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MARION COUNTY BUILDING INSPECTION <br />SENATOR 8LDG, NO. 2~5 <br />220 HIGH STREET NE <br /> SALEM. O~REGO.~ 97301 <br /> <br /> PHONE: 588-5147 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />DATE: 09/03/92 TIME: 9:57:49 <br /> ' ....................... '%' <br />COX-QUINTO~ PHILIP & DE,AA <br /> <br /> 165 CLIFFORD AVE <br /> OET~OIT oR <br /> <br />3745 SN COHUS <br />PORTLAND, OR 97219 <br />PHONE: 245-64~8 <br /> <br />SIGNATURE O~ APPLiCANT~ ...... <br /> <br />DATE! ..... <br /> <br />PATTON II <br /> <br /> SZ'TE NU~BE~' 92-00450 <br /> VALUAZ:'ON: <br /> <br />CATEG RY: <br /> RESIDENTIAL <br /> <br />LOAD: <br /> <br />LOT: <br /> <br />TYPE: ON-SITE SEWAGE <br /> <br />~ER~IT OR APPLICATION <br />CONTRACTOR, NO. <br />COX-OUINTON, PHILIP & OEBRA <br />574~ SW COHUS <br />PORTLAND, OR <br />PHONE: 245-6458 <br /> <br />: 20 " SE RS <br /> <br /> ~TER ~UPPLY: CW <br /> TEST HOLE~ RE~OY: YES <br /> ~[TE EVRLUnTION NUMBER: <br /> EXI~TtN~ T~NE SIZE: <br /> EXIST~N~ D~AIN FIELD LINE~: <br /> ~EPTIC T~NX PUMPED: <br /> PEEV[OU~ NO, BEOEoOH3; <br /> <br />MAP; <br /> <br /> [TEN QUANTITY ANOUNT <br />SITE EVALUAT[ON~ FIRST LOT 1 $220.00 <br /> <br /> TOTAL ASSESSEO FEES $220.00 <br /> PREVIOUS RECEIPTS $220.00 <br /> THIS RECEIPT $0.00 <br /> 'BALANCE DUE ~0,oo <br /> <br />PAYEE: INVOICE NO: <br />RECEIVEO BY: cl TYPE: CHECK ~: 0 <br /> <br />S~E ATTACHED DOCUMENT FOR REQUIREMENTS OF ON-SITE S~NAGE SYSTEM. <br /> <br />NOTE: THIS DOE3 NOT GRAHT OR IMPLY PERMISSION TO BUILD ON THIS PARCEL. PLANNIN~ AND <br />ONSTRUCTION PERMITS MUST BE OBTAINED BEFORE 8UILOING OR ~EPTIC INSTALLATION BEGINS. <br /> <br />REMARKS: SE denied / ~taKe out required for revaluation <br /> <br />DONALO E. WQODLEY, MAR[ON COUNTY BUILOIN~ OFFICIAL / BY <br /> <br />OFFiCECOPY <br /> <br /> <br />