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MARION COUNTY BUILDING INSPECTION
<br />SENATOR BLDG, NO. 225
<br />220 HIGH ~TREET NE
<br /> SALEM, OREGON 97301
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<br />PHONE: 588-5147 8:00 - 4:30
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<br />AURORA OR 97002
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<br />5~Kg OSWEGO, OR 93035 ~ SITE N~ER: 94-00776
<br />PNONE: 63g-88Sl [ VALUATION:
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<br />TYPE: ON-SITE SEWAGE
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<br />PERMIT OR ~PPLICATION NO: 9053093
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<br />CONTRACTOR, NO,
<br />~OGAN, JACK
<br />2575 $~ PALISADES CREST' DR .... "''
<br />LAKE OSWEGO, OR 97035
<br />PRONE: 638-888I
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<br />TEST HOLES READY:
<br />SiTE EVALUATION NUMBER:
<br />EXISTING TANK S~ZE;
<br />EX~STiNG DRAIN FIELD bINES:
<br />SEPTZC,T~K ?UHPED:
<br />~R~VIOUS' NO.. BEDROOMS:
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<br /> ITEM QUANTI~Y AMOUNT
<br />SITE EVAL. - FIRST $000 GAL. DSF · · ' " = $265.00
<br /> .... ':' " TOT~AsSE$SED:,iFEgS $265.00
<br /> , .:: :::,.,.,,,',, .~EV'ZO~S~REC~Z~TS So.oo
<br /> "',',"' TNZ$'~EC~I~: $265.00
<br /> · . ' · .... ?,':,f: ~.,~E' $0·00
<br /> ";'"'"J""!"""'"?!":',;r,',L:,',t~.........-.~'/,,,' ,,.:...:..
<br />PAYE~; OREGON PACIFICCOMST~UCTION ..... ,4.,..,~,,, RECEIPT NO: 5555~
<br />R~CE/VED BY: PM ....... .' :.. "-' '"-" :"' ....... ',' ...... ".' i! TYPE: CK CEECK #: 14675
<br />SEE ATTAC~D DOCUMENT.FOR RKgUIRE~ENT$.0~ 'ON=~iTE'"~WA~E SYSTEM.
<br />" ............... " ""-~-:'--:7'-,~-~ ..... ",,~--~----7,'---= ..................................
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<br /> ONSTRUCTION PERMITS ~U~T BE. OBTAI.NED..BEFORE BUILD'I.NG~OR SEPTIC INSTALLATION B~G~F$.
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<br />PLAN REVIEW: BY DATE ." , cITY JURzSDzC,ION. BY DATE
<br />RE,ARKS:
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<br />~o~ # ~c ,~.~ .~,. ~m OFFICE COPY
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