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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:S0 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />of a registered builder, <br />The work will be performed by ~ registered builder. <br />Other_ <br /> <br />this document, <br /> <br />DAT[; <br /> <br /> 185 CLIFFORD AVE -,- <br />DE"'fROIT OR 97342 <br /> <br />3748 SW COMUS , <br />PORTLANI)~ OR 972;I, 9 ; SITE NUHBER: ~3-81527 : <br />PHONE: 245-8438 : VALUATION: <br /> <br />TYPE: ON-SITE SEWAGE <br /> <br />PERHIT OR APPLICATION NO: 9846816 <br /> <br />CONTRACTOR, NO,, 44077 <br /> Henry Allu',i.s Excavating'Ltd <br />400 Loaf Rd <br />~ilver ton,, ~7~81-8888 <br />FHONE: 872-4247 <br /> <br />WATER SUPPLY <br />TEST HOLES READY: -, <br />SITE EVALUATION NUMBER: <br />EXISTING TANK SIZE: <br />EXISTING DRAIN FIELD LINES: <br />SEPTIC TANK PUMPED: <br />F'REVIOIJS NO. BEDROOMS: <br /> <br />ITEM QUANTITY AMOUNT <br /> <br />$8.00 <br />$0.00 <br /> <br /> TOTAL ASSESSEI) FEES <br /> PREV:IOUS RECEIPTS <br /> THIS RECEIPT <br /> <br /> : BALANCE DUE <br /> <br /> PAYEE: Fte~lry Alluis E:~cavat~ng Ltd 'fN¥OICE NO: 4~064 <br /> RECEIVED BY: PM ' TYPE: IN CHECK ~: <br /> SEE ATTACHED DOCUMENT:: FOR ,REQUIREMENTS,OF ON-9ITE SEWAGE SYSTE~. <br /> ~ THIS IS NOT A PERHIT.: :THIS APPLIC~TI, ON HUST ~: THROUGH A REVIEW PROCESS WHERE THE <br />FOL, LOH~NL; NUST ~E COHPLETBD. ~T Z~ ~HE RESPONS~D[LZ'FY OF THE ~PPL~CANT TO ~,~,~UREC'¢' ~ THaT <br />~LL NECESSARY ~NF~R~T]DN::H~ ~EEN <br /> <br /> F'LAN REVIEW. BY_ Al'ES ....... CITY JURIS~ICTION: BY .................... DATE .................... <br /> REHARKS'.I REF': SE ~ENIAI~ ~4204~ <br /> <br /> <br />