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FOR OFFICE USE ONLY <br /> <br /> MARION COUNTY BUILDING iNSPECTION <br /> 220 High $~fee! NE <br /> ,~lem: OR 97301 <br /> <br /> 8 00am-4 3Opm Phone $~$-5~47 <br /> Cgde-A-Ph~e ~8-~04 <br /> FAX 5~-~48 <br /> <br /> SITE EVALUATION APPLICATION <br />COMPLETE ALL SECTIONS, 1 THROUGH 4 <br />1. Loc3{ion of Installation <br /> <br />3 Septic mtormation (Check where applicable) <br /> <br />W,:ve: Suppl~ W'~II ~ City [] Spnng [] <br /> <br />4. Fee Schedule <br /> <br />Rgcgipt No- <br /> <br /> ..... <br /> <br />Test Holes Ready: <br /> <br />Will Call When Tes[ Holes Regidy:: <br /> <br />This is a technical report for on-site sewage disposal only and does not grant or <br />imply permission to build on this parcel. Planning approval, construction and septic <br />permits must first be obtained before building or septic installation begins_ <br /> <br /> <br />