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MARION COUNTY BUILDING INSPECTION SENATOR BLDG. NO. 225 220 HIGH STREET NE SALEM, OREGON 97301 PHONE: 588-5147 8:00 , 4:30 24 HOUR CODE-A-PHONE: 588-7904 of a registered builder. The work will be performed by a registered builder. Other , ,, ' this document, OATE: 10/06/72 TIHE: 12:00:48 ~ HOSTETLER, OANIEL ~ .~ COMMERCIAL [ ~52~TTAWAY RD NE / .................. ~i~: ~OOOUPA~ ~0: i ~URORA OR 97002 ~a~ ' ~ "~{b~' ~bb~; .................................................. ~~6~i~s~bA~ .................. P 0 BOX 656 ~ ......................................................................... CANBY, 0R ~70~3 ~ ~ITE NUHBEE: PHONE: 2~-~?73 ~ VALUATION: =Lbf.. ~[bd~ ............. ~iO'~ .................. 1YC'~'i~Tt ..... r~ ""i'~'EE; ....... ~--"T'~d~ .................... ~ ~"'. WioT~l: , . ',d~ ....... ~'"l~[~l'- '7~5'~'~""?~¢~"~-- ~ i~G, LOT= TYPE: ON-SITE SE#AGE PERMIT OR APPLICATION NO: CONTRACTOR, NO. HOSTETLER, DANIEL P 0 BOX 656 CANBY, OR 97013 PHONE: 26~-199~ 42304 WATER SUPPLY: TEST HOLES READY: YES SITE EVALUATION NUMBER: EXISTING TANK SIZE: EXISTING DRAIN FIELO LINES: SEPTIC TANK PUMPED: PREVIOUS NO. BEDROOMS: ITEM SITE EVAL. - FIRST LO00 GAL DSF TOTAE ASSESSED FEES PREVIOUS' RECEIPTS' THIS RECEIPT QUANTITY AMOUNT 1 $220.00 $220.00 $220.00 $0.00 8ALANCE DUE $0.00 INVOICE NO: TYPE: CHECK ~: 0 PAYEE: RECEIVED BY,: PB ................................ SEE ATTACHED DOCUMENT FOR REQU'IREMENTS'OF ONrBtTE SEWAGE SYSTEM. NOTE: THIS DOES NOT GRANT OR IMPLY PERMISSION TO BUILD ON, THIS PARCEL~ PLANNING AND ONSTRUCTION PERMITS MUST 8E 08TAINED BEFORE BUILDING OR SEPTIC INSTALLATION BEGINS. REMARKS: SE ~ DONALD E. WOOOLEY, MARION COUNTY 8UiLOIN~'OFFIOiAL / 8V _ ............... _~__. ~.Zq .... OFFICE COPY