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MARION COUNTY BUILDING INSPECTION <br />S;:NATOR BLDG. NO, 225 <br />220 HIGH STBEPT NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE: 588-5147 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />registered builder. <br /> <br /> CONT~AOT CITY; { UGB: ~ OOOUPANT ~AD: <br /> <br />~" "- '~'iq'~ 0S~--~3~'%r'~'~ <br /> <br /> i SITE NU~IBER: 94-84254 <br /> [ VALUAT]:ON: <br />SECTION'. TOWNSHIP: i RANGE'. ! ZONE; ,' MAP; <br /> <br /> U NI'~;~,~ OCI~NER; <br /> <br />TYPE: ON-SITE SEWAGE <br /> <br />PERNIT OR APPLICATION <br /> <br />CCI,Fi P, ACTOR, NO <br /> <br />1975 MAI)RONA AVE: S <br /> <br />PHONE: <br /> <br />9859392 <br /> <br />WA1ER SUPPLY: OW <br />'l'~::S';' HOLES REAl)Y." YES <br />SITE: EVALUATION NUMBER: <br />EXISTING I'ANK SIZE: <br />EX1STZN6 DRAIN FIELD LINES: <br />SEPTIC TANK PUNPED: <br />I:'R£¥IOUS NO, BEDROOMS: <br /> <br /> ]: I'EM QUANTITY AMOUNT <br />SITE EVALUA'I:(ON,~ FIRST LOT I $26~L, 8(,~ <br /> <br /> TOTAl,, AS~F. SSED FEE,~ $265. ~8 <br /> ( PEEVIOUS RECEIPTS $~,, ~B <br /> ,THIS F(ECEIP~' $265.08 <br /> <br /> BALANCE DUE $¢. <br /> <br />PA?;t{'.: f:IEDIERSEH,~ ERLAN I'-t IIqVOZC~ N~: ""; 61972 <br />RE'CEIVED BY: El TYF'E: ]:N (.HI'u, ~',: [~ <br /> <br />~EF: ATTACHED ~OCUMENT F'OI~ RE:QUZREMENTS OF' ON-SITE SEWAAE SYSTEM,. <br /> <br /> N(Yl'E: '/'HIS 1)OE..~; NOT (RANT OR INFLY PERMISSIOn, TO BUILD ON THIf~ FARC[d' " ..... ],_AN,- ' "11,:,," AND <br />OHSi'Rt. JC~'ZON P[:;F~H];iS kiUST ~E OBT~I,~E~ ~EF'ORE 'OUILI)ING OR SEF:"~'ZC :i:NS'TALLAT]:ON BEG']:NS,, <br /> <br />OFFICE COPY <br /> <br /> <br />