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MARION COUNTY BUILDING INSPECTION <br />SENATORBLDG NO 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE 588-5147 <br />CODE-A-PHONE 4::30 PM - 8;00 A,M <br /> <br />Other <br /> <br />JOHNSON, EARL <br /> <br /> 8754 MILL CREEK RD <br />AuMSVILLE, OREGON <br /> <br />OR 9?828 <br /> <br />SE <br /> <br />CONTRACT CITY UGB <br />MARION COUNTY NO <br /> <br /> SAME <br /> <br /> PHONE: 749-250q <br /> <br />LOT EILOCK <br /> <br />35.00¢0 <br /> <br /> SiTE NUMBER: 4275 <br /> VALUATION: <br /> <br />8S 2W EFU <br />AC NO NO <br /> <br />RESIDENTIAL <br /> <br />MAP <br /> <br /> 51 <br /> <br />TYPE: 0N-SITE SEWAGE <br /> <br />PER~4IT OR APPLICATION NO: <br /> <br />CONTRACTOR, NO, <br />JOHNSON, EARL <br />SAME <br /> <br />~ONE; 748-2601 <br /> <br />8146 <br /> <br />WATER SUPPLY: <br />TEST HOLES READY: <br />SITE EVALUATION NUMBER: <br />EXISTING TANK SIZE: <br />EXISTING DRAIN FIELD LINES: <br />SEPTIC TANK PUMPED= ~25~8B <br />PRE¥1OUS NO. BEDROOMS: <br /> <br /> ITEM QUANTITY AMOUNT <br />AUTHORIZATION NOTICE - FLD. VISIT 1 $$5.0C <br /> <br />PAYEE: <br />RECEIVED BY: dw <br /> <br />TOTAL ASSESSED FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />$85.00 <br /> 65.00 <br /> $0.00 <br /> <br />BALANCE DUE $0,00 <br /> <br />RECEIPT NO: <br /> CHECK <br /> <br /> TYPE: <br /> <br />SEE /~T'FACHED DOCUMENT FOR REOUIREMENTS OF ON-SITE SEWAGE SYSTEM. <br /> <br />* THIS IS A VALID PEI;~'4IT x< THIS PEENIT EXPIRES $60 DAYS FRC~I ITS ISSUE DATE. IF <br />CONSTRUCTION FAILS TO MEET ALL REQUIREMENTS OF STATE LAWS AND mElON COUNTY BUILDING AND <br />ZONING ORDINANCES., THIS PEE~IT SHALL BECOME NULL AND VOID. <br /> <br />REMARKS: ALJ-FH <br />DONA. LO E_ WOOOLEY, MARION COUNTY BUILDING OFFICIAL / BY ............ _,~,~__ ............. <br /> <br />o~ ,, Mc I~ :~, *~* e~, OFFICE COPY <br /> <br /> <br />