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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: B88-5147 8:00 - 4:30 <br /> <br /> 24 HOUR CODE-A-PHONE: 588-7904 <br /> <br /> am performing work on a property ~ own or occupy, <br /> am a regi.tered builder OR the authorized representative SIGNATURE OF APPLLCANT: ~ 1~~ <br /> of a registered builder, <br />The work will be performed by 8 registered builder, <br /> <br />Other. <br /> <br /> this document, <br /> <br /> DATE: 11/03/92 TIME: 12:04:50 <br />OWNER: <br /> PALHER/GROSS CONSTRUCTION <br /> <br />57260000 RESIDENTIAL <br /> <br /> 9398 SILVER FALI_S HWY <br /> AUNSVILLE OR <br /> <br />USE OF BUILDING: <br /> <br />SE <br /> <br />20NTRAC1 CiTY UGB: OCCUPANT LOAP' <br />MARION COUNTY NO <br /> <br />SUBDIVISION <br /> <br />PHONE: <br /> <br /> :15 88 <br />250 609 152250_ SF <br /> <br />SITE NUMBER: 92-05874 <br />VALUATION: <br /> <br /> RANGE ZONE <br /> <br /> 2W AR5 <br /> RREG LOT CORNER: <br /> NO NO <br /> <br />MAP' <br /> <br />TYPE: ON-SITE SEWAGE <br /> <br />PERMIT OR APPLICATION NO: <br /> <br />CONTRACTOR,~NO. <br />PALMER/BROSo CONSTRUCTION <br /> <br />PliONE: <br /> <br />904~6i6 <br /> <br />WATER SUPPLY: PW <br />TEST HOLES READY: NO <br />SITE EVALUATION NUMBER: <br />EXISTING TANK SIZE: <br />EXISTING DRAIN FIELO LINES: <br />SEPTIC TANK PUHPED: <br />PREVIOUS NO. BEDROOMS: <br /> <br /> ITEM QUANTITY AMOUNT <br />STANDARD ON-SITE SYSTEM 1 $210.00 <br />SITE EVALUATION, FIRST LOT 1 $220.00 <br /> <br /> TOTAL ASSESSED FEES $450.00 <br /> PREVIOUS RECEIPTS $0.00 <br /> THIS RECEIPT $430.00 <br /> <br /> BALANCE OUE $0.00 <br />PAYEE: PALMER/GROSS CONSTRUCTION RECEIPT NO: 45704 <br />RECEIVED BY: CL ....................................... TYPE: OK CHECK ~: 5229 <br />SEE ATTACHED DOCUMENT FOR REQUIREMENTS OF ON'-SITE SEWAGE SYSTEM. <br /> <br />NOTE: THIS DOES NOT GR~NT OR IMPLY PERMISSION TO BUILD ON THIS PARCEL. PLANNING AND <br />ONSTRUCTION PERMITS MU~T BE OBTAINED BEFORE BUILDING OR SEPTIC INSTALLATION BEGINS. <br /> <br />PLAN REVIEW" BY DATE ~ CITY JURISDICTION: BY DATE ......... <br />REMARKS: SE & PERMIT <br /> <br />~ # MC 1 ~-56 REV, 4190 <br /> <br /> <br />