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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 />The work will be performed by a registered builder. <br />Other. <br /> <br />SIGNATURE OF AI2PLICANTZ <br /> <br />8231 fl SANTIAM HWY <br />AUMSVILI_E <br />PHONE: 749-207e/ <br /> <br />SITE NUMBER: <br />VALUATION: <br /> <br />TYPE: ON-SITE SEWAGE <br /> <br />PERH~T OR APPL/CATIOH NO: <br /> <br />CONTRACTOR~ NU, <br />BAKER~ CHUCK <br />8231N SANTIAM NWY <br />AOflSVILLE <br />PHONE: 749-207~ <br /> <br />37962 <br /> <br />WATER SUPPLY: PW <br />'rEST HOLES READY: YES <br />BITE EVALUATI0N NUMBER: <br />EXISTING TANK SIZE: <br />EXISTING DRAIN FIELD LINES: <br />SEPTIC TANK PUMPED: <br />PREVIOUS NO. BEDROOMS: <br /> <br /> ITEH QUANTITY AMOUNT <br />SITE EVALUATION~ FIRST LOT 1 $265.00 <br /> <br /> T0TAL ASSESSES FEES $265,00 <br /> PREVIOUS RECEIPTS $265.00 <br /> THIS.RECEIPT $e.00 <br /> <br /> 'BALANCE ~UE $0,00 <br /> <br />PAYEE: RECEIPT NO: <br />RECEIVE~ BY: cl TYPE: CHECK 8: 0 <br />SEE ATTACHED DOCUNENT FOR REOOIREMENl:S OF ON-SITE SEWAGE SYSTEM. <br /> <br />NOTE: THIS DOES NOT GRANT OR IMPLY PERMISSION TO BUILD ON THIS PARCEL. PLANHING AND <br />ONSlR lIE, lION PERMITS MUST I;4E OBTAINEB BEFORE BUILDING OR SFPTIC INSTALLATION BEGINS. <br /> <br /> RJ:,;HARKS: SE.., -approved for Std syste~ ~/ ret:o~lmm~ded stakeout <br /> <br />FORM # MC 15.56 R~V, <br /> <br /> <br />