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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:$0 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />of a registered builder, <br /> <br />Other <br /> <br /> 14625 EASEL CT <br /> AURORA <br />USE OF BUILDING: <br /> <br />MAILING ADDRESS: <br /> <br />,1755 FI HAPI..,E <br />~ANIIY~ 0R 97015 <br />FHONE: 25,5-8355 <br /> <br /> 9~1.77--101 <br /> ....... CONSTRUCTION TYPE <br /> <br /> CONTRACT Glib UGB' <br />OR 9700 AURORA <br /> <br />RE. SIBENTtAL <br />OCCUPANCY; <br /> <br />iOCCUPANT LOAD~ <br /> <br />SUBDIVISION <br /> <br />...... K~'..S.E.L. COU~.T...F'HASE.. 2 <br /> <br />, MAP; <br /> <br />SITE NUMBER: <br />VALUATION: <br /> <br /> RANGE <br /> <br /> lW R 1 <br /> RI~EG. LOT CORNER· <br /> <br /> [40 NO <br /> <br />LOT: , BLOCK· SECTION: TOWNSHIP; <br />· 16 2 12 45 <br /> 0.'334 AC <br /> <br />TYPE: ON-SITE SESAGE <br /> <br />PERMIT OR APPLICATION NO: ?854852 <br /> <br />C. ONTRACT[II~.~ NO. 44877 <br /> Hem"/ Altuis Excava'b:i. ng L~:d <br /> <br />~ilver ton. 77381.,,.eeee <br />F~-IONE: 873-4347 <br /> <br />WATER SUPPLY: CW <br />TEST HOLES READY: <br />SITE EYALUATZON NUMBER: 4-,25-91 <br />EXISTING TANK SIZE: <br />EXISTING BRAIN FIELD LINES: <br />SEPTIC TANK F'UHPED: <br />PREVIOIJS NO,, BEDROOMS: <br /> <br /> I TEi'i QUAI,ITITY AMBUNT <br /> STANDARD ON,,,.$ITE SYSTEH :L <br /> <br /> TOTAL ASSESSED FEES $2,~5,,80 <br /> PREVIOUS RECEIPTS $0. (~0 <br /> THIS RECEIPT $255.00 <br /> <br /> BALANCE DUE <br /> <br /> PAYEE;; Hm~ry Alluis Excavmt~ng~Ltd INVOICE NO: 5~5;I, 7 <br /> RECEZVE~ BY: P~ .......... ~ ........... .,2,~ ............................. TYPE:', IN CHECK :~: <br /> <br /> SEE ATTACHED ~OCUMENT FOR REQUiREmENTS OF ON~SZ~E SEWAGE SYSTEM. <br /> * TNIS IS HOT A PERHIT. TNIS APPLICATIO~ HUST ~ THROUGH A REVIEW PROCESS WHERE THE <br />FOLOW]:N~,~UST DIE CO~PI_ETED. ~ ~'F~IS TNE R~SPONS:[BILZTY OF THE APPLICANT TO ASBUI-~E THAT <br />~i.,L Nl;. :E~SARY Ii, FOR~ATZON NBS Bg~N <br /> <br />PLAH REV:[FW: BY ................. DATE~ ................... <br />RENARN.S: S,: <br /> <br />CITY JUR]:SD]:CTION: BY ...................BATE .......................... <br /> <br /> OFFICE COPY <br />FORM # MC ~ ~-~6 REV, 4/90 <br /> <br /> <br />