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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-PHONE: 588-7904 <br /> <br />Other <br /> <br />this document. <br /> <br />'bWN~; DATE: .02/2A/BA .... <br /> <br /> OVERFIELD, MARK <br />I~yVSAOD~ESS; <br /> <br /> 23640 WISTERia DR NE <br /> AURORA OR 97002 <br /> <br />USE OF BUILDING; <br /> <br />MAILING AODR£BB~ <br /> <br />MARION COUNTY NO <br /> <br />SUBDIVISION <br /> <br /> PO BOX 239 ....................................................................................... <br /> ~UBBARD ORE,ON 97032 SiTE NUMBER: 94-0080~ <br /> PHONE: 981-718~ VALUATION: <br /> <br /> gdT' 8[OOK~ ...... ~EOTION ............... %~SN P RAN6~: <br /> <br /> ~ il ....................... AS .................. i~ ........ <br />i'WI'~TH: IbBP~' ' ARE~ UNITS' ~REG, LOT <br /> 78 <br /> 2¢2 <br /> SF YES [ NO <br /> <br />TYPE: ON-SITE SEWAGE <br /> <br />PER~!T OR APPLICATION NO: 9053139 <br /> <br />CONTRACTOR, NO, <br />OVERFIELD, MARK <br />PO BOX ~39 <br />HUBBARD OREGON 97032 <br />PRONE: 981-7187 <br /> <br />~ATER SUPPLY: CW <br />TEST HOLES READY: <br />SiTE EVALUATION NUMBER: <br />EXISTING TANK SIZE: I000 <br />EXiSTiNG DRAIN FIELD LINES: <br />SEPTIC TANK PUMPED: 2/8/9~ <br />PREVIOUS NO. BEDROOMS: 3 <br /> <br />276 <br /> <br /> ITEM QUANTITY AMOUNT <br />AUTNORZZATION NOTICE - ELD. VISIT ~. $~_60.00 <br /> <br />TOTAL ASSESSED FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />$160.00 <br /> $0.00 <br />$160.00 <br /> <br /> ~ A~A~C~ DUE $0_00 <br />PAYEE: OVERFIELD, ~ARK ~ ' ' RECEIPT NO' 55596 <br />RECEIVED BY: DM2 %.'"'}'-----~ TYPE' ~¢ <br />SEE ATTACHED DOCUMENT FOR REQUIREMENTS OF ON-SITE SEWAGE SYSTE~. <br /> <br />* TNIS IS NOT A PE~IT. ~IS ~PLICATION.~UST ~ ?NROUGH A REVIEW PROCESS WHERE THE <br />FOLLOWING MUST BE COMPLETED. iT iS THE RESPONSiBiLiTY OF TEE A?PLiCANT TO ASSUR~ <br />A55 NECESSARY INFORMATION HAS BEEN PROVIDED. <br /> <br />PLAN REVIEW: BY~ DATE ~ -~'~ CiTY JURISDiCTiON: BY DATE <br />REMARKS; <br /> <br />~OBm, ~c ~s-~ ~Ev, ~ OF FICE COPY <br /> <br /> <br />