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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 8:00.4:30 <br /> 24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />Other ..... <br /> <br /> DATE: 08/10/92 TIME; 8:25:23 <br /> <br />i owM~ni ........................................................ t'kx "CGfi ........... ' ............................... <br /> SDHMID, THOMAS <br /> <br /> 7490 SHERMAN RD <br /> AUHSVILLE OR <br /> <br /> 7496 SHERMAN RD : ...... <br /> ~UHSVZLL~ 97~25 '~"~ ~ -'-'&~ <br /> PHONE: 749~00~ V~LU~T~ON= <br /> <br />TYPE: ON-SITE SEWAGE <br />PERMIT OR APPLICATION NO: 41590 <br />CONTRACTOR, NO. <br />$CHMlO~ THOMAS <br />7496 SHERMAN RD <br />AUHSVILLE 97325 <br />PHONE: 749-1001 <br /> <br />WATER SUPPLY: PW <br />TEST HOLES READY: <br />SITE EVALUATION NUMBER; <br />EXISTING TANK SIZE: lOOO <br />EXISTING DRAIN FIELO LINES~ <br />SEPTIC TANK PUMPED: GIVEN FORM <br />PREVIOUS NO. BEDROOMS: <br /> <br />AUTHORIZATION NOTICE - FLO. VISIT QUANTITy AMOUNT <br /> 1 $130.00 <br /> <br /> TOTAL ASSE$SEO FEES $150.00 <br /> PREVIOUS RECEIPTS $1~0.00 <br /> THIS ·RECEIPT $0,00 <br /> BALANCE DUE $0.00 <br /> PAYEE: ,~ ' <br /> RECEIVED BY, mb - I .. RECEIPT NO; <br /> ........... L.~_: .... ~_-_=_-_-%=:_._~--.%.~_ .... TYPE: CHECK ~; 0 <br /> S~E ATTAOHEO O0~UNENT FOR REQUIREMENTS OF ONJSITE 8~WA8~ SYSTEM. <br />~ THIS IS A YALIO P~R~IT · THIS PERMIT EXPI'R~S ~60 gAYS FROM ITS ISSUE OAT~. IF <br />CONSTRUOTION FA~L8 TO MEET'ALL REQUIREMENT80~ STATE LAW8 AND MARION COUNTY 8UILDIN8 AND <br />ZONING ORDINANCES, TH~S PERMIT 8HALL BECOHE NULL AND VOID. <br /> <br />REMARKS: AUTH - FIELD CHECK <br /> <br />DONALD E_ WOODLEY, HARION COUNTY BUILDING OFFICIAL / 8Y <br /> <br />~o~ ~ ~c ~=,o~ A~,, +~ OFFICE COPY <br /> <br /> <br />