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MARION COUNTY BUILDING INSPECTION
<br />SENATOR BLDG. NO, 22~
<br />220 HIGH STREET NE
<br /> SALEM, OREGON 97301
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<br /> PHONE: 588-5147 8:00 - 4:30
<br />24 HOUR CODE-A-PHONE: 588-7904
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<br />am ~ re,~[stered buHdo¢ OR ) the authorized representative
<br />have read and Agree to the terms stated o~ {h:e rever~e ~'id~ of
<br />
<br />DATE! ~, . , ,, ~ ~ ~ ........................... i ....
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<br />; ~A[UNG k'l~hE~$: ' ......................................
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<br /> PHONE:
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<br />K]d. MARTIN~ PAT ~ 75~1~8~ ~RESIDENTIAL
<br /> AUHSV~L, LE OR 97~25 ~MAEiON COUNTY { NO [
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<br />TYPE.. ON-SITE SEWAGE
<br />B~RI~IT OR A~B~LIEATION NS: ~443
<br />CONTRACI'OR~ NO, 3381~
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<br /> ZTEH ..
<br />STANDARD OH-SITE SYSTEM ,~'." :,', · .
<br />SITE EVALUATION, FIR'ST.LOT ..,,'
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<br /> WATER SUPPLY: PW
<br /> TEST HOLES READY: YES
<br /> ~ITE EVALUATION
<br /> EXISTING TANK ~IZE:
<br /> EXISTING DRAIN FIELD LIHES:
<br /> ' SEPTIC TANK PUMPE~:
<br />'|,'PREViOUS'NO.
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<br /> QUANTITY AMOUNT
<br />· . 1 $255,,0~~'
<br /> 1 $265.00,
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<br /> .FEES
<br /> ,,, ': . ...:., ,, "P~E¥'IOUS,;RE'CEiP, TS
<br /> . ", · -' ...':'"
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<br /> '":""':."**~.'.~ .:.'~"'...BA&~NOE :DUE .;,
<br /> ' ::': :'"
<br /> · ~ .' .'..'.. '" ':~,,,', ',',, ~:t,,.~ '.,~ ...:..:..: · :;-.~'.' ,"'" ' ' ·
<br /> PAYEE: , :..., ..... ' '~'". · , .- , ·
<br /> RECEIVEO ~Y:
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<br /> NOTE: THIS ~OES
<br />ONSTRUCTION FERfllTo NUST BE OgTA~'N~D BEFORE BUILD~N6 OR SEPTIC !N~TALLATION
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<br /> ,~(:MnRKS~.,,.~.;; S$.-$TD SYS.," MAR¢~NAL ON uPPERNos~ SURFAOE,. PRE-~TRUC'TZON STAKEOUT
<br /> ~E~unnENDED. ACE SEPTIC: 'PHONE-~?~-I¢3~I · ~ }
<br /> DOhhtkD E. WOODLEY, ~ARIOH COU~ITY BUILDING OFFICiaL / BY ~
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<br />2RM ~ M6 15-56 REV. 4~ O;~FICE GOBY ~0 ~
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