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ION 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 am performing work on a property I own or ooctJpy. <br />18ma registered builder OR( )theaud~orized representative <br />of a registered builder. <br />The work will be performed by a registered builder, <br />Other <br /> <br /> CRAI£;,, ME, RIL & ANN <br />SITUS ADDRESS: <br /> <br /> 7741. TERRANCE L,N <br /> AUNSV I L.I..I!! <br />USE O~ 5UILOING: <br /> <br />MAILING ACDRESS: <br /> <br />OR <br /> <br /> SE CONTRACT CITY: : UGB; iOCCUPANT LOAD; <br />97:]29 ', HARION COUIPF¥ NO <br /> <br /> SAME: <br /> PHONE~ 749.,.:1.51~;B <br />LOT: BLOCK: <br /> <br />WROTH: DEPTNi <br /> <br /> 9ITE HUMBER: 93-0~477 <br /> YAI,,UA 1 ION. <br /> <br />$~CTION: ..... TOWNSHIP: , RANGE: : ~'(~r~E: MAR: <br /> <br /> AREA: UNITS: <br /> :L. 41 At:: NO <br /> <br />TYPE: ON-SiTE SE!,JAGE <br /> <br />PERMIT OR APPLICATION <br /> <br />L[!IITRAC I OR. <br />£;R~:r6,, MEIr¢.[L & ANN <br />SAME; <br /> <br />PHONE: 749-1558 <br /> <br />WATER SUPPLY:: I':'W <br />TEST HOI,,.ES READY: YES <br />SITE EVAL. UATI'ON <br />EXISTING l"Al,IK SIZE: <br />~×ISrlNG I)RAJlbl F'IE/,I) <br />SEPTIC TAIqK F'UMPED~ <br />PREVIOUS biO. <br /> <br /> ITEM C4UANT I'I"Y AMI)UN'F <br />AI,,.TEI~A ri:ON 1 '~ 2 .... .... ;'lF_~ ', <br /> <br /> TOTAL ASSESSED F'EIE!:';si">, ........ ...... 00 <br /> PREVIOUS ..... ~ ' <br /> TI-IlS RECE. IIT $~,,80 <br /> <br /> BALANCE PUE <br /> <br /> PAYEE: I~EgEIPT <br /> RECE~VEO BY: PB lY~ <br /> <br /> SEE: ATTACHED ~OCI,I~ENT FOR RE(~UIREMENfS OF ON-S~fE ~EWA',,E SYS'I'EH. <br /> <br />CONSTR[IC'fION I,~.ILS TO NEET ~1,,.I RI~:BUZRE~ENF., OF STATE L~BS ~1,13 ~AR~ON COLINTY BLt}L.D).I.~C. ~,11~ <br /> IH.I..~ PERHZT SH~LL ~EEOHE NULL AND <br />Z[)NIM~ ORO:[N~NCES,¢ .... <br /> <br />REHARKS:~ AI,.'f'EI,~ATION,¢ NEW CCN).:gH~tATIOH SEPTIC/DOS~N(:¢ TANK AND ~RA:fI4F'Ik.~,, * ~ <br /> <br />DShI~LO E. WOr.)DL~Y~ H~RION (.,.)UIHY BUIL~fNG 3FE~L,~AL / ~Y ..................................~ .......... ..._....,~[j .......... <br /> <br />¢o~ ,~ MC ls.s,~ R~V. ~/¢ OFFICE COPY <br /> <br /> <br />