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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: 508-5147 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />Iarn performing work on a property I own or occupy. <br /> <br />I have read and aDroe to the terms stated on the reverse side of <br />this document. <br /> <br /> 8.37.] .... <br /> <br />KAILEY~ J)HN M,. <br /> <br /> 74'730-01~ RESII)ENTtAL <br /> : OCCUPANCY: <br />; CON~TRLJCTfON TYPE: <br /> <br /> 79~0 STONE FIELD CT SE : CONTRACT CITY; <br /> AUMSVILLE OR 97325 MARION gOUNTY NO <br />USE O~ ~u~Lb~Ne: <br /> <br /> STONE; .FIELD GLEN <br />~ SA~E <br /> SITE HUMBER: <br /> PHSNE: 945--6222 VALgATION~ <br /> <br />OCcuPANT LOAD: <br /> <br /> NO OF BED~00MD: <br /> <br />: ................................... ,~._' .... 86 ....... NO ..... <br /> <br />TYPE: ON-SITE ~EWAGE <br /> <br />PERMIT OR APPLICATION NO: <br /> <br />?HTRAC'rOR, NO,, <br />kAILEY~ JOHN M. <br />SAME <br /> <br />PHONE: ~45-&222 <br /> <br />48972 <br /> <br />WATER SUPPLY: PW <br />TEST HOLES READY: <br />SITE EVALUATION NUMBER: <br />EXISTING TANK SIZE: 1088 <br />EXISTING DRAIN FIELD LINES: <br />SEPTI6 TANK PUMPED: <br />PREVIOUS NO. BEDROOMS: ~ <br /> <br />225 <br /> <br /> ITEM QUANTITY AMOUNT <br />EXISTING SYSTEM EVAL. RPT. i $160.00 <br /> <br /> TOTALASSESSE~ FEES $160.00 <br /> PREVIOUS RECEIPTS $168.88 <br /> THIS RECEIPT: $0.00 <br /> BALANCE DUE <br /> <br />PAYEE: <br />RECEIVED BY: <br /> <br /> RECEIPT NO: <br /> PB ..................... %; ...... _ ...... TYPE: CHECK ~: 0 <br /> SEE ATTACHED ;)OCUMENT FOR REQUIREMENTS OF ON-;SITE SEWAGE SYSTEM. <br /> Z THIS IS A VALID PERMIT $ THIS PERMI~:T EXPIR.E,B 360 DAYS FROM ITS ISSUE ~ATE. IF <br />CONSTRUCTIOII FAILS TO NEET ALL REQUIREMENTS OF STATE LAW~ AND MARION COUNTY BUILDING AND <br />ZONING OR~INANOES,~ TH~S PERMIT SHALL BEBO~E NULL AN~ <br /> <br />I;;EMAkkS~ SS;ESE. NO ArFARENT FAILURE. DRIVE CONFLICTS WITH D/F. F Oo,~I~I~4E ,~ANDEII.,TER EOR <br />D~IAL. D E,, WOOI)LEY, MARION COUN-fY BUILDING OFFICIAL / BY ........................... ;[~ ............... ~. ................ <br /> <br /> OFFICE COPY <br /> <br /> <br />