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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 />of a registered builder. <br />The work will be performed by 8 registered builder, <br />Other <br /> <br />; owNE~)Al~!.. 10/~ 8/9 TIME= 1 ~.~ ~2,~ 49 fax LOT; <br /> <br /> ROUMD MELVIN & EU~;[CE i~782-~e <br />~TU8 ADDRESS: ' CONSTRUCTION TYPE: <br /> <br /> CA rEGORY: <br /> <br />I' ES 1, DEN f ,I. Al_ <br /> <br />i DfZTROIT OR 97~42 ~ETRfJlT <br /> <br /> PO ~OX 988 <br /> PHONE: 749-'17~2 VALUATION: <br /> <br />TYPE: ON-SITE SEWAGE <br /> <br />PERMIT OR APPLICATION <br /> <br />CONTRACTOR~ NO. <br />ROUND~ MELVIN & EUMICE <br />PO BOX 9~0 <br />AUMSVILt..E OR 97352 <br />PNONE: '749-I7¢~2 <br /> <br />WATER SUPPLY: CW <br />TEST HOLES READY: YES <br />SITE EVALUATION NUMBER: <br />EXISTING TANK SIZE: <br />EXISTING DRAIN FIELD LINES: <br />SEPTI~ TANK PUMPED: <br />PREVIOUS NO. BEDROOMS: <br /> <br />ITEM QUANTITY AMOUNT <br /> <br />SITE EVALUATION~ <br /> <br />FIRST LOT 1 $265,00 <br /> <br />TOTAL ASSESSE~ FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />$26%00 <br /> $0,.00 <br /> <br />BALANCE DUE ¢0. ¢o <br /> <br />PAYEE: INVOICE NO: <br /> <br />RECEIVED BY: CL_ ..................................... TYPE: CHECK :~: 0 <br /> <br />SEE ATTACNED DOCUMENT FOR REQUIREMENTS OF ON-SITE SEWAGE SYSTEM. <br /> <br />NOTE: I'HIS DOES NOT GRANT OR IMPLY PERMISSION TO BUILD ON THIS PARCEL. F'L. ANNINF~ AND <br />ON,~TkUCT,[OII PEiRMITS MUST BE OBTAINED BEFORE BUIL, DING OR SEPTIC INSTALLATION BEGINS, <br /> <br />REMARKS: SE PARTIT:t, ON: OKAY FOR STANDARD SYSTEMS AS FIELD STAKED F~R,d. OCATION SEE SITE <br /> F'LAN OF S'f'A[kI!.O~T DATED 10/17/94. II} [J <br />DONALD E. WOODL. EY, MARION COUNTY BUILDING OFFICIAL / BY ............... [~ ........................................ <br /> <br /> <br />