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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO. 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 973Ol <br /> <br /> PHONE: 588-5147 8:OO - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />I am performing work on a property I own Dr occupy. <br />lam a registered buiiderOR( ) the authorized representative <br />of ato¢ istered builder. <br />The wo'rk wlll be performed by a registered builder, <br /> <br /> DA'rE: 04/19/91 TIME: 10'-24:49 <br />OWNER' HILLS, HAROLD <br /> <br />OATE: <br /> <br />TAX LOT <br /> <br />120 PA'r'rON RD <br />DETROJ. T <br /> <br />P.O. BOX 463 <br />DE'rROUF, OR 97342 <br />PHONE: 854-3441 <br /> <br /> CONSTRUCTION TYPE <br /> <br />OR 9?342 CONTRACT ClT~ uOB. <br /> DETROIT <br /> <br />NO <br /> <br />LOT BLOCK: <br /> <br />DEPTH: <br /> <br /> SiTE NU~ER= 9328 <br /> VALUATION: <br /> <br />AREA JNITS IRREG, LOT NO CORNE~o <br /> <br />RESJ_DBNT [AL <br /> <br />DCCUPANT LOAD <br /> <br />MAP <br /> <br />TYPE: ON-SITE SEWAGE <br /> <br />PERIvlI'F OR APPLICATION NO: <br /> <br />OONT~C'FOR, NO. 36421 <br />KE"VlN~S BACfg'IOE SERVICE <br /> BOX 465 <br />D~I'ROIT, ORE'tON 97342 <br /> <br />9031681 <br /> <br />NATER SUPPLY: CN <br />TEST HOLES <br />8ITE ~ALUATiON NUMBER: <br />~15TiNG T~K ~IZE: 500 <br />~ISTiNG D~IN FIELD LIN~: <br />~EPt'IC T~K <br />PREVI~ NO. BED~: <br /> <br /> i l'B'l <br />REPAIR - MAJOR <br /> <br />PAYEE: HILLS, HAROLD <br />RECEIVED BY: PR <br /> <br /> QUANTITY AI~,31JNl' <br /> $80.00 <br /> <br />TOTAL A...,~58~ED FE~,S $80.00 <br />PRE¥1OC~ RE~EIP~rS $O.O0 <br />THISRECEIPT $80.00 <br /> <br /> BALANCE I.~JE $0.00 <br /> <br /> INVOICE NO: 33434 <br /> TYPE: IN CHECK ~: 0 <br /> <br /> SEE ATI'ACHEO DOCUMENT FOR REQ[J~[REt, IENTS OF ON-~iTE SEWAGE ~'r~. <br /> <br /> ~ THIS IS NOT A P~[T. ~'I~TI~ ~f ~,~ A ~1~ ~ ~ ~E <br />~L~I~ ~T BE ~TED. IT. J5 ~E ~[BIL[TY OF THE A~I~T TO ~ THAT <br /> <br />RE~RKS: SEPTIC REPAIR- f, IAJOR <br /> <br />JURISOICTION t 8Y ........................ <br /> <br />OFFICECOPY <br /> <br /> <br />