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MARION COUNTY BUILDING INSPECTION <br />SENA'fOR BLDG- NO, ~5 <br />220 HIGH STREET NE <br /> SALEM, OREGON ~T301 <br /> <br /> PHONE: 588-5147 8:00 - 4:30 <br />24 H(~UR CODE-A-PHONE: 5~-7904 <br /> <br />OATE: 12/2S/92 TINEs 11s04:27 <br /> ....... · ?Af'LST~ .................. 6^Tt=-~o'~Y: <br />DUNCAN, JA~ES E & DOROTHY Y :: 6J,38~-000 R~SIDENT~A,,, <br /> <br /> ............................... ocbO¢~bY: <br /> , CONSTRUCT[ON TYPE; <br /> <br /> 903~ ~ ST~YT'0H ~0 SE ~ ............................ <br /> AUHSVZL, LE OR 97325 ' ~f~ ~NI'Y ' ~¢: <br /> <br />SANE <br /> <br />PHONE: <br /> <br />8ITE NUMI~ER: <br />VALUATION: <br /> <br />LOT; <br /> <br />TYPE; ON-SITE SEWAGE <br /> <br />PERMIT OR APPLICATION NO: <br /> <br />CONTRACTOR. NO. <br />OUNCAN, JAMES E & I)ORO'THY Y <br />SAME <br /> <br />PHONE: 749-J~45 <br /> <br /> ~ 9S ; 2~ ; EFLJ 62 <br /> , 4 98 . AC : YE~ : NO <br /> <br /> j WATER SUPPLY: PW <br /> T~ST HOLES READY: <br /> ~SITE EVALUATION <br /> [XISTINB TANK SIZE: <br /> IEXISTING DRAIN FIELD LINES: <br /> / SEPTIC TANK PUMPEOt GVH FORT1 <br /> ~ PREVIOUS NO. BE~ROOHS: 4 <br /> <br /> I'i'EH QUANTITY <br /> AUTHORIZATIOH NOFZCE ," FLO, VISII' <br /> <br /> TOTAL ASSESSEQ FEE3 $].5o_0~ <br /> PREVIOU~ RECEIPTS <br /> <br /> BALANCE DUE $0. <br /> PAYEEs DUNCAN, JAMES E & DOROFHY Y ~ ~ ~ RECE'~'T' NO: 46787 <br /> <br /> SEE ATTACHED DOCUMENT P0R REQUIREME~T~ OF ON-S~TE SEWA~8 SYSTEM. <br /> <br />· THIS IS NOT A P~RMI~. THIS APPLI6AT~ON NuOT 60 THROUGH A REYIEW PROCE88 WHERE TNE <br />FOLL, ON,~6 NUS'¢ BE COMPLETEO. IT IS THE RESPONS~8ILITY OF Tide APPLIOANT TO ASSURE <br />ACk ~ECESSARY INFORMATION HAS SEEN <br /> <br />SEPTIC AUTH <br /> <br />CITY JURISDICTION: BY ....................... Ofll'E ....... <br /> <br />OFFICE COPY <br /> <br /> <br />