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MARION COUNTY BUILDING INSPECTION <br />SENATOR 8LOG, 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: S88-7904 <br /> <br />I am performing work on a proper~7 t ow,n ~ O~¢uOY, entwine <br /> <br />~IGNATg~ OF AFPLICANT: ................ <br /> <br /> ........................... , T~ 'L~T~ ............................ : O~TEGORY: <br /> OWNER <br /> DATEs 07/01/92 TIHE: 10:~0:54 ....... ,, ,, <br /> PITTERLE~ E~SE K ; 4026~000 ' COHHERC~L <br /> ........................... 7' bG~ .............. ~UPAN~ COA~= <br /> <br /> - ~ 10575 CHAHPDEG, .RD .................... NE ; .............................................. <br />us[ OF ~u ~m~ROEA OR 97002 MARION COUNTY NO <br /> <br /> .................. : ~da6~)5~7 ..................... <br /> <br /> 10569 CHAHPOEG RD <br /> AURORA, OR. ?7002 : SITE NUHBER: 92-0Z859 <br />COT; PHONE~oEEE '[ 2~ 8-"' ':'~c~b.; ....... ?d~6= ............. ;~U~T [ ON ~- - --"~-~ ...... . ~A,: <br /> <br /> , ~ ~ 4~ ZW EFU ~ <br /> 2~.4 AC HO ~0 <br /> <br />TYPE: ON-SITE SEWAGE <br /> <br />PERMIT OR APPLICATION <br /> <br />cONTRACTOR. NO. <br />PIT~ERLE. ~LISE K <br />10369 CHANPOEG RD <br />~URORA, OR 97002 <br />PHONE: 678-1228 <br /> <br />40350 <br /> <br />WATER SUPPLY= PW <br />TEST HOLES READY: <br />SITE EVALUATION NUM6ER: 9039997 <br />EXISTING TRN~ SIZE: <br />EXISTING DRAIN FIELD LINES: <br />SEPTIC TANK PUHPED: <br />PREVIOUS NO. BEDROOMS: <br /> <br /> ITEM <br />STO ONsITE SYS < 1000 GAL <br /> <br />TOTAL ASSESSED FEES <br />PRE¥IOU8 RECEIPTS <br />THIS RECEIPT <br /> <br />~UANT~TY AHOUN7 <br /> I $210.00 <br /> <br />SZlO.O0 <br />$2~0.00 <br /> $0.00 <br /> <br />BALANCE DUE $0.00 <br /> <br />PAYEE: RECEIPT NO: 0 <br /> <br /> RECEIVED BY: PB ............... TYPE: CHECK ~: 0 <br /> <br /> ~EE ATTACHED DOCUMENT FOR REQUIREMENTS OF ON-BITE SEWA~£ SYSTEH. <br /> <br />CONSTRUCTION FALLS TO MEET ALL REQUIREMENTS OF STATE LAWS AND HARION COUNTY BUILOING AND <br />ZONING ORDINANCES, THIS PERMIT SHALL ~EOOHE NULL AND VOIO. <br /> <br />REMARKS: STANDARD 8YSTEH <br /> <br />DONALO E. WOOOLEY. HARION COUNTY BUILDING OFFICIAL / BY <br /> <br />OFFICECOPY <br /> <br /> <br />