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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 8:00 - 4:S0 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />of .~ registered ..builder, <br />Thu work will bu performed by a registered guilder. <br /> <br />SIGNATURE OF APPLICANT; <br /> DATE: <br /> <br /> CATE: 10/20/92 TIME: 13:3~:12 <br /> <br /> THERRIEN, HARRY 1-74730-~050 RESIDENTIAL <br />SITUS ADDRESS; , CONSTRUCtiON TYPE: OCCUPANCY: <br /> <br /> 7908 STONE FIELD CT SE iU6~; ;OCCUPANTLOAC; <br /> AUHSVILLE OR 97325 ;MARION COUNTY NO <br /> <br />ADDRESS: SU 8D$VISION: <br /> STONE FIELO GLEN <br />7771 TERRANCE LANE <br />AUMSVILLE 97525 WK 750-4552 SITE NUMBER: 92-0~624 <br />PHONE: 749-2666 VALUATION: <br /> <br />....... 2~ .... 8S 2W AR <br /> ,DEPTH; AREA: [ UNITS; IRREg. LOT; ...... <br /> 5. i AC NO NO <br /> <br />MAP: <br /> <br />TYPE: ON-SITE SEWAGE <br /> <br />PERMIT OR APPLICATION NO: 904~155 <br /> <br />CONTRACTOR, NO. <br />THERRIEN, HARRY <br />7771 TERRANCE LANE <br />AUMSViLLE 97525 WK 750-4552 <br />PHONE: 749~2666 <br /> <br />WATER SUPPLY: PW <br />TEST HOLES REAOY: <br />SITE EVALUATION NUMBER: 7-76~8 <br />EXISTING TANK SI~E: <br />EXISTING BRAIN FIELO LINES: <br />SEPTIC TANK PUMPED; <br />PREVIOUS NO. BEDROOMS: <br /> <br /> ITEM QUANTITY AHOUNT <br /> STANOARO ON-SITE SYSTEM i $210~00 <br /> <br /> TOTAL ASSESSEC FEES $210.00 <br /> PREVIOUS RECEIPTS $0.00 <br /> THIS RECEIPT $210.00 <br />  xk8ALANCE DUE $0.00 <br /> PAYEE: THERRIEN. HARRY ~ ~ RECEIPT NO: 45413 <br /> <br /> SEE ATTACHEO DOCUMENT FOR REQUIREMENTS OF ON-SITE SEWAGE SYSTEH. <br /> <br />~ ~ THIS IS NOT A PERMIT. THIS APPLICATION MUST GO THROUGH A REVIEW PROCESS WHERE THE <br />FOLLOWING HUST BE COMPLETED~ IT IS THE RESPONSIBILITY OF THE APPLICANT TO ASSURE THAT <br />ALL NECESSARY INFORMATION HAS BEEN PROVIOEC~ <br /> <br />PLAN REVIEW: BY .......... DATE ............. CITY JURISDICTION: BY .......... DATE <br /> <br /> SEPTIC SYSTEN- OLD SITE EVAL OOES NOT SNO APPROVEO REA <br /> <br /> OFFICE COPY <br />FORM # MC 15-56 REV. 4/90 <br /> <br /> <br />