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MARION CO[J~ BUILDING INSPECTION <br />SE~)R 8LOG. NO. 225 <br />2231~1GH STREET NE <br /> SAL~, OREGON 97301 <br /> PHONE! 585-5147 8:00 - 4:30 <br /> 24 HOUR CODE-A-PHONE: 588~7904 <br /> <br />~)AI'E= 89/30/~3 T~NE: 16:35:19 <br /> <br />DATE: <br /> <br />SITUS ADDRESS: ' ' ' '" ' <br /> <br /> 7~;~8 STONE FIELD CT SE <br /> AUMSVILI. E OR 97325 <br /> <br />'~ENTIAL <br /> <br /> OCCUPANCY: <br /> <br />USE OF eUII. DII~ <br /> <br />;LOT: <br /> <br />777[ TERR~flgE LANE : <br />PHONE: 749~2666 VALUATION: <br /> <br /> ~ 26 ~ 8S ~ 2W AR <br /> <br />TYPE: ON-SITE <br /> <br />PERHZT OR APPLZCATION NO; 9858354 <br /> <br />CONTRACTOR. NO. 44SS1 <br /> Dwain Bethel & Sons Excavation <br />PO Box 504 <br />Turner~ OR 97392-0000 <br />PHONE: 74~-2343 <br /> <br />WATER SUPPLY: PW <br />TEST HOLES READY: <br />SITE EVALUATION NUMBER: <br />EXISTING TANK SIZE: <br />EXISTING D~AIN FIELD LINE~: <br />SEPTIC TANK PUMPED: <br />PREVIOUS NO. BEBROOHS: <br /> <br /> · ' · ·TOTAL 'AS~ESSE)3 <br /> PREVIOUS 'RECEIPTS <br /> · THIS... RECEIPT <br /> <br /> · ' BALANCE DUE <br /> PAYEE: MArC NEILSON ~ .... <br /> RECEIVED BY." CL TYPE: CK CHECK ~: [525 <br /> ...........~- --~ ;=:=:=~--==:===::--==:-:-:;=~'--- -- - ~ -=.-.':~='~L .......................... ..._ <br /> SEE ATTACHED DOCUMENT FOR REQUIREHENTS'.OF ON-SZTE SEWAGE ~YSTEM. <br /> <br />FOLLOWING MU~T BE ~unrgm~. ~ ~ /M~ N~FONSIBIL.ITY' OF 'THE APPL:(~ANT TO A~U:~E TJ4T <br />ALL NECEgSARY INFORMATION HAS BEBN <br /> <br /> AMOUNT <br /> <br /> $455.00 <br /> $0.00 <br /> <br />.... ,,,,,, . . RECEIPT N0: 52742 <br /> <br />F~RM # MC [5-5~ REV. */1~ OFFICE COPY <br /> <br /> <br />