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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG, NO. 225 <br />220 HiGH'STREET NE <br /> SALEM, OREGON 9730'1 <br /> <br /> PHONE: 588,5147 8;00 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7g04 <br /> <br /> WILLAMETTE NA'ri~AL FOR~'F : <br /> <br />HC 73~ CITY 97260 ~/~ ;~ n ..... ~. <br /> <br /> ............... ~ :, ............ ~.~... _~ ......... 5~ ...... ~ - <br /> S.8 AC s NO NO <br /> <br />TYPE: ON-S41'f'E SENAGE <br /> <br />PERMIT OR APPLiCArtoN NO: 9835157 <br /> <br />C'ON'FRA~'I'OR, NO. <br />WiLLAJV1ET'YE NATIONAL FORES'f <br />~E'r~K)l'I' RANGER <br />HC ?3 80X 320 ~ILL CiTY <br />PHONE: <br /> <br /> i T ~1'4 ,,,. <br />SiTEEVAI_. - Fl~.3't' 1000 GAL C~F <br /> <br />PAYEE: W1LLA~E'¥T~ NATIONAL FOREST <br /> <br />NATER SUPPLY: ~ <br />TEST HOLP..~ READY: 9-15-g! <br />511'6 ~VALUATION <br />EXISTING TANK SIZE: <br />gXISTING DRAIN FieLD LIN~ <br />SEPI[C T~K ~MPEO: <br />PRk~I~S NO. <br /> <br />PREViOU~ R~EIPTS <br />THiS R~CEIP'r <br /> <br />BALANCE <br /> <br />QU~NIITY <br /> <br /> $180.0U <br /> <br />$0, O0 <br /> <br />REC~iP'I' NO: <br /> <br />RECE],VEO BY: c"l TYPE: CA CHECK <br /> <br />SEE AT'f'ACHED [XDCUMENT FOR REQUiRF-~ENT$ OF 0N-SiTE SE~AG~ SYSTEM. <br /> <br />NOTE: TH~S DOES NOT GRANT OR IMPLY PERDIISSiON TO BUILD ON THi~ PARCEL~ PI_~NNiNG AND <br />G~NSTRUCTiON PER~tT~ ~LIST E:E C~ITAiNE. D 8~1=0R~ 8UfLOiNG OR SEPTIC INSTALLATION BEG,[NCJ. <br /> <br /> ....... ,,Y ............. ........................ <br /> <br />OFFICE COPY <br /> <br /> <br />