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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 /> DATE: 0~/07/74 I'IHE: 10:24.'01 ! ) ................... <br />mTds AOO~E'~; , .... , <br /> WILKINS,~ ~ASON ~ R[olDLNTIAL <br /> <br /> OR ~7342 QETROIT NO i <br /> '~ETROZT ~ : <br /> <br /> ~ PATTON A~DITION <br /> 387& PLEASANTVZEW DR NE <br /> KEIZER OR ~73~L~ SITE NUNBER: <br /> <br />75 J.:~5 10125, SF HO NO <br /> <br />TYPE: OH-SITE SEWAGE <br /> <br />PERHIT OR APPLICATION <br /> <br />COHTRACTOR~ HO, ~6421 <br />~EV:[N' S BOCKHOE <br />FO BOX 465 <br /> <br />PHONE: 854-37?7 <br /> <br />9~53318 <br /> <br />WATER SiJPPLY: CW <br />'rEST HOLES READY: <br />SITE EVALUATION NUHBER: <br />EXISTING TANK SIZE: <br />EXISTING BRAIN FZELD LIHES: <br />SEPTIC TANK PUMPED: <br />PREVIOUS NO. BE~ROOMS: <br /> <br />ITEH QUANTITY AMOUNT <br /> $0.00 <br /> <br /> TOTAL A~SESSED FEES <br /> PREVIOUS RECE I F"I'S $.9.6'8 <br /> THIS RECEIPT <br /> <br /> BALANCE DUE <br /> <br /> PAYEE: KEVIN'S BACKHOE¢~ ]'.NVOICE N~: , ,55778 <br /> RECEIVED BY: MB~{]_/~_.~"Z~_. .. ~ TYPE;: 'IN CHEbK <br /> ,..:.,_,::..: ......... ::::::::::::::::::::::::::::::: .................. :,,_: ............ <br /> SEE ATTACHE~ QOCUMENT FOR EEQUIREHEHT8 OF ON-SITE SEWAGE SYSTEM., <br /> <br /> * THIS IS HOT A PERHIT. ,THI~ APPLICATION HUST ~ THROUGH A REVIEW PROCESS WHERE THE <br />FOI[_OWIH~ HUST BE COMPLETEg. ZT IS THE RESPONSIBILITY OF THE APPLICANT TO ASSURE THAT <br />A.~ NE[ESoAEY INFORMATION HAS BEEN PROVIDED~ <br /> <br />PLAN REVIEW: BY ............ OATE ....................... <br /> <br />REMARKS: PRECOH~TRttCTION STAKEOUT <br /> <br />CITY JUI:<]:SDICTION: BY .................... :()ATE ............................ <br /> <br />*o~ ~ ~c ~s-~ Re~. ~ OF FICE COPY <br /> <br /> <br />