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FOR,OFFICE USE OI~fLY <br /> <br />Zoning Validation ~ <br />Date: <br /> <br />MARION COUNTY BUILDING INSPECTION <br />22o Hig~ st~gt 1,,w-.. <br />l~l~m, OR 97301 <br /> <br />8_-00 ~m. - 4:~0 pm Pk, one gtt$-$147 <br /> PAX <br /> <br />SITE EVALUATION AND/OR SEPTIC I'ERM1T APPLICATION <br /> <br />$;~ Bvaluatioa~ ~.~ ~ ~. DSF 245.~ 2.0.~ <br />Cons ~c oa & ~p~ f~its [ ,, <br />$245,~ · $ ~ 5 c~h ~dJ. ~ ~sl. ~F ...... I0,00 <br />~ping Fill 415.~ <br />Holding T~ ~5.00 10~ <br />P~u~.DJgn~lion ~S0 ~ 10,~ <br />l~u, U~ Sy~m ,295.~ 10~ <br />~pggc Trc,ch ... 24~.~ I0~ <br />>~ ~z, 0s~,<'~oot ~, ~ [~.~ ~o I <br />Co n ~m~io ~ ~ii ~ae~[ ~Field Visitl} .... t$0.00 10~ <br />~iaing SECUre ~Val~n RcPog , 150.~ , 10.~ <br />Authog~iipn Not~ ~o ~ visit) ~.~ . <br />Annual ~vslu~oo of~m~ve ~m. 1S0.00 t9,oo <br />An ~o~.1 EvMu~;on of ~a~ ~ 90.~ lO.oo <br />~bcz <br /> <br />(Mark if Applicablc lo thli ApplicafiotI) <br />( ) T~t Itot~s ~-~ Dug <br />( ) I wilt ~sll wbo~ 'l'est Holes D~lg <br /> <br />MC 15-S1 REV 2/93 <br /> <br /> Reo~ipt No, <br /> <br />¢ft~e ~lair OtOVego~ ~d ~c ordluances of M~ioa County, <br /> <br />NATL~ 01~ AP~'/ DATE. <br /> <br /> <br />