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PHONE:588-5147 8:00- 4:30 <br />24 HOUR CODE-A-PHONE'. 588-7904 <br /> <br />AliSBERRY ~ VALERY 753~360 ~ESIDENTIAL <br /> <br /> 897~ SFAW S~UAE R9 SE <br /> AUMSVILLE OR 97325 ~ARIQN COUNTY <br /> BUILDING= NO OF BEDROOMS: <br /> <br /> SAME: ~ 5ITE HU~BER~ 94-83969 <br /> PHONE: 749-3~45 _~l. VALUATIOW: <br /> <br /> f ~ 1. ~ AC ~ NO ~ NO <br /> <br />TYPE: OH-SITE SENA~ I WATER SUPPLY: PW <br /> TEST NOLE~ READY: YES <br /> SITE EVALUATION NUMBER: <br />PERHIT OR APPLICATION HO: 9~5882& <br /> EXISTING <br /> TANK <br /> SIZE: <br />CQNTEACTOR~ NO. 34916 ~ EXISTING DRAIN FIELD LINES: <br />STAYTON SEPTIC , ~EPTIC TAflE PUHPED: <br />STAYTON, 97383 <br />PHONE: 769-2382 <br /> <br /> ITEM <br />REPAIR - MAJOR <br /> <br />.... ':, QUANTITY AMOUNT <br /> I $125.00 <br /> <br /> PAYEE: STAYTON SEPTIC <br /> RECEIVED BY: MB <br /> <br /> SEE ATTACHED DOCUMENT ~ <br /> ~ THIS IS NOT A PERNiT~~ <br />F'OI.I...OWING MUST BE <br />AL[., NECCZSoARY <br /> <br />PL.(IH REVIEW: BY (:;f~ff <br /> <br />REMARKS; ,,~. MAJ. TH,. READY <br /> <br />$1~5.00 <br /> $0.00 <br />$125 00 <br /> <br /> $8.00 <br /> <br /> RECEIPT NO: 61394 <br /> :TYPE: CE CHECK ~: 15173 <br /> S~$TEM. <br /> · REVIEu PROCESS UNERE THE <br /> E APPLY'CANT TO ASSURE THAT <br /> <br />I~I)~'CTION." 9Y ............... D~TE ................. <br /> <br />OFFICE COPY <br /> <br /> <br />