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MARION COUNTY <br /> BUILDING INSPECTION <br />Senator Braiding . 220 l'txgh Streel NE * Second Floor * Salem, Oregon <br /> <br /> Office Mours:: 8 00 - 4 30 Phone 588-514'* (-odc-&-Pho~c 4 30 p m - ~ 00 ,I m <br /> <br />DATE: 04/04/89 TIME: 11:35:18a <br /> <br /> JOHNSON, EARL <br /> <br /> 8754 MILL CREEK <br />AU~SVILLE, OREGON OR 97325 <br /> <br />MARION COUNTY <br /> <br />NO <br /> <br />RESIDENTIAL <br /> <br />~AME <br /> <br />PHONE: 749-2001 <br /> <br />SITE NUMBER: <br /> VALUATION: <br /> <br />4275 <br /> <br />26 8S 2W EFU 51 <br /> <br />35.0000 <br /> <br />AC NO NO <br /> <br />TYPE: ON-SITE SEWAGE <br />PERMIT OR APPLICATION NO: 9014938 <br /> <br />CONTRACTOR, NO. q <br />JONNSON, EARL $ <br />SAME <br />PHONE: 749-2601 %~''t'--Tq''-'' <br /> <br />WATER SUPPLY: PW <br />TEST HOLES READY: <br />SITE EVALUATION NUMBER: <br />EXISTING TANK SIZE: 1000 <br />EXISTING DRAIN FIELD LINES~ <br />SEPTIC TANK PUMPED: <br />PREVIOUS NO. BEDROOMS: 2 HOUSE <br /> <br /> ITEM QUANTITY AMOUNT <br />ANNUAL EVAL. - TEMP OR HDSHP I~ 1 $60.00 <br /> <br />TOTAL ASSESSED FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br /> $o,0o <br />$60.00 <br /> <br /> ~ BALANCE DUE $0.00 <br />PAYEE: JOHNSON, EARL ~ % RECEIPT NO: 15868 <br />RECEIVED BY- DM - TYPE* CK CHECK ~- 1287 <br /> <br />SEE ATTACHED DOCUMENT FOR REQUIREMENTS OF ON-SITE SEWAGE SYSTEM. <br /> <br />m THIS IS NOT A PERMIT. THIS APPLICATION NUST GO THR~GH A REVIEI~ PROCEE~ WHERE THE <br />FOLL0~IN6 I~JST BE COMPLETED. IT IS THE RESPONSIBILII~Y OF THE APPLICANT TO ASSURE THAT <br />ALL NECESSARY INFOI~flATION HA.% BEEN PROVIDED. <br /> <br />REMARKS: ANNUAL EVAL HARErSHIP R~7389 <br /> <br />CITY JURISDICTION: BY DATE <br /> <br /> <br />