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MARION COUNTY'BUILDiNG INSPECTION <br />SENATOR ~LDG, NO. 226 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE: 588-5147 8:00 - 4:30 <br /> <br />The Work wi, be performed by ~ regTste~ed build~r, <br />Other <br /> <br />OWNER: <br /> BETHEL. ~ARRELL <br /> <br /> AU~Vi LLE OR 9?325 <br /> <br />RE~iOEN1 <br /> <br />PO BOX 623 <br />S'I AYTON <br />PHONE: 769-28'1¢. ~ ~ITE NUI'C~ER: 92-01502 <br /> ; VALUAT [~: <br /> <br />fYPE: ~-$1'I'E SEWAGE <br /> <br />PE~I'I' OR APPLICA'Ti~ NO= 9039389 <br /> <br />BETHEL, DARRELL <br />S'rAY'I'~ 9'1383 f.~;,~'"~ ./ <br />~E: 76g-287~ <br /> <br />FILTER <br /> <br />WATER .~AJ PPLY: <br />TE~T HOLE8 READY= <br />SiTE EVALUATION NU~3ER: 83-'i948 <br />~iSTING 'r~K SIZE: <br />~iSI'~NG DRAIN FIELD L~NES: <br />SEPTIC T~K <br />PRE~ ~S NO. <br /> <br />C~AN't I TY AHOUN T <br /> <br /> '/OTALAZ%~ED FEES <br /> PREVI,OUS RECEIPTS <br />.. 'f:HIS RECEIPT" <br /> <br />'l $355_00 <br /> <br /> $365.00 <br /> $0.00 <br /> $365.00 <br /> <br /> $0.00 <br /> <br /> BALANCE CUE <br /> <br /> PA,.Y, EE: ~E'I'HEL~. OARRELL .. ... i'' RECEiP'I' NO: <br /> <br /> SEE ATTACHED ~u~ENT FOR RE~IR~ENTS OF' ~75ITE SEWAGE <br /> <br />~C~NG ~ST BE ~LET~D. ~T, ~.'THg. ~Si~iTY OF TH~ APPL~O~T TO ~RE THAT <br /> <br />REf'4ARKS: 5ANO FILTER <br /> <br />OFFICE coPY <br /> <br /> <br />