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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: 58@-5147 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />of a registered builder. <br /> <br />Other <br /> <br />COAKLEY,.EOD~EY & ~ARIA 560,55~E88 _ RESiDEnTIAL <br /> ,5785 SHAW NWY SE I ! I , <br /> <br />SAME <br /> S'rTE NUMBER: 74-i~8~132 <br />PNONE: 581-1872 VALOATION: <br /> <br /> &..9... ;-...-~ ~..NO L__.~ : <br /> <br />TYPE: ON-SITE SEWAGE <br /> <br />PERNZT OR APPLICATION HO: <br /> <br />CONTRACTOR~ NO. <br />BOAKLEY~ RODNEY & MARIA <br />SAME <br /> <br />PHONE: 981-1872 <br /> <br />52138 <br /> <br />WATER SUPPLY: PW <br />TEST HOLES REABY: <br />SITE EVALUATION NUMBER: <br />EXISTING TANK SIZE: <br />EXISTING DRAIN FIELD LINES: <br />SEPTIC TANK PUMPED: <br />PREVIOUS NO. BEDROOMS: <br /> <br /> ITEM QUANTITY AMOUNT <br /> ANNIJAL EVAL. - TEMP OR HBSHP MN 1 $90.00 <br /> <br /> TOTALASSESSED FEES $~0.00 <br /> PREVIOOS RECEIPTS $90.80 <br /> ~HIS RECEIPT $0.0~ <br /> BALANCE DUE $0.00 <br /> PAYEE: <br /> RECEIPT NO: <br /> RECEIVED BY: PB TYPE: 6NECK ~: 0 <br /> SEE ATTACHED 90CUMENT FOR REQOIREMENTS OF ON-~ITE SEWAGE SYSTEM. <br /> ~ THiS IS A VALID PERMIT ~ THIS PERMIT EXPIRES:3&e D~¥S FROM ITS ISSUE DATE. IF <br />CONSTRUCTION FAILS TO MEET ALL REQUIREMENTS OF'STATE ~AWS AND MARION COONTY BUILDINI; AND <br />ZONIN~ ORgINANCES, THIS PERHIT SHALE BECOME NULL AND VOID. <br /> <br /> REMARKS: HDSP. PF:i-I~4. OKAY TO CONTINUE HARDSHIP CONNECTION~ <br /> DC~NALD E. WOODi...EY~ MARI~N CouHTY BUILDING OFFICIAL / BY ................... [~ ....................................... <br /> <br />FORM ~ MC 18,~ R~, ~ OFFICE COPY <br /> <br /> <br />