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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 /> RESIDENTIAL <br /> <br /> ~46~f4 KASE:L C1 NE <br /> <br />).375B CEDAR CT I,[E <br />AURORAe OR ?'Z~)B2 ~[TE NU~ER= 94-B2925 <br />PHONE; 678-5777 ,, VALUATION: <br /> <br /> (DE~H'. ...................... A ~EA'.~ ............... L ...................... UN I~G. LOt'. ~ GORNER~ <br /> <br />TYPE: ON-SITE SEWAGE <br /> <br />COI,17RA~TOR ~ <br />KENI)I;~ICI( H, MCINTIRE <br />1375e CEbAR ';f NE <br />~URORA~ OR ~7~2 <br />F HONE~: 678--o777 <br /> <br />WAFER SUPI:'LY: CW <br />TEST HOLES REAl)Y: <br />SITE EVALUATION NUMBER: <br />EXIB'I'INI; TANK SIZE: <br />EXISTING DRAIN FIELD LINES: <br />SEPTIC TANK PUMPI:"D: <br />PREVIOUS FIB. BEDROOMS: ~ <br /> <br /> :I. TEM ~UAN'ITTY AMOUNT <br /> STANDARD ON-SI I'E SY,~ f I:.M 1 $~,:,.¢,,~ <br /> <br /> TOTAL ASSESSE~ FEE~ <br /> PREV-IOOS RECEIPTS $~,, <br /> ~H%~ REBEIPT <br /> <br /> BALANCE ~I,IE $~., <br /> PAYEE: KENDRICK H. HCIN'rIRE INVQICE NO: <br /> RECEIVE~) B'(: pm .......................................................... TYF'E: IN CHECK ~; <br /> <br /> ,¢.t,E ATTACHEI) 90CUHENT :OR RE~UIREHENTS OF ON-SI'rE SEWAGE SYSTEM. <br /> <br /> ~ THIS IS NOT A PERMIT. THIS APPLICATION HU~T GO THROUGH A REVIEW PROCE~ WHERE THE <br />FC;I..L. OWING MOa? BE COHIL,.ETED. IT THE REGPONSI8iL.:[I'Y OF THE APPLICANT TO ASSURE THAT <br />ALi.., HECES~ARY .INFORMATION HAS BEEN PROVIDED. <br /> <br />REMAJ:i:K,S SS/Pr,'OPOSE 0 <br /> <br />CITY JURISDICTION: BY .................... DATE .................... <br /> <br />OFFICE COPY <br /> <br /> <br />