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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO. 225 <br />~20 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE 588-5147 <br />CODE-A-PHONE 4:30 P.M. - 8:00 A.M. <br /> <br />J~J~: 01/22/90 TI'ME: 12:22;54 <br /> <br /> BIELENBER~, TIM <br />S~TUS ADDRESS: <br /> <br /> 7925 HILTON LANE SE <br />TUENER OR 97392 <br /> <br />TAX LOTI <br /> <br /> 61964-000 <br />CONSTRUCTION TYPE: <br /> <br />MARI~)N' CCtlNTY ; NO <br /> <br />CATEGORY: <br /> <br /> RESI DENT fAL <br /> <br /> 2 <br /> <br />11314 MILL CK RD <br />.AUMSVILLE, ORE 97325 <br />PHONE; 769-2090 <br /> <br /> LOT: SL~K: <br /> <br /> SECTION: TOWNSHIP; <br /> <br />AREA; 26 U ~ frs'.9S <br /> 60 AC <br /> <br />SITE NUMBER; <br /> VALLIATICN: <br /> RANGE: <br /> <br /> 9138 <br /> <br /> ZONE; <br /> <br />NO : YES <br /> <br />MAP: <br /> <br />TYPE: ON-SITE SE[~&AGE <br /> <br />PERMIT OR APPLICATION NO: 21071 <br /> <br />CONTRACTOR, NO. 34916P-2 <br />STAYTON MILL CITY SILVERTON SEP <br />41155 STAYTON SOlO DRIVE, SE <br />STAYTON, OREGON 97383 <br />PHONE: 789-2302 <br /> <br /> ITB~ <br />ALTERATIO~ <br /> <br />~TER SUPPLY: P~4 <br />TE!~T HOLES READY: <br />SITE EVALUATION NUMBER: <br />EXISTING TANK SIZE.* <br />EXISTING DRAIN FIELO LINES*- <br />SEPTIC TANK PUhlPED~ <br />PREVIOUS NO. BEDROOMS: <br /> <br />QUANTITY AMOUNT <br /> 1 $145.00 <br /> <br />TOTAL A~ED FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />$145.00 <br />$145.00 <br /> $0.00 <br /> <br />BALANCE DUE $0.00 <br /> <br />PAYEE: RECEIPT NO= <br />RECEIVED BY: PR TYPE: CHECK <br /> <br /> SEE ATTACHED BCCUMENT FOR REQUIREMS~ITS Of ON, SITE SEWAGE SYSTEM. <br /> <br /> ~ ~i~ IS A V~ID ~IT ~ ~IS ~iT ~PI~ 360 ~ ~ ITS I~E ~. IF <br /> BU~LO[NG ~D <br /> ~N~ <br />~I~ FAI~ TO ~ ~L R~I~ ~ ~A~ <br />~ING ~i~C~, ~IS ~iT ~ 8~ ~ ~D <br /> <br />REMARKS: ALTERATION <br /> <br />DONALD E. ~¢30DLEY, MARION COUNTY 8UILDINGOFFICIAL / BY <br /> <br />OFFICE COPY <br /> <br /> <br />