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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 B:O0 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br /> DATE: 06/30/92 TINE: 10:[6:00 ..... <br />............................................... {'"~'5~ ~ E~i~%- ~'~ ............... <br /> ROTH~ ROGER ~ ~ RE~IOENT[AL <br /> <br /> ........................... .............. NO OF 8EO~OOMS: <br /> <br /> 2 <br /> <br /> : ; ................................ i ............................... L ................... ~ ..................... <br /> <br /> ; ,,.,~,~ ................... ~ .................... zos <br /> , .................... ..................... <br /> 1o0 110 110o0~ 8F NO <br /> <br />TYPE: ON-SiTE SEWAGE <br />PERMIT OR APPLICATION NO= 40604 <br /> <br />CONTRACTOR, NO. <br />BOTH, ROGER <br />S~ME <br /> <br />PHONE: 8S4~72~ <br /> <br />WATER ~UPPLY: cw <br />TEST HOLES REAOY: <br />SITE EVALUATION NUMBER: <br />EXISTING TANK SIZE: <br />EXIST'lNG'DRAIN FIELD LINES= <br />SEPTIC TANK PUMPED: <br />PREVIOUS NO. BEDROOMS: <br /> <br /> ITEM QUANTITY AMOUNT <br /> EX~STING SYSTEM EVAL. APT. 1 $150.00 <br /> ToT~ A$~E$$EO"FEES <br /> -PREVIOUS ~RECEIPT$ $1~0.0o <br /> THiS RECEIPT $0.00 <br /> <br /> BALANCE DUE $0_00 <br /> <br /> PAYEE: , ' ' "· . iNVOiCE NO: <br /> RECE~VEO 8Y: OM ......... ,___:...~ ' ' .' ~;_.~;.~_ TYPE: CHECK #: 0 <br /> SEE ATTACHED DOCUMENT FOR RE~UIREHEN,~S,.OF ON~ITE~'SEW~GE 'SYSTEM. <br />· THIS iS R VALID PER~IT. ~' THZ9 pEla'fIT..EX~E~, ~00~YS ;FRON ITS ISSUE ORTE. <br />CONSTRUCTIOH FALLS TO MEET.tALL REqUIrEMENTS .OF,STAT~ E'~WS AND H~RION COUNTY BUILDING AND <br />ZONING ORDINANCES, THIS PERHIT'S~A[L BECOHE EULL' ANO'VOIO; <br /> <br />REMARKS: AUTH <br />DONALD E. ~DOOLEY, MARION COUNTY ~U'~LOING OFFICIAL / BY <br /> <br />OFFICE OOP¥ <br /> <br /> <br />