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MARION COUNTY BUILDING INSPECTION <br />SPNATOR BLDG. NO. 225 <br />220 HIGH STREET N6 <br /> SALEM, OREGON 97301 <br /> <br /> PHONE:SSS-5147 8:00- 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />Other , , <br /> <br />HAMPTON, KE:LLY & VERMOIq I iRESIDEN'f'IAL <br /> <br /> 8673LLESHAW SQUARE RgOR ~7325 ~ <br /> AUHSVI <br /> COUNTY <br /> NO <br /> ~'~b:"6~ ~o~oo~: <br /> <br /> SAHE ~ SITE NUHBER: 94-88845 <br /> PNDNE: 362~44'7 [ V~LUATION~ <br /> <br /> :DE~TH: ~ AREA; ~ UNITS: ~ IRREG. LOT: ~ CORNER: <br /> <br />TYPE: ON-SITE SEI~IAI;E <br /> <br />PERMIT OR APPLICATII]H NO: <br /> <br />¢O;.ITRACTOR,~ NO. <br />HAMF'TDN~ I(ELLY & VERNON <br />S~HE <br /> <br />PI"IONE ~ ~62-8447 <br /> <br />9e532~4 <br /> <br /> WATER SUPPLY: PW <br /> TEST HOLES READY: <br /> SITE EVALUATIOW NUMBER: <br /> EXISTING TANK SIZE: 1000 <br /> EXISTING DRAIN FIELD LINES: <br /> SEPTIC TANK PUMPED: 2/7/94 <br />' PREVIOUS NO. BEDROOMS: ~ <br /> <br /> ITEM QUANTITY AHOUN'i* <br /> AUTHORIZATION NOTICE - FLD; VISIT 1 $168.68 <br /> TOTAL ~sSEssED FEES <br /> ~ ~ ~ ~ PREVIOU~ RECEIP:T~: ~. <br /> <br /> PAYEE~ HAMPTON. ~,~& VERNON RECEIP'r NO: . <br /> EF~EIVE'O BY: NBVF~ :::: : :: TYPE: CK CHECK :~; ~8~6 <br /> _: ..... :: ........ ======================================== ....................... :: .............. : .................. <br /> SEE ATTACHED DOCUMENT :SYSTEM. <br /> <br /> ~ THiS IS NOT A PERMIT. THIS APPL~CATI~ MUST ~O THrOUgH A REVIEW PEO~E~S WHERE THE <br />FOLLOWING ~LJST BE COMPLETED. IT IS THE RESPONSIBILITY OF THE APPLICANT TO ASSURE TNAT <br />ALL NECESSARY INFORMATION HAS BEEN PROVIDED. <br /> <br />FO~ ,~ Mc ~ ~,-,~ ~Ev. 4mo OFFICE COPY <br /> <br /> <br />