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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 />I have reed and agree to the terms stated on the reverse side of <br />this document. <br /> <br />OW~E~ DATE: f~BZ16/93 Tt~'iE: ,13; 4,4,;,.58 Lo'r~ ................... IC~Y~dRyi <br /> BOOZE,~ KENNE'fN & JUDITH 48;~87-eee ~ RESZ~EN'T'I~L <br /> <br /> 18287 HAT"rHZEU LANE NE :'~b~SYE~gl ~'o'~ <br /> AtJRORA OR 97882 ; MARION ' : ]OCCUPANT LOAD: <br /> COUNTY, NO ~ <br /> <br /> SITE HUI, IBER: ?3;-02572 <br /> F'HONE: ; VAL, UATION: <br /> <br />i LOT: BL, OCK, E~ECT ON. TOWNSH P RANGE ~ ZONE ~ MAP: <br /> : Z _E~ ..... ~ ~ EFIJ 4 <br />~ ; , 28. ', AC ~ NO ~ NO <br /> <br />CONTRACTOR, NO. <br />BOOZEr KEMNETH & JUDITH <br /> <br />PHONE: <br /> <br />WATER SUPPLY: PW <br />TEST HOLES READY: <br />SITE EVALUATION NUHgER: <br />EXISTING TANK SIZE: <br />EXISTING BRAIN FIELI) LINES:: <br />SEPTIC TANK PUMPEg: <br />PREVIOUS NO, BEDROOMS: <br /> <br /> ITEM QUAIffITY AMOUNT <br /> AUTHORIZATION NOTICE - F[_D. VISIT 1 $168.08 <br /> <br /> TOTAL ASSESSEB F~ES $150.06 <br /> PREVIOUS RECEIPTS $],60.88 <br /> THIS RECEIPT' $0,,08 <br /> <br /> BALANCE ~UE $8.00 <br /> PAYEE: RECEIPT <br /> RECEIVED BY: PB TYPE: CHECK ¢: 0 <br /> SEE ATTACHED QOCUflENT FOR REQUIREMENIS OF,ON-SITE SEWAGE SYSTEM. <br /> <br /> ~ THIS IS A VALID PERNIT ~ T~IS PERMIT EXPIRES ~8'DA¥$ FRON ITS ISSUE DATE. IF <br />COMSTRUCTION FAILS TO ~EET ALL REQUIEEMEMTS OF:sTATE ['AWS AND MARION COUNTY BUILDING AND <br />ZONINO OI~DINANCES, TNIS PERMIT SNALL BECOME' NULL' AN~ ~OID~ ' <br /> <br />REMARKS: AUTH <br /> <br />DONALD E., WOODLEY, <br /> <br />COUNTY BUILDING OFF:rCIAL <br /> <br />FORM # MC 1~-~ ml~V, 4/~0 OFFICE COPY <br /> <br /> <br />