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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG, NO, 2~5 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE~: 588-5147 B:O0 - 4-:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />registered by Ider. <br /> <br /> ~)ATE:. 09117193 .T,[fiE:. 16-'i4:19 . <br />OWNER; <br /> COX-QUINTON~ PHILIP & ~EBRA <br /> <br />.... . 'TA~ LOT: ' <br /> 902607 <br /> CON$'(RbC?I'O N <br /> <br /> RESIDENTIAL <br />:'~CCUPANCY: <br /> <br /> 165 CLIFF'OR9 AVE i CONTRACT CITY: ; USS: <br />I)ETROIT OK 973~2 ; DE'fEOI:T NO <br /> <br />3746 ~W COMUS <br />Por<'rLn~9, oR 97219 <br />PHONE: 2~L5- 6438 <br /> <br /> 6 . '~ ....... 20 ..... <br /> <br />,' ~CUPANT LOAD; <br /> <br />. E'AZION II ............ <br /> <br />VALUATION= <br /> <br />75 , 1~5 1~125~ · SF NO : NO <br /> <br />TYPE: ON-SITE SEWA[E <br /> <br />PER~IT O~ APPLICATION NO: <br /> <br />CONTRACTOR~ NO. 44077 <br /> Hm'~ry Allu~s Excevattn~ Ltd <br />40~ Loaf' Rd <br />~ilver~on, 77~81-8~00 <br />PHON£: <br /> <br />WATER ~UPPL¥: CW <br />TE~T HOLES READY: <br />SITE EVALUATION NUMBER: 46816 <br />EXISTINE TANK S[ZE~ <br />EXISTING DRAIN FIELD <br />SEPTIC TANK PUMPE~= <br />PREVIOUS NO. <br /> <br /> YTEM QUANTITY AMOUNT <br />B'I'ANDAFdO ON-S'ITE SYSTEt4 1 '~=~ <br /> <br />TOTAL ABSESSE~ FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />$255.00 <br /> $0.00 <br /> <br />· BALANCE ~)LIE $0.00 <br /> <br /> F'AYE~; Hem'y Alluis Excavating Ltd ' ' INVOICE NO: 52403 <br /> ~ECEiV~ BY: PM TYPE: IN CHECK ~: 0 <br /> S..E ATTACHED DOCUMENT FO~ REQUIREMENTS OF ON-SITE SEWAGE SYSIEM. <br /> · THIS IS NOT A PERMIT, THIS ~PPLIC~TION MUST ~0 ll~ROU~H A REVI/~ PRQCE~ WHERE THE <br />POLLOW~NG MUST 8E COMPLETED~ IT ~S THE RESPONSIBILITY DF'THE APPLICANT TO ASSUR~ THAT <br />ALL NECESSARY INFORMATION HAS BE~N.PROVI~E~, <br /> <br />OFFICE COPY <br /> <br /> <br />