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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG- NO 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 9730~ <br /> <br /> PHONE: 588-5147 8:00 - 4:30 <br />24 HOUR OODF~.,A-F'HONE: 588-7904 <br /> <br />DATE: 03/25/92 TIME: g:49=54 <br /> <br /> C, AU-IOUN CHARLES <br /> <br />4000-74,110'] 20 <br /> <br /> 7968 BAI~AI~ I.N SE <br />AUM~V[LLE OR 9?325 <br /> <br />USE OF ~UILDING <br /> <br />PO 0OX 12042 <br />~L~J~IOR 97309 <br />PHON£: 364,-3239 <br /> <br />TYPE: ON'-:StTE 5~qNAGE <br /> <br />2B <br /> <br />pEJ~,II'F OR APPLICATiCN NO.* 38378 <br /> <br />CAI. J'iC~N *CHARLJ~[S <br />PO 80X 12042 <br />E, ALE~OR 97309 <br />P/',I(~IE: 364-3239 <br /> <br />CONTRA~ CITY UGB <br />hlARICW COUNTY NO <br /> <br />THE RANOH <br /> <br />VAL.UAT ION: <br /> <br />NAT~R SUPPLY: I:~ <br />~E~T HOLF.~ READY= <br />~ZTE EVALUATION NUMSER~ <br />E~iSTING TANK SLZE= <br />~XISTiNG ORAIN F[E~D LINES~ <br />SEPTIC III~K PUMPED: <br />PREVIOUS NO. 8E~ <br /> <br /> ~1 ElY) <br />SFANDARO ON-~I rE <br /> <br />~XJANT I TY A,~I3JN T <br /> <br />TOTAL A,Tx~T~D FEF.7,S <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />BALANCI~ DUE <br /> <br />210_00 <br />$0.00 <br /> <br /> PAYEE: RECEIPT NO= <br /> RECEIVED 8Y~ cl ................................... TYPE.* CHEC~ ~: 0 <br /> <br /> S~ ATTACHED DOOJJe~I~NT FOR REI~.[REFIENT~ OF ON-SI rE *~Y~.AGE sY~rEIR. <br /> <br />~ '*tHiS iS A VALID P'EI~RIT ~ THiS PE~IT EXPII;~5~ 360 DAY~ PRCIR IT~5 131~UE DATE. IF <br />CON~TRtJCTJ[C~ FAIL~ TO MEET ALL. RL=OU.L,R:JE,~E~T~ OF STATE ~ AND IvlAR2ON CCIJ'NTY 8UI'LOINI~ AND <br />ZC~II~ ~I~, 'THIS P'ElaJ4IT~t.l~a~J_ 8EC::Of/~ NULL. ~O VOIOo <br /> <br />R, EMAR~: E~TANDARO SY~TE~ <br /> <br />DONALD E. HKX3DL~Y. FARioN COUN?Y b3UILDING OFFICiAl-` / 8Y ........................ <br /> <br /> OFFICE COPY <br />FORM # MC 15-56 REV <br /> <br /> <br />