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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: 58B-5147 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE; 588~7904 <br /> <br /> T IHE. <br /> ~ TAX LOT: <br />~ HOSTETLER, OANIEL ~ ~ COMMERCIAL <br /> <br /> AUROnn on e7002 :'~nunonn NO ~ I0~ ~ ~') <br /> <br />,' P 0 BOX ~56 <br /> CANDY, OR 970[3 ~ BilE <br /> PHONE: 265-1995 i VALUATION: <br /> <br />491 1097 5~8627. SF NO [ NO <br /> <br />TYPE: ON-SITE SE#A~E <br /> <br />PEEt~IT OR APPLICATION <br /> <br />CONTRACTOR, NO. <br />HOSTETLER, DANIEL <br />P 0 BOX 656 <br />CANBY~ OR 97013 <br /> <br />'9042504 <br /> <br />WATER SUPPLY: <br />TEST HOLE8 READY~ <br />SITE EVALUATION <br />EXISTING TANK SIZE: <br />EXISTING DRAIN FIELD LINES: <br />SEPTIC TANK PUMPED: <br />PREVIOUS NO. BEDROOMS: <br /> <br /> ITEM QUANTITY AMOUNT <br />SITE EVAL. - FIRST 1000 GAL DSF 1 $220.00 <br /> <br /> TOTAL ASSESSED FEES $220.00 <br /> PREVIOUS RECEIPT8 $0.00 <br /> ,THIS'RECEIPT $220.00 <br /> "B~E'ANC B 'O"E $0.00 <br /> <br />PAYEE: HOSTETLER, DANIEL IN¥OZCE NO: 44372 <br />RECEIVED BY: ¢1 ...... TYPE: IN CHECK ~: 0 <br /> <br />SEE ATTACHED OOCUNENT FOR REQUIREMENTS OF ON-SITE SEWAGE SYSTEM~ <br /> <br />NOTE: THIS DOES NOT C~ANT OR IMPLY PERNISSION TO BUILD ON THIS PARCEL. PLANNING AND <br />ONSTRUCTION PERMIT~U~T BE OBTAINED BEFORE BUILDING OR SEPTIC INSTALLATION BEGINS. <br />PLAN REVIE.: BY___,L~J____ DATE_f_,~_~--/.'~___ CITY JURISDICTION: BY .... ~__ DATE <br />REMARKS: SE <br /> <br /> · OFFICE COPY <br />FORM # MC 15.56 REV. 4/~JO <br /> <br /> <br />