r~ <br /> EXIEiTING I)RAtN F]~EL[~ LINES: <br /> .qEF'TIC TANK PUMPED: <br /> PREVIOUS NO. BF-;OROOH$: 2 <br /> <br /> ITEM QUANTITY AMOUNT <br /> AUTHOR,IZATTOI,I NOTICE - FLI). Vi[SIT 1 <br /> <br /> TO'f AL; ASSESSEt)FEES $160,, ~0 <br /> Z]AREVIOUS RECEIPTS <br /> THIS RECEIPT: <br /> <br /> :BAL=ANCE DUE <br /> <br /> PAYEE= RECEIP <br /> - r" TYPE: CFIECK <br /> <br /> SEE ATTACHED DOCUMENT FOR REQUIREMENTS OF ON-SITE SEWAGE SYS'FEM. <br /> <br />CONSTRLJCTION FAILS TO MEET ALL REQU~REMEN'T~ OF ~TATE L'AWS At,I~ MARION COUIf1'Y BUILDING AND <br />ZONING ORBIHANCES,¢ TH~S PERMIT SHALL BECOME NUlL AND <br /> <br />,,~(EMARKS: AUTH FIELD VISIT <br /> DONAI,_I) Eh, WOOOI,.EY.¢ MARION COUNTY BU:£LDII,II; C)FFICIAL /BY <br /> <br />FORM # MC 15,,~ REd. 4/90 OF FiCE COPY <br /> <br /> <br />