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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:$0 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br /> DATE: 05/~[/~3 '?IME: <br /> <br />................................................ ~ ~0~6~4Ei'5~T ...................................... 1 ..... " <br /> 2885 SW 224TH ; <br /> HIL~SBORO~ OR ~712~ ~ SITE NUMBER~ <br /> PNOhE: 64~-7~7 ~ VALUAT[ON~ <br /> <br /> ' ~u~: ........................................ , S~OT~ON: ~0~WSH~.~'-- ..... = ....................... ~AN~ ] T~E~: Z . ........... l ~B:, ........, <br /> : ; 28 8S ~ [W <br /> <br />TYPI~ ON-SITE SEWAGE <br /> <br />PERi'IT OR APPLICATION <br /> <br />CO!,ITRACTOR,~ NO~ <br />L.O~E~ gOUG <br />2885 sw 224TH <br />HIL, L. SBORO~ 0~ <br />PHONE~ <br /> <br />47212 <br /> <br />WATER SUPPLY <br />TEST HOL£S READY: <br />$:~TE EVALUATION <br /> <br />EXISrI,,~ <br />SEF'T~C TANK F'tlNP~D~ <br />PRE~IOUS NO, <br /> <br /> ITEH ~:~UAN'f ITY AHOUNT <br /> EXISTIN(; SYSTEK EVAL, RPT. 1 $160.8~ <br /> <br /> TOTAL ASSE~E;~ FEF_$ <br /> PREVIOUS RECEIPTS <br /> <br /> ,, ,,BALANCE ~U[{ '~. <br /> PAYEE: ' '" .RLCEIF r N~. <br /> RECI~IVED BY: PB _ .~ "'"] · ].' IYPE: CHECK ~; <br /> <br /> SEE A]'TACHE~ DOCUMENT FOR REQUI~EMENT~ OF' ON-~tTE ~EWAG~ gYSTE~. <br /> <br /> · THIS I~ A VALI~ PER~IT * TRIS PE~IT ~XPIRES ~68 ~AY~ FROM IT~ ISSUE DATE. <br />COIqSTRUCT~ON FAILS TO MEET ALL ~EQUIREMENTS OF ~TATE LAWS AND MARION COUNTY BUILDING AND <br />ZONiNf~ ORDINANCES~ TH!B PERMIT SHALL 'BECOME NULL AND VOI~. <br /> <br /> -- ' " '"' CHECK SEWER L' NE FOR AI..IGHP, EHT O~ <br />,E, NARKS~ STAY]O~ F:EPORTS H~.~-N LI,3UID LEVEL IN TANK, <br /> PL. UgL;ZNg. NO DNAX; rlEL. D FAIt, URE, ' <br />DONALD E~ WOCd)l.~?¥~ HARION ¢OUh~TY BUILDING OFF]]O~AL / BY ........................................................~ <br /> <br />./~c ~s~ ~,~. ,~,~ OFFICE COPY <br /> <br /> <br />