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MARION COUNTY BUILDING iNSPECTION <br />SENATOR BLDG, NO, 225 <br />220 H~GH 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 occupy. <br />l arA a registered builder OR ( ) tho authorized represent~tfve <br />of a registered builder. <br />The work wfJl be podormed by 8 registered builder. <br />Other <br /> <br />I have read and agree to the terms stated on the reverse side of <br />this document. <br /> <br /> DATE." 02/18/95 TIHE: $;29:02 <br /> ECEN'f'ON> OENN'rB & LOLA <br /> <br />90220,~870 <br /> <br />CATEGOR <br /> <br /> 45,5 NW ,SANTIAH AVE CONTRACT CfT'Y UL~B. <br /> DETROIT OR <br /> <br /> USE OF ~IUILDIN6'. ' <br /> <br /> _ tAHH{)Ni) <br /> BINES OR 97738 ~ STTE IMBER: <br /> <br /> L, OT; ~LOCK; ' SECTION: ~ T~i~'WNSHIP; - RANGE' <br /> <br /> 18 ;5 01 <br />WIDTH' DEP¢~: A~EA: <br /> 143 131: 18733. SF <br /> <br />OCCUPANT LOAD: <br /> <br /> 95-00609 <br /> <br />ZONE' MAP; <br />O <br />YES <br /> <br />PERMIT OR APPLICATION NO: <br /> <br />CONTRACTOR, NO. <br />BENTON, DENN'fB & L. OLA <br />PO BOX 8(>6 <br />HINES OF] 97758 <br />PHONE', 573'"3239 <br /> <br /> ITEM <br />ABTHORIZATION NOTICE - FLD, VISIT <br /> <br /> SUPPLY: <br />TEST HOLES READY <br />SI'I(~ EVALUATION ill <br />EXISTING TANK SIZE: <br />EXISTING DRAIN FIELD LINE <br />SEPTZC TANK PUHPED: <br /> <br />TOTAL AS sSED <br />PREVIOUS RECEIPTS <br />THIS RECEIFIT <br /> <br />AMOUNT <br /> $ :L ~,0 ,, O0 <br /> <br /> ,"}; J, 60 ,, O0 <br /> $o _oo <br /> $ ]. 6 0.0 0 <br /> <br />BALANCE DUE $ ) <br /> <br /> PAYEE~ BENTON, GENNI,~ & LOLA ~ [NVOI(,E NO,, <br /> [ IYP }'N CE,~ CK ~ 0 <br /> <br /> SEE ATTACHED DOCUMENT FOR REQUIREMENTS OF ON-SITE SEWAGE SYSTEM~ <br /> <br />$ THIS iS NOT A PERHIT. THIS ~PPLICaTION ~UST 60 THROUGH ~ REVIEW PROCESS WHERE THE <br />FOI_LONING HUSI' BE COMPLETED. IT IS THE RESPONSIBILITY OF THE <br />~L,L NECESSARY INFORMATION NAS BEEN PROVIDED. <br /> <br /> <br />