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MARION COUNTY BUILDING INSPECTION <br />SENATOtR BLDG. NO. 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE: 588-5147 8:00 - 4:$0 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br /> ()ATE: 02/05/9;g TIME: 9:44:55 <br />OWNER'. 1'4CODY, RONALD <br /> <br /> 62?3 ~flAW LANE SE <br />AUNSViLLE OR 9?325 <br /> <br />DATE; <br /> <br />COI~ tRACT CitY: U~B: <br />MAR.[ ON COUNTY NO <br /> <br />OCC~J PANT LOAD: <br /> <br />Si'f'E NUf4f3ER.: 9~:-00fi80 <br /> VALUA'I" .(ON; <br /> <br />RESiOEN~AL,. <br /> <br />~OY: <br /> <br />: ~CTJON; f0WNS~ih: RANGE: ZOI~I:i MAP; <br /> 24 8S 2~ AR3 5 ~ <br /> <br />WIDTH: ;E)6~TH: ..... AR~A; 1 - 4 1 0NITS: <br /> <br />AC iRREg. LOT: NO <br /> <br />PERI'fliT OR APPLICATION NO: <br /> <br />OhON'f'RAC'f'OR. <br />fcf.2,COY, RONALB <br /> <br />PHONE: ?49-2553 <br /> <br /> Z'f'EM <br />ANNUAL EYAL. - 'TEMP OR HCES~P F~H <br /> <br />PAYEE: NE;COY, RONALD <br /> <br />9038213 <br /> <br />TEST HOLES RF-.~ADY= <br />SITE EVALUATION NUIViSER: <br />F...c'K1S'TiNG TANK SIZE: 1000 <br />EXiSTiNG DF.A~N FJELO LINES: <br />SEP'rtC TANK PUMPED: 1~28-91 <br />PREVZOUS NO. BEDROOm: <br /> <br />fO'I'AL A~%%ESSEO FEES <br />THiS RECEIPT <br /> <br />~U,ANTJ'~'Y AMOUNI' <br /> 1 $'75.00 <br /> <br />$'75_ 0 d <br /> $o. OD <br /> <br />'~AL.ANCE DUE $0,00 <br /> <br />RECEZP'f' NO: ~0193 <br /> <br /> RECEIVED BY= O] TYPE; CA CHECK ~: 0 <br /> <br /> SEE ATTACHED DOCU~4EN'f' FOR REdIRECt'rS OF ~-SI'FE SE~A6E SY~'FE~L <br /> <br />~ THIS tS NOT A PB~tT. THIS APPL[~T[~ ~ST ~ TH~ A R~IE~ P~E~ ~ERE THE <br />FOLL~ING ~ST BE ~PLETED. iT I~ THE R~iBILiTY OF THE APPLIC~T TO ~RE THAT <br />ALL N~ iNFO~Ti~ H~ B~ P~ViDE0. <br /> <br />~LAN REVIEW: BY ............................... DATE ...................................... <br /> <br />RE":~ARKS: HOSP RENENAL & L, OAN REPORT <br /> <br />CZ IY ,JURfS[.)IC')",'[ON: BY <br /> <br />DALE. ................... <br /> <br />~FFICEC0PY <br /> <br /> <br />