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MARION COUNTY BUILDING INSPECTION <br />SENATOR SLDG. NO, 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE: 588-5147 8:00 - <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />t am a registered builder OR ( the authorized representative <br />The wock will be performed by a re§~stered I~uil~l~¢. . <br /> <br />~;IONA'FURE OF APPLICANT; ........................................ <br /> DATE; ................................................ <br /> <br />TYPE: OH--SITE <br /> <br />PERHIT OR APPLICATION <br /> <br />CONTRACTOR~ NO. ~4916 <br /> 8TAYTON SEPTIC <br />41155 STAYTON SClO~DR SE <br />STAYTON. <br />PHONE: 7&9-2~82 <br /> <br />488~ <br /> <br />WATER SUPPLY: PW <br />TEST HOLES READYt W/CALL <br />SITE EVALUATION NUMBER: <br />£XISTIN~ TANK SIZE: <br />EXISTIN~ DRAIN FIEL~ LINES: <br />$~PTIC TANK P~MPED: 4-9~ <br />PREVIOUS:NO?BEDROOMS: <br /> <br /> SEE ATTACHED DOCUMENT <br />. ~ THIS IS A VALID pERNIT,'~' ~H[S..'-PERi~Z~"/XP[RES,,~iD~YS,FROH ITS I~SUE DATE. IF <br />CONSTRUCTION FAILS TO ~EET'AL~,, RE~UIREMEflTS,OF"::STB~E"'LB~S <br />ZONING ORD~NANCES~ THI~ PERMIT.:~HAL'L BECONE;.NQLL' 'AN~:: VOID,,: <br /> ' .',?" ...."' .",,, ..":'." <br /> <br /> REMARK8: RPR:MA~. PRESSURIZED DISTR.IiBUTION, SOHEWHAT SUBSTANDARD, REPA/~ <br /> D~NA[..I), E. WOODLEY, MARION COUNTY BUILDING'OFFICIAL / 8~", . ................ ~ .............. ~'i~ <br /> <br />m~u # ~ ~,~ ~v, ~ OFFICE COPY <br /> <br /> <br />