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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 /> ) The work will be performed by a registered builder. <br /> <br /> ]DATE: ~8/09/9,~ TIME: 9.04. ~6 <br />i'O~NER: GHRAMIAN GOORIKN ~ ~X~52'65~ d~E~ENTi[~'E <br /> <br /> 74~2 LOFTY LOOP SE <br /> AUMSVILLE OR 97325 <br /> <br /> 7725 ~STH <br />~ SALEM OR 97~5 ............. <br />, PHONE: ~8-5445 VALUATION: <br /> <br />2 i 1¢ , "88 I 2Q- tlr 49 , <br />in~A x~, 3; 5 6~' ~'C ....... ]- ~F ..... , cb~ .............. ; <br />TYPE: ON-SITE SEWAGE ' WATER SUPPLY: PW <br /> <br />PERHIT OR APPLICATIOH HQ: 486~e <br /> <br />CONTRACTOR, NO. <br />BAGHRAMIAN, GOORIKN <br />7725 65TH AVE <br />SALEM OR ?7305 <br />PHONE: <br /> <br />TEST HOLES READY: <br />SITE EVALUATION NUMBER: 79-782 <br />EXISTING TANK SIZE: <br />EXISTING DRAIN FIELD LINES: <br />SEPTIC TANK PUMPED: <br />PREVIOUS NO. BEDROOMS: <br /> <br /> ITEM QUANTITY <br />STANDARD ON-SITE SYSTE~ 1 <br /> <br />TOTAL ASSESSED FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />AMOUNT <br /> $255.00 <br /> <br /> $255.00 <br /> $285.00 <br /> $0.00 <br /> <br /> BALANCE DUE $0.00 <br /> PAYEE: RECEIPT NO: <br /> RECEIVED BY: PB TYPE: O.IECK $: 0 <br /> SEE ATTACNED DOCUMENT FOR REQUIREMENTS OF,ON-SITE SEWAGE SYSTEM. <br /> <br /> * THIS IS A VALID PERMIT'~ THIS PERHIT EXPIRES'S68 DAYS FROM ITS ISSUE DATE. IF <br />CONSTRUCTION FALLS TO MEE'T ALL REQUIREMENTS.OF STATE LAW8 qND MARION COIJNTY BtJILDING AND <br />ZONING ORDINANCES~ THIS PERMIT SHALL BECOME NULL AND VOID. <br /> <br />REHARI(S: STAI,I <br /> <br />DONALD E. WOODLEY, MARION COUNTY <br /> <br />BUILDING OFF'ICIAL / BY <br /> <br />FORM # t~C ~ 5.58 ~EV. ~,l~O O F FI r.E COPY <br /> <br /> <br />