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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG, NO, 225 <br />220 HIGH STRK-ET NE <br /> SALEM, OREGON 97301, <br /> <br /> PHONE 588-5147 <br />CODE-A-PHONE 4:30 P.M, - 8:00 A,M, <br /> <br /> of a registered builder· <br /> <br /> Other <br /> <br />O.ATE: 05/08/8'7 Ti'ME <br /> <br /> NESKERS. MARTIN <br /> <br />SIGNATURE OF APPLICANT: <br /> DATE; <br /> <br />TAX LOT: <br /> <br /> 4.0548-000 <br /> <br />CONSTRUCTION TYPE: <br /> <br /> 20?'47 HIGHWAY 99E NE CONTRACT CITY; UGS; <br />....... ROR 'OR '9~'002 <br /> <br />MAILING ADCRESSI RESIDEN'r'IAL ,ACCESSORY STRL CTL RES SUBDWlS~ON: <br /> <br />..:13 !"JO. E/',:,,KER ©RIVE. <br />CANSY. OREGON $'79-.2580 <br />o!-/ONE: 256-~- !42 <br /> <br />LOT: BLOCK: SECTION: TOWNSHIP: <br />WIDTH: DEPTH: AREA: UNITS; <br /> <br />CATEGORY: <br /> <br />OCCUPANCY: <br /> <br />OCCUPANT LOAD: <br /> <br /> S;TE NUMBER: 121'1 <br /> VALUAT I ON: <br /> <br />S F N N <br /> <br />'TYPE: Oi',4.-..S I TE SEWAGE <br /> <br />PERrvtl'f' OR ARPL~(,-¥F]ON NC,',: <br /> <br />CONTRACTOR, NO. <br />~v!ESKERS. MART'[ N <br />640 NO, BAKER DRIVE <br />.;ANBY, OREGO~ $78--·2580 <br />F,!,~ON E: 288-,,4, 143 <br /> <br />1857 <br /> <br />WATER SUPPLY: PW <br />TEST HOLES READY: ARE OUG <br />SITE EVALUATION NUMBER: <br />EXZST;NG TANK S~ZE: <br />EXIST;NG D~&:N FIELD LINES: <br />SEPTIC TANK PUMPED: <br />HOLDING T.~NK AGREEMENT: <br /> <br />AFFIDAVIT: <br />WINTER WATER CHECK: <br /> <br /> ; TE~ ~L ANT ~ TY A.~10{ hi T <br />SE < $ IVDNTHS OLD ~ $65. <br />SITE EVALUATTON. F~F'CST L~ !,~85 <br /> <br /> TOTAL ASSESSED FEES $230_00 <br /> PREVIOUS RECEIPTS $230.00 <br /> THIS RECEIPT $0,00 <br /> <br /> BAL&N;E OUE $0.30 <br /> <br />PAYEE: INVOICE NO: <br />qEC, ETVEO BY: O~ ~v°E: "'.r~EC,<I ~: <br /> <br />SEE ATTACHED ©OCUMENT FOR REOUiREM~4TS OF ON-SITE SEWAGE 3YSTE. q. <br /> <br />SP .... A,~_ REQL IREMEN-S- <br /> <br />NOTE: TH~S DOES NOT GRANT OR IMPLY PERMI~ION TO BUILD ON THIS PARCEL. PLANNING AND <br />CONSTRUCTION PERMITS Iv~ST BE OBTAINED BEFORE BUILDING OR SEPTIC INSTALLATION BEGINS. <br /> <br />.,.¢.~..D E. HOOOLEY. MARION COUNTv 8UTLO'rNG OFFICIAL / .P.Y ............... <br /> <br />OFFICE COPY <br /> <br /> <br />