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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: 588-7994 <br /> <br />I am A registered builder OR ( ) the authorized representative <br />of a registered builder. <br />The work will be performed by a resistered builder. <br /> <br />this doaument. <br /> <br />,/S~TU$ ACDREss:ALLE' ,J~ KEN ........... I COI~S~;~T~I'E: . ............ I O~[~C~!'4~ J' ~L. <br /> ... .................. ' .................... <br />~ ' ~' ~ ~--'~,j,_. ~ CONTRACT CITY ~ U~8: OCCUPANT LOAO; <br />~, ~ /oTN F'L SE <br /> ~uo o s: ' <br />; ~ SUmO~WmON: <br />~ 7927 STONEFEIL~ CT <br /> <br /> · ~ ; <br /> <br />TYPE: OH-SITE SEWAGE <br /> <br />PERMIT OR APPLICATI0N NO: <br /> <br />CONTRACTOR, N0, <br />ALL. El*L, KEN <br />7927 STONEFEIL. I) CT <br />AUM~VIt_LE,, ORE 9732,5 <br />PFIONE: 749-18&0 <br /> <br />44866 <br /> <br />WATER SUPPLY <br />TEST HOLES READY: NO <br />SIT~ EYAI UAT~ON N~MBER: <br />EXISTIN{;"TANI~ SIZE~ ' <br />EXISTING DRAIN F'IEI..D LINES: <br />SEPT:ICTANE PIJMF'ED: <br />PREVIOUS NS. BEDROOMS: <br /> <br /> ITEM L'IUANTITY AMOUNT <br />SI'TE EVALUATION~ FIRST LOT I <'"~'~ <br /> · ~.~., 0 ,, 00 <br /> <br />TOTAL ASSESSED F'EE,~ <br />F'REVIOI S RECE~I.PTS <br />THIS RECEIPT <br /> <br />$220,, 80 <br /> <br />BALANCE DUE $0.00 <br /> <br />PAYEE: RECEIPT NO: <br /> <br />RECEI:VE;D BY: CR ............................................................ TYPE: CHECK :1~: 0 <br /> <br />SEE ATTACHED DOCUMENT FOR .REQUIREMENIS OF ON,SITE SEWAGE. ,SYSTEM. <br /> <br /> NOTE: THIS DO~iS N,O.T GRANT. OR IMPLY PERMISS.~ON.TO BuIbD ON TH,I~,S PARCEL. F'L,,ANN:[N; AND <br /> ONSTROCT20N PER,IT5 ~UST Bt~ OBTAINED BEFORE B'OIL~IN6 OR SEPI'II~ INSTALLAI'IO4 <br /> <br /> REMARKS:"' SE API.-IROVED' ~'OR SA,ID F~LTER. SYSTEMS., ~ PEcIF"'rC, . ,. AR:'~_,.. <br /> , DONALI) E,, WOO~)LEY, MARION COLINTY BU~[,,D'[N6 orrzc'[~L / ~y ~ <br /> <br />FORM. MC 15-56 R~, 4/~ OFFICE COPY <br /> <br /> <br />