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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 <br />CODE-A-PHONE 4:30 PM - 8::00 A M <br /> <br />DATE: 11/15/88 TIME.+ 11:58:52a <br /> <br /> DETROIT STATE PARK <br /> <br />SITUS ADDRESS <br /> <br />SIGNATURE OF APPLICANT <br /> DATE <br /> <br /> ~AX LO[ <br /> <br /> 47 MILE POST. NO SANTIAN H[,¢¢ SE <br />DETROIT OR 97242 <br /> <br />USE OF BUiLDiNG <br /> <br />CONTRACT CITY t. IGB <br />MARION COUNTY NO <br /> <br />MAILING ADDRESS <br /> <br />20024 SILVER FALL~ HNY SE <br />SUBLIMITY OR 97385 <br />PHONE: 873-8881 <br /> <br />L ¢)T RI OCK BECTION TOWNSHIP <br />104.000 <br /> <br /> SITE NUMBER: <br /> VALUAT I ON: <br /> <br /> RANGE <br /> <br />10 5E <br /> IRREG LOT <br />AC NO <br /> <br />/jo,¢ /5',,/?cs <br /> <br />CATEGORY <br /> RES I DENT ! AL <br /> <br />OCCUPANT IOAO <br /> <br /> 11 <br /> NO O~ BEOAOOr~S <br /> <br /> ZONE MAP <br /> <br />CORNER <br /> NO <br /> <br />TYPE: ON-SITE SENAGE <br /> <br />PEPC~IT OR APPLICATION NO: 9012386 <br /> <br />CONTRACTOR, NO. <br />DETROIT STATE PARK <br />20024 SILVER FALLS HNY SE <br />SUBLIMITY OR 97385 <br />PHONE: 873-8881 <br /> <br />NATERSUPPLY: PN <br />TEST HOLES READY= <br />SITE EVALUATION NUrZ~ER; <br />EXISTING TANK SIZE: <br />EXISTING DRAIN FIELD LINES: <br />SEPTIC TANK PUMPED: <br />PREVIOUS NO. BEDROOHS: <br /> <br /> ITEM <br />AUTHORIZATION NOTICE w FLD. VISIT <br /> <br />TOTAL A~E~:xSED FEES <br />PREVICXJS RECEIPTS <br />THIS RECEIPT <br /> <br />BALANCE DUE <br /> <br />QUANTITY AMOUNT <br /> 1 $105.00 <br /> <br /> $105.00 <br /> $0.00 <br /> $105.00 <br /> <br /> SO.DO <br /> <br />PAYEE: DETROIT STATE PARR ,-, cd RECEIPT NO: 13258 <br />RECEIVED BY= JB ~ ~ TYPE: OK CHECK ~.* 74921971 <br /> <br />SEE ATTACHED DOCUMENT FOR REQUIREMENTS OF <br /> <br />~ ~S IS NOT A ~IT. ~IS <br />FOLL~ING ~T BE ~PL~+ IT I8 ~E ~IBILI~ OF ~E APPLIC~T TO ~RE ~T <br />ALL N~ IN~TI~ H~ BE~ P~IDED. <br /> <br />PLAN REVIEW: 8Y .......... DATE <br />RE~RKS: AUTH <br /> <br />CITY JURISDICTION: BY ........ DATE <br /> <br />~-O~M ~' MC ~55~ RE',' ~,a~' OFFICE COPY <br /> <br /> <br />