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REMARKS: NEW STANDARD SEPTIC SYS/'EM <br /> MARION COUNTY BUILDING INSPECTION <br /> SENATOR BLDG. NO, 225 <br /> 220 HIGH STREET NE <br /> SALEM1 OREGON 97301 <br /> <br /> PHONE: 588-5147 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 555-7904 <br /> <br />am performing work on a property I own or occupy. <br />amarugbtered" ¢' buiMerOR( )theauthorizedropresentative <br />of a registered builder, <br />The work will be performed by a registered builder. <br /> <br />Othcr_ <br />I have read and agree to the terms stated on the reverse side Ct <br />this document, <br /> <br /> DATE: 10/13/92 TIME; 8:51:28 <br /> <br /> R~?DENT I AL <br /> THERRIEN~ M~RRY <br /> <br />SITUS ADDRESS: CG~RUOflON f~PE; : OCCUPANCY~ <br /> <br /> 7908 STONE F[ELD OT SE <br /> ~UHSVZLLE OR 97525 ~ ~T~UNTY ~: :OCCU.Am' LOA~: <br /> <br /> STONE FIELD GLEN <br /> 7771 TERRANCE LANE <br /> ~UHSV~LLE 97325 ~K 750~4552 <br /> PHONE: 749-2666 V~LU~TZON: <br /> <br />LOT: <br /> <br /> 4 <br /> <br />: BLOCK: ]: S~CTIONi ; TOWNSN IP: , RANGE: ZONE; ; MAP: <br /> :26 <br /> <br />TYPE: ON-SITE SEWAGE <br /> <br />PERHIT OR APPLICATION NO: 9043155 <br /> <br />CONTRACTOR, NO. <br />THERRIEN, HARRY <br />7771 TERRANCE LANE <br />AUBSVILLE 97525 WK 750-4552 <br />PHONE: 749-2666 <br /> <br />WATER SUPPLY: PW <br />TEST HOLES READY: <br />SITE EVALUATION NUMBER: 7'~76-8 <br />EXISTING TANK SIZE: <br />EXISTING DRAIN FIELD LINES: <br />SEPTIC TANK PUMPED: <br />PREVIOUS NO. BEDROOMS: <br /> <br /> ITEM QUANTITY AMOUNT <br /> STANDARD ON-SITE SYSTEM 1 $210.00 <br /> <br /> TOTAL ASSESSE8 FEES $210.00 <br /> PREVIOUS RECEIPTS $0.00 <br /> THIS:RECEIPT $0.00 <br /> <br /> LANCE DUE $210.0(} <br /> PAYEE: ~ RECEIPT NO; <br /> RECEIVEO BY: DM2 .................... J_"Z~.._~_~"C'L-~_.. ......... TYPE: CMECK ~: 0 <br /> <br /> SEE ATTACHED DOCUMENT FOR REQUIREMENTS OF ON-SITE SEWAGE SYSTEM. <br /> <br />· THIS IS NOT A PERHIT. THIS APPLICATION HUST GO THROUGH A REVIEW PROCESS ~HERE THE <br />FOLLOWING MUST BE COMPLETED. iT IS THE RESPONSIBILITY OF THE APPLICANT TO ASSURE TMAT <br />ALI_ NECESSARY INFORMATION HAS BEEN PROVIDED. <br /> <br />PLAN REVIEW: 8Y .......... DATE ................. CITY flURISDICTION: BY ........ DATE .................. <br /> <br />REMARKS; NEW STANDARD SEPTIC SYSTEM <br /> <br /> OFFICECOPY <br /> <br /> <br />