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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO, 225 <br />~20 HiGH STREET NE <br /> SALEM, OREGON 97801 <br /> <br /> PHONE: 588-5147 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />FIL'E <br /> <br />of a registered builder, <br /> <br />Other. <br /> <br />this document. <br /> <br />8201 KASA LN <br /> <br />823:[ N SANTIAM H!.~Y <br />AUMSVILLE ~ SITE NUNBER: <br />PHONE: 749-2~79 ~ VALUATION: <br /> <br />TYPE: ON-SITE SEWAGE <br /> <br />PER~IT OR ~PPLICATIOH NO= 9857118 <br /> <br />CONTRACTOR~ NO. <br />~AK~R, CHUCK <br /> 2~1 N SANTIAM HWY <br />AUNSVILLE <br />PHONE: 74~-2079 <br /> <br />WATER SUPPLY: pw <br />'rEST HOLES READY: <br />SITE EVALUATION NUMBER: 57?62 <br />EXISTIN~ TANK S~ZE: <br />EXISTING DRAIN FIELD LINES: <br />SEPTIC TANK PUMPED: <br />PREVIOUS NO. BEDROOMS: <br /> <br /> I TEH BUANT I TY AMOUNT <br />STANDARD ON-SITE SYSTEM 1 $,~,5o.00 <br /> <br />TO~AL ~SSESSED FEES <br />PREVIOUS RECEIPTS <br /> ISRECEIPT <br /> <br />$255.00 <br /> <br /> $0.00 <br /> <br />$255.00 <br /> <br /> PAYEE: RECEIPT NO: <br /> RECEIVED BY,~ cl ................................... TYPE: CHECK ~:: 0 <br /> <br /> SEE ATTACHED DOCUMENT FOR REOUIREMENIB OF ON-SITE SEWAGE SYSTEH. <br /> <br /> * THIS IS HOT A P[RHITi THIS APPLICATION ~ST~ THROUGH a REVIEW PROCESS WHERE THE <br />FOLLOW?I~ fl~ST BE COHPLETEQ. IT ~8 THE RESPONSIBILITY OF THE APPLICANT TO ASSURE THAT <br />ALL NECE5~ARY INFOEHATION HAS BEEN <br /> <br /> PI,,AN REVIEW: BY ..... DATE.. _ CITY JURISDICTION: BY .................. DATE ....................... <br /> <br /> REhARK,9; *~baI d~m for s(d mymte~*.s~akeout re~oMmended~ repor~ Mailed <br /> <br /> <br />