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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG NO 325 <br />220 HiGH STREET NE <br /> SALEM, OREGON 97501 <br /> <br /> PHONE 555-5147 <br />CODE-A-PHONE 4::30 PM - 8 00 A M <br /> <br />APPLICANT <br /> <br />DATE . - <br /> <br />02/ol/89 TI~AE; <br />LOFDAHL, LCAJ 1SE <br /> <br />2:07~01p <br /> <br />CATEGOR¢ <br /> <br />OCCUPANCY <br /> <br /> 12122 FRY ROAD <br /> ALIRORA <br />USE ©~ BUILDIN~ <br /> <br />PHONE; 678~2300 <br /> <br />OR 9'7002 <br /> <br />NE <br /> <br />TOWNSHIP <br /> <br />MARION cOUNTY NO <br /> <br />SITE NUMBER: <br /> VALUATION: <br /> <br />AC YES NO <br /> <br />EFU 6 <br /> <br />TYPE; ON-SITE SEWAGE <br /> <br />PER¢I7 OR 4PPLICATICN <br /> <br />CONTRACTOR, NO <br />LOFD~,HL, L©U~SE <br /> <br />PPiONE; 678~2300 <br /> <br />9013818 <br /> <br />WATER SUPPLY: PW <br />TEST HOLES READY: <br />SZTE EVALUATION NUMBER: <br />EXISTING TANK SIZE: <br />EX~STING DRAIN FIELD LiN~S; <br />SEPTIC TANK PU~PED= <br />PREVIOUS NO. BEDROOMS; <br /> <br /> ! 'FEH QUANT Z'FY AMOUNT <br />ANNUAL EVAL., ,~ TEMP OR HDSHP ~ I $80,Qa <br /> <br /> TOTAL ASSESSED FEES $60 OO <br /> PREVIOUS RECEIPTS $0.80 <br /> THIS RECEIPT $60.00 <br /> <br /> BALANCE DdE $0.00 <br /> <br />PAYEE: LOFOAHL., LOUISE RECEIPT NO; !4654 <br />RECEIVED 8YE XXX TYPE: OK CHECK ~: f485 <br /> <br />SEE ATTACHED 0OCU~ENT FOR REQUiREmENTS OF ON-SITE SE~AAGE SYSTEN. <br /> <br />* THIS IS NOT A PER~4IT. THIS APPLICATION ~ST GO THF~)U6~4 A R~VIEN PROCBSS ~ERE THE <br />FOLLOWING MUST BE COfAPLETED. IT IS THE RESPONSI8ILZI~¢ OF THE APPLICANT TO ASSURE THAT <br />ALL NECESSARY INFOR~4ATION HAS BS~ PROV[DED. <br /> <br />REMARKSt SE?rIO CHECK FOR HARDSHIP R~8373 <br /> <br /> <br />