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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO. 225 <br />220 HIGH STRJ[ET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE: 588-5147 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE; 588-7904 <br /> <br />of a registered builder, <br />The work will be performed by a registered builder. <br />Other ,, <br /> <br /> DATE: 02/14/94 TIME: 16:i2:18 <br /> <br /> t2~9~ NEST S~YTON RD SE <br /> dUHSVILLE OR 97~25 '~ ~ ~UNTY ~ ~: 106OUPANT LOAD: <br /> <br /> Sift NUMBER: 94-80648 <br /> PHONE: V~LU~TION: <br /> <br /> ~ ~S ~ 1~ EFU i 60 <br /> <br />TYPE: ON-SITE SEWAGE <br /> <br />PEENIT OR APPLICATION NO: <br /> <br />CONTRACTOR. NO. 34916 <br /> STAYTON SEPTIC <br />41155 STAYTON SCIO OR SE <br />STAYTON, 97~85 <br />PHONE: ?69-2302 <br /> <br />9052887 <br /> <br />WATER SUPPLY: PW <br />TEST HOLES READY: <br />SITE EVALUATION NUMBER: <br />EXISTING TANK SIZE: <br />EXISTING ORAIN FIELD LINES: <br />SEPTIC TANK PUMPEO: <br />PREVIOUS NOt 8EOROOMS: <br /> <br /> ITEM QUANTITY AMOUNT <br /> REPAIR - MAJOR 1 $125.00 <br /> TOTAL ASSESSED FEES $125~00 <br /> PREVIOUS RECEIPTS $0.00 <br /> THIS RECEIPT $125400 <br /> (~"% BALANCE DUE $0.00 <br /> PAYEE: STAYTON SEPTIC kX~''t ~ RECEIPT NO: 55343 <br /> RECEIVED BY: OM2 _~ ' '.__ TYPE- OK CHECK ~, 14570 <br /> SEE ATTAOHEO OOCUMENT FOR,REQUIREMENTS OF ON-SITE SEWAGE SYSTEM. <br />* THIS IS NOT A PERMIT. THis APPLICATION MUST GO THROUGH A REVIEW PROCESS W~RE THE <br />FOLLOWING MUST BE COMPLETED. IT IS, THE. RESPONSIBILITv OF THE APPLICANT TO ASSURE THAI' <br />ALL NECESSARY INFORMATION HAS SEEN PROVIOEO~ <br /> <br />FOa~ ~ ~c ~ ~-s~ say. 4/~o 0 F IF lC E COPY <br /> <br /> <br />