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MARION COUNTY BUILD ,I~PECT1ON <br /> SENATOR BLDG. <br /> 220 HIGH STRE~,'"NE <br /> SALEM, OREGON G7301 <br /> <br /> PHONE: 588-5147 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br /> 7oo2 i cou T <br /> <br />12490 S~ LO~G~OR~ ~Ng ~A ~ ..................................................................... <br />BEAVERTON ORE~N 97006 ~ SI~. ~,: 94-OO653 <br />PRONE; '-,,.,~ -1. 052 .~ VALUATION: <br /> <br />TYPE.: .O~-$ITE SE~AG'/~.., <br /> <br />PEREIT..OR APPLICATION NO: <br /> <br />CONTRACTOR, NO. <br />MURRAY, JOHN <br />~2490S~ 5ONGHORN 5ANE #A <br />BEAVERTON OREGON, 97006' <br />PHON~: 524-1052 <br /> <br />.9052893. <br /> <br />t,~ATER SUPPLY:. PV TEST HO~ES READY: <br /> SI~ L'srA,I~UATION ~-O~HER: 34388 <br /> EXISTIN0 TANK SIZE: <br /> EXISTENG DRAIN FIELD LINES: <br /> SEPTIC TANK PU~D; <br /> · P~EVIOUS, NO. BEDROOMS: <br /> <br /> ITEM <br />~'~'ANDARD ON-S'TB SYSTEM <br /> <br /> TOTAL.ASSESSED FEES <br /> · PREVIOUS RECEIPTS <br />, 'T~IS RECEIPT' <br /> <br />QUANTITY <br /> 1 <br /> <br />A~OUNT <br /> $255.00 <br /> <br />$255.00 <br /> $o.oo <br />$255.00 <br /> <br />$0.00 <br /> <br />PAYEE: MURRAY,.JOR]~ , . .'."'."'"!".:" ,..:..'..:..: :.'.'..,' RECEIPT NO: 55358 <br />RECEIVED BY: CL '" ".".:. ' · TYPE: CK CHECK ~: 0 <br />SEE ATYACHED DOCU~ENT. FOR.REQU~REI~ENTS-OF,..ON~SiTE SEWAGE':SYSTEH. <br />· -..T~t$. I$' ~OT.:A. P~f~.~T,;; ~-~.~P~TI~N,'~W...'~.'~UGH A ~, PE~E$S ~ T~ <br />~:~)LLO~ING ~US'F BE CO~ETED.', .IT .IS-THE '.RE~PONSIB~L'ITY OF THE APPLICANT TO ASSURE <br />ALL NBCES~Y INFOR~T~ON~ BE~N,;~IDE~; ', ~ . /~ ~ <br /> <br /> REMARKS: SS: STD ~ERMIT <br /> <br />~o~ # uc ~s.~,.~'. ,v~o OFFICE COPY <br /> <br /> <br />