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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 />of a registered builder- <br /> <br />Other. <br /> <br /> DA'~, ?.. ~' o <br />i ' <br /> I .LL,.gG,.~,~ Di:~'iI RE <br /> <br /> ~, :l. 8 :': ]:~,[!,~E'( ........ CONTRACT CITY: ~ UGh; ~ OCCUPANT LOAD: <br /> DE;TFU)TT OR 97%42 i D,:~Ld.,.~ <br /> <br /> DE'F~:.OZT,, (;;:~ I SITE NUMBER: <br /> ~(.L I .... (~ .... 5¢,¢ <br /> <br />TYPE; ON-SZTE SEWAGE <br /> <br />PERMIT OR APPLICATION NO: 477;~6 <br /> <br />WATER S~UPPLY: CW <br />TEST HOLES READY: <br />SZTE EVALUATION NUMBER;: <br />EX;I;~,~T:[NE, 'TANK S'.I'.ZIF: <br />EXISTING DRAIN F'IELD <br />SEPTIC TANK <br />PREVIOUS NO. BEDROOMS; <br /> <br /> .~:TEH [~IUAN'i" I T¥ Af~OUN'f <br /> 'TOTAL ASSESSED FIE'ES 1255, <br /> <br /> BALANCE I)UE $~,.b, <br /> J, Nv_ ,ICI: <br /> <br /> SEE Af :..,,,~::.D DOLUnf;h,T F.],~ ~:t~(~U;[RE~ENTS OF' O~',i-'SITE oE~AGc, oYt <br /> <br /> ~ THIS IS A VALZ~¢ PERMIT * THiS PEEHIT EXPIRES 38e BAYS FROM ITS ZSSUE DATE. IF <br />CONSTRL~('.;T~'.(?,N F'A]'.L.S TO H,:,,:,T ALL RE[~LU:REHE:NTS OF STATE LAWS AND HARZOI,I CCUN?Y },~.[...b ..... <br />ZON']ZNIZ[; Oi:;;~INAN[]~'9,~ THiS F'E~?[ Si,ALL BECgME ~Jgl,,.i,~, AND VOID. <br /> <br />i:;~ E !q A R i< S :: <br /> <br />DONALD E,, <br /> <br />FORM # MC 1~-~0 RE¥, */~Q OFFICE COPY <br /> <br /> <br />