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MARION COUNTY BUILDING INSPECTION <br /> · - SENATOR fBLDG. NO, 225 <br /> 220 HIGH STREE'f NE -, <br /> SALEM, OREGON 9'~301 .... <br /> <br /> PHONE; 588-5147 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />SJGNATURE OF APPLICANT: ......................................... <br /> <br /> DATE: 07/22/92 <br />SITUS AO§~E~_EY :' STEVE <br /> <br />TIME: <br /> <br /> 139 4T.H ST <br />use or <br /> <br />" 'b'R '"973;~2' <br /> <br />0~TR0Z'f ....... ~d ........ <br /> <br />o~fB~,¥R T I A L <br /> <br />1804 P'c'PPERTREE C'f' <br />SALEH OR ¢7306 <br /> <br />TYPE: ON-SITE SEWAGE <br /> <br /> PATTON <br /> <br /> SITE NUMBER: ¢2-02515 <br />......... ~6~NSH'm; ....... V~I~TI0'N:' <br /> <br />..................... ' ICIR'B~, gOT: .... bO'RN~: .... <br /> 1 10 5 R <br /> .......... """ ' ......... ":' ' <br /> 105~0, SFNO <br /> <br />R~RMIT OR APPLICATION NO: 9041421 <br /> <br />CONTRACTOR, NO. <br />STANLEY,STEVE <br />1804 PEPRERfREE CT <br />SALEN OR 97306 <br />PIA()NE: ~78-1602 <br /> <br />W~TER SUPPLY: CW <br />TEST HOLES READY: <br />SITE EVALUATION NUMBER: 41131 <br />EXISTIN~ TANK SIZE: <br />EXISTING DRAIN FIELD LINES: <br />SEPTIC TANK PUMPED: <br />PREVIOUS NO. BEDROOMS: <br /> <br />2 <br /> <br />MAP: <br /> <br />10-5 <br /> <br />ITEN QUANTITV ~HOUNT <br /> <br />STANOARO ON-SITE SYSTEIt <br /> <br />",2~F~EE: STANLEY,ST(VE <br /> RECEIVED BY: JT <br /> <br />TOTAL ASSESSED FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />BALANCE DUE. <br /> <br />INVOICE NO: <br />TYPE; OK <br /> <br /> $210.00 <br /> <br /> $210.00 <br /> $0.00 <br /> $210.00 <br /> <br /> $o.oo <br /> <br /> 45475 <br />CHECK ~: 1954 <br /> <br /> SEE ATTACHED OOCUHEN~ FOR REqUIREMENTS'OF ON'SITE SEWAGE SYSTEH~ <br /> <br />* THIS iS NOT A PERMIT. THIS APPLICATION MU~T 80 THROUCN A REVIEW PROCESs WHERE THE <br />FOLLOWING MUS~ BE COMPLETED. 1T IS THE RESPONS[8ILITY OF TNE APPLICANT TO ASSUR~ l'MAl <br />ALL NECESSARY iNFORMATION NAS SEEN PROVIDED. <br /> <br />PLAN REVIEW: ~Y__CT_6~ ~',._4~'~_ DATE~_~./C/_~Z~-- CITY 3URiSDICI';[ON: BY ....... DATE <br />' -- <br /> <br />OFFICE COPY <br /> <br /> <br />