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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 />OWNS. R: lOA'i'E,'. 09/28/93 TIME: :L2: ~: 82 ~x LOT: CATEGORY: <br /> <br /> "< ..... RE, S,[I)EN] IAI_ <br /> JEI%I:.N,¢ DALLAS '- ' - ' <br />S~T~S ADDRESS: OCCUPANCY; <br /> <br /> 7228 9233 W S'fAYTON RD SE ~(~RAd~G[TY: UGS; :OCCUPANT LOAD: <br /> <br /> AUNSVII_LF_ OR ? ~, ~ARION COUNTY; NO <br />~E : NO OF BEDROOMS: <br /> <br /> MAILING AOBRESS; <br /> <br />SAME <br /> <br />PHONE: 749-1089 <br /> <br />SITE HUMBER: <br />VALUATION: <br /> <br /> ~s _ _ _ 2w i .. B:~u ~2 <br />2.81 AC ~ NO , NO <br /> <br />TYPE: ON-SITE SEWAGE <br />pERi, iTT OR APPLICATION <br /> <br />CONTRACTOF~ <br />JI-'NSEN ~ I)ALLAS <br />SAME <br /> <br />PHONE: 749-1089 <br /> <br />49255 <br /> <br />WATER SUPPLY: PW <br />TEST HOLES READY: <br />SITE EVALUATION NUMBER: <br />EXISTING TANK SIZE: <br />EXISTING DRAIN FIELD LINES: <br />SEPTIC TANK PUMPED: <br />PREVIOUS NO. BEDROOMS: <br /> <br /> ITEM @UANTITY AMOUNT <br /> ANNUAL EYAI_. -- TEMP OR HDSHP MH 1 <br /> <br /> TOTAl_ ASSESSE~ FEES $90.00 <br /> PREVIOZUSRECEIPT8 $90.00 <br /> ZTHIS RECEIPT $0.00 <br /> <br /> BAEANOE ~UE $0.00 <br /> <br /> PAYEE: ~ RECEIPT NO: <br /> RECEIVE~ BY: PB TYPE: CNECK ~: 0 <br /> <br /> SEE ATTACNE~ DOCUHENT FOR REQUIREMENTS OF ON,SITE SEWAGE SYSTEM. <br /> <br /> * THIS IS A VALI~ PERHIT ~ THIS PERHIT EXPIRES ~8 DAYS:FROH ITS ISSOE ~ATE. IF <br />;O48T~ CTIOh FA[? TO MEET ALL REQUIREMENTS OF STATE LAWS AN~ ~ARION COUNTY BUIL~ING ANt) <br />ZONIblG OROINANCES~ TNIS PERHIT SHALL BECOME NULL AN~ VOID. <br /> <br />REMARKS: <br /> <br />3~JNAL_D E. <br /> <br />I-iBSHP PF': 8-;'~0-98,. NS APPARENT PR. OBI_Ei'~. OKAY TO CONT. bOt,dl~:DT]?,i <br /> -, <br /> WOODI_EY,~ ~ARION LOJNTY BUILQ:[NG OFFICIAL / BY .......................................................... <br /> <br /> OFFICE COPY <br /> <br /> <br />