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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO. 225 <br />220 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 />I am performing work on 8 property I own or occupy. <br /> <br />Other <br /> <br />DATE: 09/0 ]/8'~ Ti~E: 4:07:53p <br />OWNER: <br /> HUMMEL, 8ILL I R <br /> SITUS ADDRESS: i CONSTRUCTION TYPE; i OCCUPANCY: <br /> <br /> 215 F~NT ST ~ co~mAc~ C~TY; ~ uee; ¢ OCCUPANT LOAD: <br /> DETROIT OR 97342 ~ <br /> <br /> q4695 S~ 138RD · <br /> TZGARD+ OR <br /> PHONE: i SiTE NUHBER = 2271 <br /> ~ VALUAT <br /> <br />WIDTH: DEPTH: [ AREA; ~ UNITS: ~ IRREG. LOT: <br /> 50 100 : 5000.00 , SF ~ NO : NO <br /> <br />'TYPE= ON-SITE SEWAGE <br /> <br />PERMIT OR APPLICATION NO: 3893 <br /> <br />CONTRACTOR, NO. <br />HUN1NIEL, BiLL <br />14895 SW ]33RD <br />TIGARD, OR <br />PHONE: <br /> <br />WATER SUPPLY: <br />TEST HOLP'~P'~P'~P'~P'~P'~P%S READY: ? <br />SITE EVALUATION NUMBER: <br />EXISTING TANK SIZE: <br />EXISTING DRAIN FIELD LINES: <br />SEPTIC T~K PUMPED: <br />PREVIOUS NO. BEDROOMS: <br /> <br /> ITEM QUANT I TY AMOUNT <br />SITE EVALUATION,. FIRST LOT : , $'185.00 <br /> <br /> * TO~AL ,ASS~ED ,:FEES $1 ~5- 00 <br /> ,, PREVIOUS RECEI ,S $1o5_00 <br /> <br /> ,: TH TS ~RECEIPT $0.08 <br /> ', ,:' ,,:': !:: AL: NCE ou'E S'c_ <br /> <br />PAYEE: INVOICE NO: <br />RECEIVED BY: J8 TYPE~' ?CHECK <br /> <br />,SEE ATTACHED DOCUMENT FOR REQU:IREH~TS OR,ON~SITE,::,,S~ACE~:SYSTE~. <br /> <br />NOTE= ~lS m~ NOT 6~r OR ~M~Y <br />~CTI~ PE~ITS ~ST BE ~TAI, NED 'B~OE~: 8U:I~[~ 0E SEPTIC INSTAL~TI~ B~INS. <br /> <br />RE~RKS: SE DENZED <br /> <br />DONALD E. N~DL~Y, ~RZON COUNTY BUILDING <br /> <br />*D.M '~ MO IS Se ~Ev.e/87 OFFICE COPY <br /> <br /> <br />