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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO- 225 <br />220 HIGH STRJ~£T NE <br /> SALEM~ OREGON 97301 <br /> <br /> PHONE: 588-5147 E:O0 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br /> ~4 a registered builder, . <br /> The work will be performed by a regJs~eretJ builder. <br /> Omcr, <br /> <br /> DATE: 02/14/94 TINE." 16:12:18 <br />:'~*~: ccitt,' ~'~ ......................................... ~;';' .............................. ~.~o~: , .... <br /> ~ RESIDENTIAL <br /> .............................................................. ~ ............................. OONSTRUOTtON TYP~: .----- --~Bad~: ................ <br /> i2~9~ WEST STAYTON RO SE i~ ............. .'"'-'~O~k~-'~X~: <br /> AUMSVILLE OR 97~25 ~ ~UNTY <br /> <br />PHONE; <br /> <br />TYPE: ON-SITE SE#AGE <br />PERMIT OR APPLICATION NO: <br />CONTRACToR~ NO. ~49Z6 <br />STAYTON SEPTIC <br />4ii.55 STAYTON S010 OR SE <br />STAYTON~ 97585 ..... '" <br />PHONE: 7~-~302 <br /> <br />VALUATION: <br /> <br /> 5. UNI'¢~ ,]~ LOT,~O0 I~R: ." <br />............ ..................... .............................................. <br /> WATER SUPPLY: PW <br /> TEST HOLES READY; <br /> 9052887 SITE EVALUATION NUHBER: <br /> EXISTING TANK SIZE: <br /> EXISTING DRAIN FIELQ LINES: <br /> SEPTIC TANK PUMPEO: <br /> ,,...... .... <br /> <br /> ITEM ..... ., , <br /> REPAIR - MAJOR QUANTITY AMOUNT <br /> · , ',' ". '"" I $i25.00 <br /> · .' '"" -..~OTAL, A~SES'SED, FEEs $125. O0 <br /> : ,'PREVIOUS RECEIPTS $0. O0 <br /> ', ,:,',',' '~'","', :" '7.:~.~Nb~'.:Ou~ "·" ~o.oo <br /> PAYEE: ST~YTON SEPfZC ':':"":' '":"';"~'""¥"::"':'~':'~" "': :. '." :"' ,' ".:" RECEIPT NO 55~4~ <br /> <br />SEE RTT~CHEO OOCUHENT ~OE..'.EEQU~EE~EN/~ aF,.,,~N,-SI. IE. 'SE, N~GE SYSTEH. <br />ALL flECE$SAEY INFORMATION, HAS'.':SEEN ,PROVI~ED,~,, .'..' ' ,' ' : 0 ASSURE THAT <br /> <br /> .... ........... D~TE <br /> REH~RKS: H~OR REP~ZR ............... <br /> <br />OFFICE COPY <br /> <br /> <br />