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BUII..~.[~O II~IiILtlI~II~ME [] SEPTIC ~ PERMIT APPLICATION <br /> <br />/;'rope~ty Owner: ........ Photle: ....... I Mailing Address: ......... <br />DANIE.L. AND JANET HOSTETLER 1263-1995I p_.O, BOX 656 CANBY~ ORE. ~70] <br /> <br />14593 OTTAWAY RD. N.E. AURORA, ORE. ~T~ao' FixtUre <br /> <br />411.84 1097.58 10.58 YES <br /> <br />Con~aclor ~Slna~s Name and No <br /> KAL CONSTRUCTION 11L56 <br /> <br /> 678-5,860 24037 S. MERIDIAN RD,AURORA <br />A¢~Re~lE~ine~. ~ Pho~ .... ~dr~,, ' ..... <br />TRUSS T STRUCTURES INC. t,981"9581 2100 N. PACIFIC ~WY.W,QPDBURN I <br /> <br />r ~e ~ Permit <br />Building <br />.,, Septic <br /> Ne~ht ~ ~ild~: <br /> 18 <br /> <br />Mobile Nome <br /> <br />[] ,~dition: <br /> <br />[] RelOcation: [] Ooc Chg_: <br /> <br /> No. Stories, S~1- H-t_ Main <br /> 1 12500 <br /> Mobile ~ <br /> <br />I~'of)o~d Septic Installation: <br />Previous $~e ~'aluati0n <br /> Type of System:: <br /> <br />~ ~ Reacly <br />V~II o~)l when holes ready~ X <br /> <br /> Tach. <br /> <br />r..~q. Ft,, ~.~ <br />Occupancy, <br /> <br />Use of I~ildtng: ] R~$ [] <br />Warehouse = ..... ~d~ <br />~- ~t- Gera~- ~he~ <br /> <br />~up~t Lo~ ~ W~ Supply, <br /> CITY <br /> <br />Propose(l Bedtooms~ <br /> <br />Date Tank Pumped. <br /> <br />81GNATURE OF APPLICANT <br /> <br />OTHER PERMITS REQUIRED BY TNL~ DEP'IL' PLUMBING, MECHANICAl., ELECTRICAL <br />MC 15-~ <br /> <br />Valuation- $ <~ ~, '~'0,~ <br /> <br />TOT.~& FHE <br /> <br />RECEIPT NO. <br /> <br /> <br />