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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 -4:30 <br />24 HOUR CODE-A-PRONE: 588-7904 <br /> <br />of a registered builder, <br /> <br /> D~TE: 08/06/92 TIME: 16:15:;L7 .... <br /> OWNER: TAX LOT: ; ~XT~¢OgY; <br /> BARLOW, THOMAS ' RESIDENTIAL <br /> SITUS AODRESS; CONSTRUCTION TYPE~ O~OPANcY; <br /> <br /> 9?34 H[LL CREEK RD SE , CONTRAC~ C~TV: UCa: ~CCco~k~Y [bA~: <br /> AUHSV[LLE OR 97525 H~R[ON COUNTY NO ; <br /> <br />USE OF ~UILDING: <br /> <br />~ 2 <br /> <br />SAME <br /> <br />PHONE: 749-1782 <br /> <br />SITE NUMBER: 92-02554 <br />VALUATION: <br /> <br />LOT: <br /> <br />'6LOCK: <br /> <br /> , NO NO <br /> <br />TYPE: ON-SITE SEWAGE <br /> <br />PERH[I OE APPLICATION NO: <br /> <br />CONTRACTOR, NO. <br />BARLOW, THOHAS <br />SAME <br /> <br />PHONE~ 749-1782 <br /> <br />9041790 <br /> <br />WATER SUPPLY: PW <br />TEST HOLES READY: <br />SITE EVALUATION NUMBER: <br />EXISTING TANK SIZE: 1200 <br />EXISTING ORAIN FIELD LINES: <br />SEPTIC TANK <br />PREVIOUS NO. BEOROOh'S~ <br /> <br /> ITEM QUANTITY AMOUNT <br /> AUTHORIZATION NOTICE - FLD. VISIT 1 $1S0.00 <br /> TOTAL ASSESSED FEES <br /> PREVIOUS RECEIPTS $130,00 <br />  THIS RECEIPT $0~00 <br /> BALANCE DUE $0.00 <br /> PAYEE: RECEIPT NO: <br /> RECEIVEO BY: DM2 .............. ~ ................ ] . TYPE: CHECK ~: 0 <br /> <br /> SEE ATTACHEO OOCUHENT FOR REQUIREMENTS OF ON-SITE SEWAGE SYSTEM. <br /> <br />* THIS IS NOT A PERMIT. THiS APPLICATIOR MUST GO THROUGH A REVIEW PROCESS WHERE THE <br />FOLLOWING MUST BE COHPLETEO, IT IS THE RESPONSIBILITY OF THE APPLICANT TO ASSURE THAT <br />ALL NECESSARY INFORMATION HAS SEEN PROVIDED. <br /> <br />PLAN REVIEW: BY .... DATE ...... ~ CITY JURISDICTION: 8¥ .......... DATE <br /> <br />~ uc l~-~..sv. 4/~o OFFICE COPY <br /> <br /> <br />