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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO. 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br />DATE; 08/14/87 TIME: 11:08t02a <br /> BOOCK, BRIAN <br /> <br /> 8053 MILL CREEK RD <br />AUMSVILLE <br /> <br />MAILING <br /> <br /> SANE <br /> <br />LOT: <br /> <br />WIDTH: U~RTH~ <br /> 117 <br /> <br /> PHONE 588-5147 <br />CODE-A-PHONE 4:30 P.M. - 8;00 A,M, <br /> <br /> jTAX LOW; i CATEGORY; <br /> RESIDENT;IAL~, <br /> <br />OR 9?325 <br /> <br />~r~._ SITE NUMBER: 2195 <br /> VALUATION: <br /> <br /> 28 ; 88 I 2W ¢ AT <br /> <br />300 35100.0 i SF , NO i YES <br /> <br />4 <br /> <br />TYPE: ON-SITE SEWAGE <br />PERMIT OR APPLICATION NO: 9003759 <br /> <br />CONTRACTOR, NO. <br />BOOCK. BRIAN <br />SANE <br /> <br />PHONE: 749~2112 <br /> <br />EXISTING :SYSTEN EVAL. RPT. <br /> <br />WATER SUPPLY: PiN <br />TEST HOLES. READY: <br />SITE EVALUATION NUNBER: <br />EXISTING TANK SIZE: <br />EXISTING BRAIN FIELD LINES: <br />SEPTIC TANK PUMPED: 2-28-84 <br />PREVIOUS NO. 8EDROONS; <br /> <br /> ,, ;TO,TAb,ASSESSED;FEES <br /> !' ::PR~"ClOUS' RE~EI PIS <br />,: ]], ,THIS,:~EGEIPT <br /> <br /> BALANCE DUE <br /> <br />QUANTITY AMOUNT <br /> $60.00 <br /> <br /> $80.00 <br /> $0.00 <br /> $60.00 <br /> <br />$0.00 <br /> <br />PAYEE: 8COCK, BRIAN /~_ ~ .., ,',:;:RECEIPT NO: 4311 <br />RECEIVED BY: JR <br />.............. , , -~ TYPE:'~ OK CHECK ~- 768 <br />SEE ATTACHED DOCUMENT FOR REQUIREMENTS OF ~ON-.-,S'~:T~, SEN'A~,E SYSTEM <br />* THIS IS NOT A PE~4IT. ]HIS APPLiCATI A R~flEN PROC~ ~i~ERE THE <br />FOLLOWING I~T BE COMPLETED. IT IS :'I~{E TO ASSURE 3~,AT <br />ALL NECESSARY INFO~ATZON HAS,SEe~ <br /> <br />PLAN REVIEW: BY__ DATE :' ]] CiTY JU'RZSBICTION: BY BATE <br />RENARKS; AC FOR LOAN <br /> <br />~RM MU ,!~se R~v ~/s~' OFFICE COPY <br /> <br /> <br />