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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 <br />CODE-A-PHONE 4:30 P.M. · 8 O0 A.M <br /> <br />I am a tegisl[ered bullUer OR ( I the aut~lorized representahve <br /> <br />The woYk will be performed by e reglsfeced builder <br />O~he¢ <br /> <br />DATE <br /> <br /> 10/30/85 TIME: <br /> <br />s~TuS^,O,~).PACIFIC RR (MEEY, ER FERTILIZER) <br /> <br />11598 NCCLELLAN RD <br /> <br />97325 <br /> <br /> ~ONT~ACT C;)TY UG8 OCCUPANT LOAD <br />MAR;ION COUNTY NO ,o of e~.,~oo~ <br /> <br />~NTA~T; ART GROSE <br />1795 16TH ST SE <br />PHONE~ 769-2330 <br /> <br />E~ALI~q 97302 <br /> SITE NUMBER; 8499 <br /> <br />TYPE: ON-SITE SEl~e~iE <br /> <br />PE;:~'~IT OR APPLICATION <br /> <br />CONTRACTOR, NO. <br />$O,PACI.FIC RR (NEEKER <br />CONTACT. ART GRQS£ <br />1795 - 16TH ~T SE SALE~ <br />PHONE; 789-2330 <br /> <br />19311 <br /> <br />NATER~UPPLY= <br />TEST HOLES READY: NO <br />SITE EVALUATION NUFIBER: <br />EX~STZNG TANK SIZE= <br />EXZSTZNS DRAIN FIELD L~NES~ <br />SEPTIC TANK PU~PED= <br />PREVI(TJSNO. BEDROOMS= <br /> <br /> TTEM <br />SITE EVAL. - FIRST 1000 GAL DE, F' <br /> <br />TOTAL ~D FEE~ <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />BALANCE DLIE <br /> <br />QUANTITY <br /> 1 <br /> <br />AMOJNT <br /> $175~00 <br /> <br /> $175.00 <br /> $175~00 <br /> $0.00 <br /> <br /> $0.00 <br /> <br />PAYEE= RECEIPT NO: <br />RECEIVED BY: ol TYPE*. CHECK #: <br /> <br />· ?~EE ATTACHED I:X:X:UI~IT FOR REX~U~[REMENTS OF ~-SITE ~E S~T~. <br /> <br />NOTE= THIS DOES NOT ~RANT OR II~Y PE~I~ION TO BUILD ON THIS PARCEL. PLANN]rNG AND <br />C~ION PERMIT~ ~ BE ~STAINED BEFORE BUILOIi~ OR ~$~TIC INSTALLATION BB3INS. <br /> <br />REMARKS: SE 1~7156 STO SYSTEN ~ <br />DONALD E. WCX3OLE~Y, t4ARiON COUNT5' BUILDING OFFICI~d_ / 8Y .... <br /> <br /> <br />