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MARION COUNTY BUILDING INSPECTION
<br />SENATOR BLDG, NO, 225
<br />220 HiGH STREET NE
<br /> SALEM, OREGON 97501
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<br /> PHONE: 588-5147 8:00 - 4:30
<br />24 HOUR CODE-A-PHONE: 588-7904
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<br />of a rsgistered bwilder.
<br />The work 'will be performed bY a Cegistered builder,
<br />Other
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<br /> TIH ..... :L 4~ IS} 4';~ if.~x LOT:
<br /> ~ CONSTRUCTION TYPE; ~ OCCUPANCY;
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<br /> 6958 SH~RH~N RD SE ~ CONTRACT CITY UGB; J OCCUPANT LOAD
<br />ALI~iS~IL,L,[~ :' ~ OR ¢'7~215' [~ARZON COUNTY j NO ~
<br /> ~NO OF BEDROOMS
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<br /> ~ SiTE NUMBER: 95-m8482
<br />F'HONE~
<br /> 74'?,,,2186
<br /> VALUAT]:ONt~
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<br />60731
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<br /> lgATER SUPPLY." I;:'W
<br /> TEST HOLES READY: YES
<br /> SITE EVALUATION NUV~BER:
<br /> EXISTING TANK S,TZE: 1000
<br /> EX[S'I'.T. NG DRAIN ::[ELD L.~'.NES;
<br />~ ~SEPTZC flANK PU~PEP~ 1:I,/94
<br />', PREVIOUS NO, t)EJ)RO0~S: 3
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<br />~EPAIR -' MA,,IOR
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<br />QLIAN'I'ITY
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<br />PAYEE:
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<br /> , ,rOYAL., Ao~E,8SE~ FE.E,,~
<br /> '',,;':;PREV'~OUS RECEZF'TS
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<br />.:,.?::,,,~LANCE
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<br />RECET. f' 1 HO,~
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<br />$ ,I, ,, 0 ,, ¢ ,,
<br />%!.50.00
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<br /> TYF'E: CHEL,,x ,I]:~ 0
<br /> ':~l::E A ~'fAONE]) DOCtJH~ T 'FOR: f~QLI~'REf~'E ~T~' 'OF/O~=5ITE ';~Eg~CE $YgTE~.
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<br />, ~ THZS iS A VALI~ PERH~T ~;'"T~ZSPERH~T~P:~ES ~68' ~AYS FROH IT~ ~SSUE ~ATE. iF
<br />LONSIRUC1 ZUN FA:[I,S TO MEET ALL REQUI'REMEN~ OF/STATE LAWS AND NAR]:ON COUNY'Y [~I~;~.~..i):[,'L; A,'.,(;'
<br />ZONIHG O~lrDZNAI,iCES~ THIS '~RM'IT' SHAE_'-[4E6OHE',~ULL A4~ VOID.
<br /> . "...:,,:', ',; , .;';~ , ' ,, , , : .
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<br />OFFICE COPY
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