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MARION COUNTY BUILDING INSPECTION
<br />SENATOR BLDG. NO. 225
<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 />~X./ i em pet orm ng work on a p oge~¥ own of occupy
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<br />!..: ...... J~ R.];, F,,~ E,B ~_ _.1~ E 't./;~ N .. _( ~U.YJG',~ ) ............................. j_ _4~84_5.29 ............................ ~RESIDENTIAL
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<br />~ 13182 MURRAY LANE NE '! CON'FRAC¥ (~l~Y: ' ' %' b~: ..... !'~6~]PANT LOAO:
<br /> AURORA OR 978~ ~NARION COUNTY ~NO
<br />b~ O~ '~d'iL-61~dl ...................................................................................... ~ ................
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<br /> .......................................................................~A~u.a A.o~: :-~O~b~9~i5~: ..........................
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<br /> 11454 ~UNT~N(; LN
<br /> AURDR~ OR 97~2 SITE flUNkER: 94-~653
<br /> PHONE: 678-2219 VALIJAT~ON~
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<br />~6+ ..................... ~ .............. ~E~d~7~'~ ........... ~ ............... ~E ........... ~'~'6.~ ................ ~'~"' '
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<br />~ ..................................... ..... ,'_...,,,., .. ~, 7~ .... ~C , ,, ........... ............ N~ ... ...... L. ~P ....
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<br />;~'or sEo~oo~s.
<br /> Z
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<br />TYPE~ OI,F-SITE SEWAGE
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<br />PERHIT OR RPPLICATZDN
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<br />COI,ITRACTOR~
<br />KRIEGER, KEVIfl
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<br />AlJ~Of~A~ OR 970~
<br />PHONE=
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<br /> WATER ~UPPLY: PW
<br /> TEST HOLES READY:
<br /> SITE EVALUATION flUNkER: 13796
<br /> EX~CT~N~ TANK S~ZE=
<br /> EX~STIflG DRAIN F'~ELD t. INE~;
<br />I.SEPTIC TANK PUMPED:
<br /> PREVIOUS NO. BEDROOMS;
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<br />STAIID~RD OH=S~TE SYSTEM '
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<br /> ", QIJANT[TY AMOUNT
<br /> ... ;',,, ,, ! $255.0~
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<br /> " .'.'TOTAL'ASSESSE~ FEES $25%00
<br /> .... '",' .... PRE¥IOU.S REQEIE~S $O. BO
<br /> · '- ..., , ,,, .-;.':.. :',, , TU~..'.REcEIPT '" $255.
<br /> ":" ........ ,' A'L UCE
<br /> ...... · ......~ ', $0.00
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<br /> F'~YEE= KR!EGER. KE¥~N (~U¥~R.!' .... ':'.::.i' !,,'>,,:,,,...',"..' RECEIPT NO~ 59445
<br /> RECEIVED BY: gL '':'" ........ ' " TYPE= 6K CHECK ~: ~7~
<br />~EE ATTACHED DOCUMENT FOR."RE~U~REMENTS..OF'ON~ITE SEWAGE SYSTEM,
<br />$ THIS IS HOT A PERflZT; ,THi]~ APPLXC~I.I]~'HUST"~,O"THRDUGH,A REVIE~ PROCESS OHERE THE
<br />FOLLOW~N~ HIJST DE COMPLETED; 'I~ ·~S 'THE', RESPONSIDZLITY·OF THE APPLICANT TO ~SSIIRE THAT
<br />ALL NECESSARY INFORHATION HA~,DEEN pROVIDED ..... '
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<br /> PLAN REVIEW: ~Y .... ·DATE_ .. CITY JUriSDiCTION: ~Y ..................... 9ATE ..............
<br /> REMARKS: STD SYSTEN
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<br />OFFICE COPY
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