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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 I~M. - 8:00 A,M. <br /> <br />Other <br /> <br />DATE: 01/17/89 TIME: 8:40:57,a <br /> <br /> HAB~NORTH . SCOTT RESIDENTIAL <br /> <br /> ??6? AL~US RD SE CONTRACT CITYI UGB: OCCUPANT LOAD: <br />AUNSVI LLE OR 9?325 <br /> ~RI~ COUNTY NO 3 <br /> <br />SAt4E <br /> <br />PHONE: 749-2419 SITE NUMgER: 2510 <br /> VALUATION <br /> <br /> 90 8S 1N SA 48 <br /> 1.00000 AC NO <br /> <br />TYPE: ON-SITE SENAGE <br />PERNIT OR APPLICATION NO: 9013531 <br /> <br />CONTRACTOR, NO. <br />ECC4EHABSNORTH' .SCOTT' $5~.~,.(~ <br />PHONE: 749-2419 <br /> <br />HATER ,SUPPLY: PN <br />TEST HOLE~ READY.+ <br />SITE EVALUATION NUMBER: <br />EXISTING TANK SZZE: <br />~[ST[NG D~[N,, FIELD LINES: <br />SEPTIC T~K ~MPED: 9-14~87 <br />PREVI~S NO. BED~: <br /> <br /> ITEM QUANT I TY ANOUNT <br />ANNUAL EVAL. - TENP OR HDSHP fvH 1 $60.00 <br /> <br /> TOTAL ASSESSED FEES $60.00 <br /> PREVIOUS RECEI ~>TS $0.00 <br /> THIS RECEIPT $60.00 <br /> <br /> /~~CE DUE $0.00 <br />PAYEE: WA~RTH+ SCOTT RECEIPT NO: 14347 <br />RECEIVED BY~ PB TYPE.= CK CHECK ~: 5450 <br /> ............ , ,...r~,4M,.,¢_, ~------ . -.==.=._..._..__~ , - <br />SEE ATTACHED DOCUMENT FOR RE~,~ZRENENT$' OF ON"~SITE SB4.AGE ,SYSTEM. <br /> <br />* THIS IS NOT A PEJ:~IT. THIS,'AP,P,,i~[CA,T, ION MUST GO THROUCH,,A REVIE~ PROCEE~ I~rlERE THE <br />FOLIJ2hlING MUST BE COMPLETED+ ","[',T,'i~S THE RE~PONS~[BILITY OF THE APPLICANT TO ASECJRE THAT <br />ALL NEC~ INFORMATION HA~',,I!~EEN PROVIDED~ <br /> <br />PLAN REVIEH: 8Y__ - DATE ......... CI~CY JURISDICTION: BY ........ DATE <br /> <br />REMARKS: ANNUAL HARD~HIP INSP <br /> <br />COrM * mC ~S-~e .F.V W.. OFFICE COPY <br /> <br /> <br />