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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG, NO, 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97;301 <br /> <br /> PHONE: 588-5147 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />lamaregisteredbuilderOR( )theauthorlzedrepresentative <br />of a registered builder, <br />The work will be performed by cz registered builder, <br />Other <br /> <br />OWNER'. DA't)~';: 04//4/~74 <br /> <br /> CONI...EY, MIKE <br /> <br /> 18244 HZI..L CREEK R~ <br />AIJ~SVlI.,.LE: OR 97 ...... ~ MA~IO~ COUNTY~ N] <br /> <br />.... <br /> <br />SILVER'~ON. OR 97381 ~ S~TE HU~BER: 94-~29~ <br />PHONE: 873-117~ ,, VALUATION: <br /> <br />TYPE: ON-SITE SEWAGE <br /> <br />~ER,,HTT OR APPLICATION NO: ~ <br /> <br />WATER SUPPLY: PW <br />TEST HOLES READY: <br />SITE EVALUATION NUMBER: <br />EXISTING TANK SIZE: 1080 <br />EXISTING DRAIN EIELD LINES: <br />SEPTIC TANK PUMPED: <br />PREVIOUS NO. BEDROOMS: <br /> <br /> TOTAL ASSESSE~ FEES <br /> PREVIOUS RECEIPTS $160.60 <br /> THIS RECEIPT $~0.00 <br /> <br /> BALANCE 'DUE $0.,00 <br /> <br /> RECEIPT NO: <br />................... TYPE: CK CNECK ~: 350 <br />~EMENTS OF ON-SITE SEWAGE SYSTE~. <br />LICATION H~T GO THROU&H A REVIEW PROCES~ W~E~E THE <br />:THE RE~PON~I~EITY OF THE APPLICANT TO AS~}URE THAT <br />PROV~BED. <br /> <br />RIFHARKS: <br /> <br /> CITY JUR]:SDI:CTION: BY .................... <br /> <br />OFFICE COPY <br /> <br />I)ATE ......................... <br /> <br /> <br />