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MARION COUNTY BUILDING INSPECTION <br />SENATOR bLDG. NO. 226 <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 />of a registered builder, <br />The work will be performed by a registered buiiCer. <br />Other__ <br /> <br /> D~qTE: 09/24/92 TIME; 16:20:56 <br /> <br /> LAOOZE SMOOOERL¥ <br /> <br /> ~.5255 OI'T~WCY RD NE ;bOCUPANT LOAD; <br /> AUROR~ OR 97002 R~ ~TCUNTY ~S <br /> <br />MAILING ADDRESS; Sa B'b'fVI'si6';': ......... <br /> <br />PO BOX 364 <br />AURORA, OR MOBZLE-784-$890 <br />PHONE: 266-7059 <br /> <br />VALUATION: <br /> <br /> ~ BL68Ri ....... ................... : fo'w~Aipl F~AN~[f ~ f0NE: MAP: <br />LOT: SECTION: <br /> <br /> : .1,3 4S 1U EFU <br /> <br />TYPE: ON-SiTE SEWAGE <br /> <br />PERHIT OR APPLICATION NO: <br /> <br />904~797 <br /> <br />CONTRAOTOR, NO. <br />LADDIE SNODDERLY <br />PO BOX 364 <br />AURORA, OR MOBILE-784-1890 <br />PHONE: 266-7059 <br /> <br />HATER SUPPLY: PW <br />TEST HOLES READY: <br />SITE EVALUATION NUMBER: 40116 <br />EXISTING TANK SIZE: <br />EXISTING DRAIN FIELD LINES: <br />SEPTIB TANK PUMPED: <br />PREVIOUS NO. BEDROOMS: <br /> <br /> ITEM QUANTITY AMOUNT <br /> STANDARD ON-SITE SYSTEM 1 $210.00 <br /> <br /> TOTAL ASSESSEO FEES $21o.oo <br /> PREVIOUS RECEIPTS $0.00 <br /> THIS RECEIPT $210.00 <br />  ,Nx, BALANCE OUR $0.00 <br /> PAYEE: LADDIE SNODDERLY '%_\ \ RECEIPT NO: , 44871 <br /> RECEIVED BY: OM2 .................... ZZS~__Z_6 TYPE: CK CHECK ~: 1282 <br /> <br />· THIS I$ NOT fl PERHIT. THIS APPLICATION MUST 60 THROU6H A REVIEW PROCESS WHERE THE <br />FOLLOWING MUST BE DOMPLETED. IT IS THE RESPONSIBILITY OF THE APPLICANT TO ASSURE TMAT <br />ALL NECESSARY INFORMATION MAS BEEN PROVIDED. <br /> <br />REMARKS: STANDARD SYSTEM <br /> <br /> OFFICE COPY <br />FORM # MC 15,56 RE~. 4/9O <br /> <br /> <br />