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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 />PETEkI~ON, GARRET'/ <br /> <br />TAX I.OT <br /> <br />CONSTRUCTION TYPE <br /> <br />DEN F l A I <br /> <br /> 7913 MiLL C~'f~EK ROAD <br />AU~SV I LLE OR <br /> <br />COUNTY NO <br /> <br />Y40 r~OONE~ ~OAD Sg <br />SALEM 97306 <br />PHONE'. 370~7556 <br /> <br />26 <br /> <br />FYPL: ON-SI TE SE~'./AGE <br /> <br />PERMIr OR APPLICAtiON NO: 29357 <br /> <br />SIONE Pi~-LD GLEN <br /> <br /> SITE NUMBER: 11950 <br /> VALUATION: <br /> RANGE ZONF M~P <br />8S 2~ AR <br />AC NO NO <br /> <br />NA'rER E~JPPLY: <br />TEST HOLE~ READY= <br />SITE EYALUA"FiON NUMBER: <br />~iSf~NG T~K SIZE: <br />~TiNG O~iN FIELD <br />SEPTIC T~K <br />PR~[~S NO. 8EO~: <br /> <br /> ITF~ <br />S l ANDARO ON-SITE <br /> <br /> TOTAL A~S~E'D FEE~ <br /> PREV I(:XJS RECEIPTS <br /> THiS RECEIPT <br /> <br /> BALANCE DUE <br /> <br />PAY~'E: RECEZP1 NO: <br />RECEIVED BY: CL TYPE~ ~ECK ~: <br />SE~ Ar'rA~O ~M~T P~R REdiReCTS OF ~-$ITE S~E <br /> <br />$165.oo <br /> <br />[165.oo <br />155.oo <br /> <br />$0.00 <br /> <br />~ THZ~ [$A VAJ.,,.,[D PERMZT ~ THIS PERffilT EXPIRES 360 DAY~ FROffi iTS I~tJE DATE. iF <br />CONSTRUCTION FA[L~ TO ~-ET ALL ~L~E~ OF STATE L_NN~ AND ~ARION COUNTY BUiLDiNG AND <br />ZONiN~ ORDINANCI~, THIS P~RMIT NULL AND VOID. <br /> <br />RIC4ARY.0S: S[ANDARD SYSTEM R:1~4.776 <br /> <br />DONALD E. WOODLEY, MARION COUNIY BUILDING OFPtCiAL / BY <br /> <br />OFFICE COPY <br /> <br /> <br />