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MARION COUNTY BUILDING INSPECTION
<br />SENATOR BLDG. NO. 225
<br />220 HIGH STREET NE
<br /> SALEM, OREGON 97301
<br />
<br /> PHONE: 588-5147 8:00 - 4:30
<br />24 HOUR CODE-A-PHONE: 586-7904.
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<br />I am a registered boilder OR ( ) the autho?ized representetive
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<br />DATE: ......................
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<br /> ...................
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<br />?w~ATE; 10/21/94 TIME: 10:41:01
<br /> '.~r~Cr~'~ CHUCK ..................... i c~s~u~i6~ ~:' .............. ~AL
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<br /> ~ .~1~_8321 KASA ......................... LN D~.-~m-- ....... ~A~ON-~ i I
<br /> COUHT~,-J~ ........................ : .................
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<br /> SITE NUNBER~ 94--~3493
<br />PHONE: 749-2~79 V 8 L U ~ T~,q.~.:T,.J~.~ ...............
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<br />TYPE: ON-SITE 5E'dAGE
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<br />PERH~T OR APPLICaTiON NO: §79&~
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<br />COI~TRACTOR~ NO.
<br />BAKER~ CHUCK ':"' " ""'
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<br />PHONE: 749-207~ ,;:', · ,Q....,
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<br /> WATER SUPPLYD PW
<br /> TEST HOLES READY: YES
<br /> SITE EVALUATION flUH~ER:
<br /> EXISTIN~ TANK SIZE:
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<br />'SEPT~ TANK PUMPED: .
<br />PREVIOUS NO. ~EDROOMS.
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<br /> ITEH D ...... '....' ........ · · · QUANTITY AMOUNT
<br /> SITE EVALUATIONs, EA. AI~ L;, LOT'"::I -... ',: ,,, ,.'. ,. · 1 $225.~0
<br /> ..... 'TOTAL ASSESSE9 FEES $225.80
<br /> .... ,";, ,~.,'.'.: :: · :. PREVIOUS. RECEIPTS $225.00
<br /> · ; "' ,, ', .' ........ ' ,: :,,TE~S :'RECEIPT ',,
<br /> ':' ~':::~":"'"":':':.:.~':-?..',,¥;',,',,,:'~L~HcE,DUE
<br /> PAYEE:
<br /> R ......... . - ', - .:";.",, "'... · ", ........ ' · RECEIPT NO~
<br /> e,u~zvLp ~Y. c~ . -'"' ~_~ .... ;', '~ ' ' TYPE~ CHECK ~
<br /> S~;E ~TTACHED DOCUMENT ~'O~.~::REaUi~[~S.~'~F:.'O~Si~' S~E
<br />................... v. 77":_ ;-,
<br /> '.'.','L' "~" :..:~ :. '" ': · <.'. ,: .......
<br /> NOTE: THIS DO~S NOT ~RA'HT. OR Z~P~Y .~ERM,~SSION.,TO,,,BUILD.ON'.'"~HI~
<br /> PARCEL.
<br />PLANN~N~
<br />ONSTRUCTION PERMITS MUST BE OBTAINE~ BEFORE ~UILDING OR SEPTIC INSTALLATION BEGINS.
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<br /> ' RECOHNENDED., " "
<br />POHAI.,,D E. ~00~ .EY~ MARION CDUNTY 'BUTL~TNO OFFICIAL / BY ~,,..~.,,.~.
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<br />OFFICE COPY
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