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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG, NO 225 <br />22O HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE: 588-5t 47 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />09/20/91 TIME: <br /> <br />TAX LOT <br /> <br />CA¥~GORY <br /> <br />OCCUPANCY <br /> <br /> 5832 VILLAGE V[E~ CT <br /> AD~VILLE, OR <br />U%E OF BUILDFNG <br /> <br />9?325 <br /> <br />.... ~RI~ COIJN, 1Y NO <br /> <br />OCCUPANT LOAD <br /> <br />PARFYK~A, STANLE~ : RE~NTOR <br />SAM~- <br />PHONE: 588-7722' <br /> <br />SITE NUMBER= 13908 <br />VA LUA r I ON: <br />RANGE ZONE <br /> <br />MAP <br /> <br />192 565 <br /> <br /> 18 8S 1~ <br />1084~0. , SF NO NO <br /> <br />AR3 <br /> <br />4~ <br /> <br />TYPE: ON-511E SE1NAGE <br /> <br />PERNII OR APPLICATION NO: 34667 <br /> <br />NAT~R ~JPPLY: P'W <br />TE~'r HOLE,S RE. ADY: <br />SITe EVALUAIION NUFIBER: <br />EXISTING T~K ~tZE~ 1000 <br /> <br />SEPTIC ~K ~ED= 8-21-91 <br />PRE~I~S NO, BED~: 2 <br /> <br /> i FE.~ <br />AU)HORiZAFiON NOI [C~- - FLD, VIgil <br /> <br /> OUAN l'l TY AA~FOUN T <br /> 1 $105.00 <br /> <br />TOTAL A,E~EE~ED FEES ¢ 105. O0 <br />PR~I~ R~6[PT5 $105.00 <br />THIS R~iPT $0. O0 <br /> <br />~ALANCE DUE $0.00 <br /> <br />RECEIPT NO: <br /> <br /> RECEIVED BY: P8 TYPE: CHECK <br /> <br /> ~gg ATTACHED DOCUMENT FOR REQUIREMENTS OF ON-SITE SE1AIAGE ~l"EM. <br /> <br />* THiS ~ A VALID 0 0AY~J F I ~ I <br />C(]~ISTRUCTION FAIL~ TOME. ET ALL R~IRE~ENT~OF~TATE LAI~ANDMAR:II~I C:~UNTYSUILDIN~AND <br /> <br />RP-.,MARKS: AUTH R~67'/9 ~ <br />DONALD E, VC0OOLEY, MARION COUNTY BUILDING OEF[CJAL / BY <br /> <br />FORM #MC lS.E~ REV G/gO OFFICE COPY <br /> <br /> <br />