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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: $$$~5147 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br /> 10755 MIX RD <br />AUMSVILLE <br /> <br /> NLf~ERt 94~4~t97 <br />VALUATZDN~ <br /> <br /> SAME <br /> <br /> PHONE: 747-1354 <br /> <br />TYPE: ON-SITE <br /> <br />PER~IT OR ~PPLi~ATION <br /> <br />CONTRAC~OR~ <br />MIX, ~RANCZS A. <br />SAME <br /> <br />PHONE: 747-1~54 <br /> <br />; EFU <br /> <br /> ITEM <br />ANNUAL EVAL. - TEHP <br /> <br /> PAYEE: PLhNN[I <br /> RECEIVEB BY: I <br /> <br /> SEE <br /> <br /> · THIS ~S <br />FOLLOW]MC <br />AL, L <br /> <br /> WATER SUPPLY <br /> TE~T HOLES READY) <br />SITE EVALUATION NUMBER: <br />EX~STIN~ TANK SIZE: <br />EXISTING DRAIN FIELD LINES: <br />SEPT~ TANK PUMPED: . <br />-PRE~'iOU~ 'NO."BE~ROOMS, <br /> <br />QUANTITY <br /> <br /> ,,,. .TYPE: IN CNEOK <br /> r FOR REQOlREME~T~:'OF, OEcS~TE,,$EaA.GE SYSTEM. <br /> ~A PERNIT~', i]THZS'..,APE~L~OATIDN' Nlii~.r,O¢..THRO~H A REVIEW,PROCESS <br /> E COHPLETED~'~.'..I.T ,IS'THE.,RESPON~'[~'~ITY"OF.THE AF'P[~CANT TO A <br /> <br />SS~ RE/HDSP PF'.:NO LETTER'.-fl~ZLE,~. <br /> <br />PLAN <br /> <br /> AMOUNT <br /> <br /> ¢0,00 <br /> <br />,16~8 <br /> 0 <br /> <br />RE THE <br />RE THAT <br /> <br />OPFICE COPy <br /> <br /> <br />