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MARION COUNTY BUILDING INSPECTION <br />SENATOR BL.DG NO 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 9;"301 <br /> <br /> PHONE: 888-5147 8;;00- 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />WILSON, JOHN <br /> <br />$1GNATURb 0¢ APPLICAN¥ <br /> <br />67644-014 <br /> <br /> 9292 ,St~,J[ rH RD SE <br />AUI'4~V I LLE OR 9"/'325 <br /> <br />I~RION COUN fY NO <br /> <br />P.O. 983 <br />AU~V[LLE, OR <br />PHONE: 3'10-4569 <br /> <br />TYPE: <br /> <br />PBl.~411 OR APPLiCATiON NO: 29689 <br /> <br />CONTRACTOR, NO. <br />~i~, JOHN <br />P.O. 983 <br />AUMSViLLE, OR <br />PHONE: 370--4569 <br /> <br /> $,T, T E NUi'4B ER +. <br /> VALUATION: <br /> <br /> AC NO <br /> <br />I~ATER <br />TEST HOL~ <br /> <br />~I3TiNG T~K SIZE= <br />~iSTIN~ B~IN FIELD LiN~: <br />S~TIC <br /> <br /> 12059 <br /> <br />ZONE <br /> <br />00RNER <br /> NO <br /> <br /> iTFJ~ <br />AUIHOEIZA'iIQN NOTICE - NO VlSi! <br /> <br />PAYEE: <br />RECEIVED ~Y: CL <br /> <br />TOTAL AE~F..T.~ED FEES <br />PREVIOUS RE~CEiPT$ <br />THiS RFJ:3EIPT <br /> <br />(,~JAN'TI'fY .AlVX~NF <br /> $60.00 <br /> <br /> ¢60.00 <br /> 60.00 <br /> $0.00 <br /> <br />~ALANCE DUE $0.OO <br /> <br /> R~CEiPr NO: <br />TYPE: CHECK ~: 0 <br /> <br /> SEE ATTACHED DOCU~EN1 FOR REI~JIRP. f,~F..NT$ OF ON-SiTE SE~,~c.~E ~YST~. <br /> <br />~ THI$ 1S A VALID PEF~[T ~ THiS pER~IT EXPIRE~ ~BO DAY~ FRO~ 1TS iSSUE DATE. IF <br />CONSTRUCTION FAIL.~ TO ~EET ALL RE~LI[REIVlENT~ OF STATE LAN~ /~D fflARION COJNTY I~U[LOiNG AND <br />ZONIN60~DINANCI~, THiS P~IT ~rlALL 8EC~C~NULLAND V01O. <br /> <br />R~R~: SEPTIC SYSTEM Nk~lgR PLACED iN USE, AUTH NO ViSiT <br /> <br />OONALO E. ~OODLEY, f4ARION Of,.,X.INfY 8'UiLD[NG OFFICIAL / BY ................................ <br /> <br />OFFICE COPy <br /> <br /> <br />