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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 />Other ...... <br /> <br />:OWNER:~)ATE~ ;t;I,/;t, 7/9;:~ TINE: 516:25:2~ 'rA~d6'r: ~t~f~e6~9: <br />SI~US AODRESS: ~ CONSTRUCTION TYPE: i OCCUPANCY; <br /> <br /> 53g N SANT'.¥.AH H~Y __ ~CONTRACTOITY; ~ UGB: ~ OCCUPANT LOAD: <br /> DETROIT OR 97~42 ~ 9ETROIT NO I <br />'b~'~ ~OiE¢i~'~; ......................................................................................................................................... T~Bi-5¢~'~Ko~;' <br /> <br /> 412;I.e KINSTON LANE <br /> STAYTOF.,, O.q 97;~83 SITE HUMBER: <br />, F'HONE~ 76~)-6483 VALOATIOH: <br /> <br />[WIDTH: ]OEPTH: [ AR~A: ' UNIf~ j t~. LOT: <br /> <br />TYPE: ON-SITE SEWAGE <br /> <br />PERMTT 8R APPLICATION <br /> <br />CONI'RACTOIr~., FID, <br />;80CHSLER, RALPH <br />41210 KINSTON I_ANE <br />STAY'ION~ OR ~7~85~ <br />PHONE: 76~-648~ <br /> <br />48499 <br /> <br /> WATER SUPPLY: CW <br /> TEST HOLES READY: <br /> SITE EVALUATION NUMSER: <br /> EXISTING TANK SIZE: <br /> EXISTING DRAIN FIELD LINES: <br />, SEPTtG;TANK PUMPED: <br /> PREVIOUS NO. BEDROOHS: 1 <br /> <br /> ITEl4 QUANTITY AMOUNT <br /> ALITI.,IORIZATtON NOTICE - FLD. VISIT 1 $;I. 60.8~ <br /> <br /> TOTAL ASSESSE~ FEES $16~,,88 <br /> PREVIOUS R~CEIPTS $8. ~ <br /> THIS RECEIFT $160.e0 <br /> <br /> BALANCE ~UE $8. ~8 <br /> PAYEE: INVOICE NO: 5~8~ <br /> RECEIVED BY: CL TYPE: OHECK $: ~ <br /> SEE ATTACHED DOCUMEHf FOR REQUIREEEIITS OF OH-SITE 9EWAGE SYSTEM, <br /> <br /> $ THIS IS A VALID PERMIT ~ THIS PERMIT EXPIRES ~6~ BAYS FEO~ ITS ISSUE BATE. !F <br />{;ONSTRUCTION FAILS TO MEET ALL REQUIREHENTS OF STATE LAWS AN~ P~ARION COUHTY BUILDING AND <br />ZONING ORDINANCES, THIS PERMIT o~A.L BECOHE NULL AND VOID,, <br /> <br />FORM # MC 1 ~-~6 RE-F, 4/~ OFFICE COPY <br /> <br /> <br />