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MARION COUNTY BUILDING INSPECTION <br /> SENATOR BLDG. NO. 225 <br /> ' 220 HIGH STREET NE <br /> 1 <br /> , . SALEM, OREGON 9730 .._./~ ~,/~" <br /> .... PHONE; 588-8147 8:00- 4:30 ' <br /> <br /> T~orkw be ~e¢ocmed by,registered builder, DATE ............ <br /> <br />~ff0~ ~ ................. CONSTRUCTION TYPE; OCCUPANCY'· <br /> <br /> 1 CON~'~'~'iT~F ......... ~ ................. dCGUPANT LOAD: <br /> lt405 JAMES BAY SE <br /> AUMSVILLE OR 97~2§ MARION COUNTY~ NO <br />MAILING AODRESS ~UeOIVISION; <br /> <br />SAME / SITE NUMBER: <br />PHONE: 749-1287 L VALUATION: <br /> <br />TYPE: ON-SITE SEWAGE <br /> <br />PERMZT DR APPLICATION NO: ~55438 <br /> <br />CONTRACI'0R~ NO. <br />HOWELL/HOOYMAN VIVIAN ~ ..... ~ ...... ., <br />8AHE '" <br /> <br />PHONE: 74~-1287 !,,::,¢* <br /> <br />WATER SUPPLY: PW <br />TEST HOLES READY: NO <br />SITE EVALUATION NUMBER: <br />EXISTING TANK SIZE: <br />EXISTING DRAIN FIELD LINES: <br />,SEP,TI~ TANK PUMPED. <br />PREVIOUS NO. BEDROOMS: <br /> <br /> ITEM <br />SI'ANBARD ON-SITE SYSTE <br />SITE EVALUATION, FIRS~ <br /> <br />PAYEE~ <br />RECEIVED BY: cl <br /> <br />SEE AfTACHED <br /> <br /> FEES <br />>TS <br /> <br />QUANTITY <br /> 1 <br /> 1 <br /> <br />AMOUNT <br /> $255.00 <br /> $~6o.00 <br /> <br />$o20,,00 <br /> $0.00 <br />$520,,~0 <br /> <br />~ECEIF'T NO: 57900 <br />TYPE: CK CHECK ~: 850 <br /> <br />;TEM. <br /> <br />NOT~: THIS <br />ONSI'RIICTION <br /> <br /> PLAN REVIEWS: BY <br /> REHARI(S: SE/SS <br /> <br />TH: ~¢ <br /> <br />BEFORE B <br /> <br /> THIS PARCFL. PLANNING AND <br /> SEP'I'I6 ZNSTALL, ATION BEGINS. <br /> <br />C!.TY JURISI)ICTION: BY .................... DA'rE ................... <br /> <br />FORM # MC 15.56 REV, 4/90 0 F F I C E COPY <br /> <br /> <br />