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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 /> t am a fegi~t~rad builder OR { ) [he ~uthor~ed repre~mative <br /> ) Other .... <br /> <br />ow~TE: 02/06/91 ..TZ~E: 12:18:14 <br /> NORTH ~[~ ~L DZ~TRZCT <br /> <br /> 20167 <br />AU~'ORA <br /> <br />SIGNATURE O~ APPLICANT _ ...... <br /> <br /> TAX LOT:: <br /> <br />97002 <br /> ~Z~,~TY-] .... NO <br /> <br />OCCUPANCY <br /> <br />OCCUPANT LOAD:: <br /> <br />2025~ GRiN RO <br />AURORA, OR 9?002 <br />Pt-fCINE: ~'18-5835 <br /> <br /> E~iTE NUMBER; 1001'2 <br /> : VALUAT ION: <br />SECYtON:: ...... ; TOWN~H [P: RANI~ E:: ~ ZONE <br /> <br /> 22 .... 45 I W ~ EFU. <br /> NO <br /> <br />TYPE: ON-SiTE ~E'v~GE <br /> <br />P~'III" OR APPLICATION NC): 28138 <br /> <br />CON'r;~CTOR, NO. <br />NORTH IVlARiC~ ~:~V, JL DISTRICT <br />20256 GRiM RD <br />AURORA, OR 97002 <br />P'HC~E: 678-5835 <br /> <br /> 1T~ <br />SI'[E ~'"VAL, - FIRST %'000 GAL D~F <br /> <br />~'~ATER ~JPPLY; P'~ <br />TrOT HOL~-~ READY: <br />Si. lIE EVALUATION NU~ER: <br />EXIE~T [NG TANK <br />EXISTING DRAIN F,[ELD <br />~EPTiC TANK, I:~JNPED: <br /> <br />PAYEE: RECEZPT NO: <br />RECEiVEO SY: CL TYPE: CHECK <br />~EE ATTACHEO CX~CU~T FOR ~!P~T$ <br /> 5YSTE~I. <br /> <br />NOTEz TH[~ Q~ NOT GR~T OR iMPLY 1~1~41~ION TO 8UJ[L~ ON THZ~ PAI~EL. PLANNING AND <br />CONSTRLICTIQN ~'E.I~flIT~ MI.~T 8E OBTAINED BEFORE 81JILOING OR S~PTIC INSTALLATION B~INS. <br /> <br />RE'IV~RKS= SEPTic SY~TE.~ FOR GRA.Nr. YSTAND~ <br /> <br />OC~ALD E. WCX3OLEW'. t,4ARION CCUN'I'Y 8UILO.[N~ OF~'J~C.tAL / BY <br /> <br />FORM * ~C ~,,~ n~v,, ~ OFFICE COPY <br /> <br /> <br />