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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 P,M - 8::00 AM <br /> <br /> Other <br /> <br />DATE: 11/15/88 TIME: 12:05:07p <br /> <br /> DETROIT STATE PARK <br /> <br />SIGNATURE OF APPLICANT <br /> <br />RESI DENT I AL <br /> <br />OCCUPANCY <br /> <br />47 MILE PO~T. NO SANTIAM H~A' SE <br />DETROIT OR 97342 <br /> <br />CONTRACT CT'IY UG8 <br />t, IAR I ON COUNTY NO <br /> <br />OOCUPANf LOAD <br /> <br /> Nn OF BEDfl00MS <br /> <br />20024 SILVER FALLS HI/Cf SE <br />SUBLIMITY OR 9?385 <br />PHONE; 873-8681 <br /> <br />t CT RLOCK SECTION TOWNSNIP <br />3 <br /> <br /> 104. 000 <br /> <br /> SITE NUNBER: 5943 <br /> VALUATION: <br /> <br /> MANGE ZONE <br />10 5E <br /> IRRE¢~ LOT CORNER <br /> AC NO NO <br /> <br />MAP <br /> <br />TYPE: ON-SITE SEHAGE <br />PERMIT OR APPLICATION NO: 901249? <br /> <br />CONTRACTOR, NO. <br />DETROIT STATE PARK ~LL <br />20024 SILVER FALLS HHY SE~,~(*~g i~ ' <br />SUBLIMITY OR 97385 <br />PHONE: 873-8681 <br /> <br /> ITEM <br />GRAY HATER DISPSL SUMP <br /> <br />PAYEE: DETROIT STATE PARK <br /> <br />HATER SUPPLY: <br />TEST HOLES READY: <br />SITE EVALUATION NUMBER: <br />EXISTING TANK SIZE: <br />EXISTING DPJNIN FIELD LINES; <br />SEPTIC TANK PUMPED= <br />PREVIOUS NO. BEDROOMS: <br /> <br /> OUANTITY ANDUNT <br /> 1 $85.00 <br /> <br />TOTAL ASSBSSED FEES $85.00 <br />PREVIOUS RECEIPTS $0.00 <br />THIS RECEIPT $85.00 <br /> <br />BALANCE DUE <br /> <br />RECEIPT NO: 13259 <br /> <br />RECEIVED BY: CL TYPE.* OK CHECK ~: 138758 <br /> <br />SEE ATTACHED DOCUMENT FOR REQUIREMENTS OF ON-SITE SEWAGE SYSTFJ~4. <br /> <br />* ~IS I8 ~T A P~IT. ~i8 APPLI~TI~ ~ ~ ~ A RBIB P~B ~ERE ~E <br />FOLDING ~ST BE ~EO. ~T IS ~E ~SIBILI~ OF ~E APPLIC~T TO ~RE ~AT <br />ALL N~ INFO~TI~ ~ 8E~ P~IDED. <br /> <br />PLAN REVIEW: 8Y DATE ..... CITY JURISDICTION.- BY ........ DATE <br /> <br />REJ~IARKS: 18 GRAY HATER SITES R:tt5891 FOR ONE CHARGE,ONE INSPECTION <br /> <br />FORM ~ M( 1556 REV ~.8' OFFICE COPY <br /> <br /> <br />