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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 />i~w~.I .............................................. } ~A~ ~oti .............. <br />: Sl~US ADD~ ]VZLL, I[ OR H~Q~Q~u~e: NJ) ~ OCCUPAN . <br /> <br /> PHONE: V~LUAI']:DN~ <br /> 3 i 2~ B~ IW AR 48 <br /> <br /> EXISTING TANK ~IZE: <br /> CONTRACIOR.~ NO. ~&415 EXISTING ~RA~i,I FIELD <br /> CNARLEY IJE',:~ BACKHOE SEPTIC TANK PUNPE~ <br /> PREV~OUB NO. <br /> <br /> ITEM QUANTITY AMOUNT <br />SITE EVAL.[JAT]iON~ EA. ADDL. LOT ], <br /> <br /> I'OTAL ASSESSED FEES $24(~,,00 <br /> PREVIOUS RECEIPT9 <br /> TH~S RECEIPT ~,, <br /> <br /> BALANCE DUE <br /> <br />PAY~I~: RECEIPT NO: <br />,, ',z . :- TYPE: CHECK ~: <br />REgE, IFL9 BY: cl <br /> <br />t:;EE ATIACHE~ DOCUHENT FOR REQUIREMENTS OF ,ON-SITE SEWAGE SYSTEM., <br /> <br />NOTE: TNIS DOES NOT GRANT OR 1MF~LY PERMISSION TO BOILD ON THIS PARCEL. PLANN:ING AND <br />OlI~TI ti{.] ION F'ERMIT,~ MUST }~E OBTAINED BEFORE BUILDING 01~ SM l I6 tNSIALL. A T.[ON BI~;L;]:N.9. <br /> <br />F, EMA f,J',.., <br /> <br />~:) CIN A!,,,r) E,, <br /> <br />SE :: STD .~YSI'E,M, RECOMMEblD STAKEOUT BEFOEE IN~IALL <br />WOODLEY~ HARION COONT¥ BUILDING OPFICIAL 7' BY ..... ~ .......................................... <br /> <br /> OFFICE COPY <br />FORM # MC 15-56 REV. 4/90 <br /> <br /> <br />