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MARION COUNTY BUILDING INSPECTION <br />SENATOR IqLDG. NO. 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE: 588.-~147 8:00 <br />24 HOUR CODE-A-PHONE: 5~8-7904 <br /> <br />I =,ma registere~J bultde? OR { ) t he a uthoH~ed representative <br /> <br />DATE; ........... <br /> <br />ROUND~ ~ELVIN & E. UMICE <br /> <br />· ~tM~:-,1~,~2~4~ ................. <br /> i~702-~0~ RESIDENTIAL <br /> ....................... fC6WST~0~N'~; ........ ~CdO~ANCY: <br /> <br />; DETROIT OR 97~42 ~ETEOIT ~NO <br /> <br />PO BOX ?88 <br />AUHSVILLE OR ~73§2 <br />PHONE: 749-1762 <br /> <br />~ D£TPJOIT_J_~EE...SH.O~EA ........................ <br /> ~AITE NUH,~EE= <br /> LUATION: <br /> <br />TYPE= ON-SITE S~E <br />PEP, HIT OR gtPPLICATION NO= 5~27 <br />CONTRACTOR, NO. <br />ROUND~ MELVIN & EUMICE <br />PO BOX ~00 "'"":;""'" '"' : ' <br />AUMSVILLE OR E7352 " <br />PHONE: 74~-17&2 , . <br /> <br /> WATER SUPPLY: CW. <br /> TEST HOLES READY. YES <br /> SITE EVALUATION HU~BE~ <br /> EXISTING TANK SIZE: <br /> E×ISTIN~ ~RA~N FIE~9 LINES= <br />,. SEPTIC TANK PUMPED. <br /> PREVIOUS NO. BEDROOMS: <br /> <br /> ITEH QUANTITY AMOUNT <br />SITE EVALUATIONw FIRST ,LO~,",,,' ~ ' <br /> · ',, I <br /> <br /> ..... TOTA~"ASSESSED, FEES <br /> .. · ...:'": ·':PREVIOUS RECEIPTS $245.00 <br /> ~ '. 'THIS RECEIPT <br /> <br />: . <br />PAYEE~ ....... "'":'"'":'":'"" ' ~ '" <br /> '" '"'.':":'"'.. ' ..................... ZNVOICE <br />RECE~VE9 ~y: CL · ..' .....· ......... ...... <br /> ..........-'--~ -- ...... _ ,. .......... .~ ,, TYPE: ONECK <br /> ....................... <br /> <br />NOTE: THIS DOES NOT cRANT oR'..~flP~f P~"%~oN;'To ~U.I'LD ON ,THIS PARCEL. PLANNING AND <br />ONSTRUCTION PERM)TS MUST DE ODTAIN~,'~E'FOEE,'BUILDING,OR SEPTIC INSTALLATION ~E*IN*. <br /> <br /> REMARKS~.~[ ~RTITIgN: OKAY FOR STANDARD SYSTEMS AS FIELD STAKED FBR^IOCATION SEE ~ZTE <br /> P'L~N U~ STAKEOUT DATED 10/177~. · · j~' ' <br /> DOHALD E. WOODLEY, NARION COUNTY BUILDIN~ OFFICIAL / BY <br /> l.~y <br /> <br />OFF;CE COPY <br /> <br /> <br />