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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 />H~.IN:[HI;.E:,~ R.I:CNARD & EL!ZABETH <br /> <br />Other <br /> <br /> ~NST~UCTIO ~ TYP~; <br /> <br /> 15:[09 oI:.C1ND ST NE l'O ~: <br />MAILING ADDRESS: ~U BOI'VISIO~; <br /> <br />F'.O- BOX 349 <br />AURORA,~ OR <br />PHONE: <br /> <br />F'ILE <br /> <br />RESIDEN')'IAL <br /> <br /> I-bAD: <br /> <br />PARCEL 2 <br /> <br /> SITE NUMBER: 94-~2854 <br /> VALOATION: <br /> <br />MAP; <br /> <br />J I i 0;,6S ] AC MO i NO <br /> <br />TYPE: ON-SITE SEWAGE <br /> <br />pEI~MlrT OR APPLt'CATIOI4 <br /> <br />CI)NT F;:A ,FJT OF~,~ IqO. <br />I,,iEZNINGI~';,~ R;rC, HARD& IF.I. IZABETN <br />P,,O. BOX S49 <br />ALIRC)RA,~ (iR <br />F'NONE: <br /> <br />WATER SUPPLY: CW <br />TEST HOLES READY: <br />SITE EVALUATION NUMBER: S80S8 <br />EXISTING TANK SIZE: <br />EXIS'flNG DRAIN FIELD LINES: <br />SEPTIC TANK PUMPED: <br />PREVIOUS NO~ BEDROOMS: <br /> <br /> ITEM QUANTI'f'Y AMOUNT <br /> STANDARD OH-SITE SYSTEM 1 $255.00 <br /> <br /> I'O'FAL ASSESSED FEES $255.00 <br /> PREVIOUS RECEIPTS $0~00 <br /> THIS RECEIPT $255.00 <br /> <br /> BALANCE DUE $0,,00 <br /> <br /> PAXEE: HEININGE~ RICHARD & ELI~ABE'¥H INVOICE NO: = "~- <br /> RECEIVI;D BY: PM TYPE: IN CHECK ~: 0 <br /> <br /> BEE A')TACHE~ DOCOMENT FOI~ REQUIREMENTS OF ON-SITE SEWAGE SYSTEM,, <br /> <br /> * THIS IS HOT A PERHIT. THIS APPLICATIOH HUST gGTHRDUGN A REVIEW PROCESS WHERE THE <br />F'OLI._0W'?I~.HUST BE COMPLETED. ITemS THE-RESPONSIBILITY OF THE APPLICANT TO ASSURE THAT <br />ALL ME(.ESSAR¥ INIZOEHA'rION HAS BEEN PROVIDED. <br /> <br />RlfiHARKS: e., <br /> S .... SlD SYS *NOTE: FII..E ~t92-524 UI'L IIq BOX-NO INFO ON FILM <br /> <br />QFF~CE COPY <br /> <br /> <br />