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MARION COUN%Y BUILDING INSPECTION <br />SENATOR BLDG NO 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE~ 588-,147 8~00 - 4:30 <br /> 24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />bye, registered builder <br /> <br /> Other <br /> I have read and agree to the terms stated on the reverse side of <br /> this document <br /> <br /> OATE: 11/20/92 TIME: 3~1:38:05 <br />OWNER:: <br /> NATIONAL WOOD INDUSTRY <br />S'TUS <br /> <br /> ~ PORTER RD <br /> AUMSVILLE, OR <br /> <br />MAfLfNG ADD~ESS <br /> <br />WERTZLER, LIN : OWNER <br /> <br />PHONE: <br /> <br />TAX LOT <br /> <br />CONSTRUCTION TYPE <br /> <br />COMHERCIAL <br /> <br />SE bChf~T City : 'UGB <br /> MARION COUNTY' NO <br /> <br />OCCUPANT LOAD <br /> <br /> NO OF 8EOROO~$ <br /> <br />BUBBIVISION <br /> <br /> BITE NUMBER: <br /> VALUgTION~ <br /> <br />LOT <br /> <br />"eCod¢, ........ ~s~d~i6~ .............;'~-UW N-§m W .... ' ~',~N<~E" ................... BONE <br /> <br /> 6 98 1W <br />]~E~TH m A~EA UNITS IRREG LOT : CORNER <br /> 35. AC NO NO <br /> <br />TYPE: ON-SITE SEWAGE WATER SUPPLY: PW <br /> ~ TEST HOLES READY: <br />PERMIT OR APPLICATION,~O: ~9044018 SITE EVALUATION NUNBER: <br /> / ~ % EXISTING TANK SIZE: <br />CONTRACTOR, NO. 0~1/>4 ~%, ~ EXISTING DRAIN FIE~D LINES: <br />Adolph H Scharff // ~ I SEPTIC TANK PUMPEO. <br /> <br /> ITEM QUANTITY AMOUNT <br />8TO ONSITE SY8 < i000 6AL ~ $210.00 <br /> <br />PAYEE: Adolph H Scharff <br />RECEIVED BY: CL <br /> <br />TOTAL ASSESSED FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />$210~00 <br />$210.00 <br /> <br />BALANCE DUE $0~00 <br /> <br /> RECEIPT NO; 46088 <br /> .... TYPE: CK CHECK ~: 27827 <br /> SEE ATTA6HEO DOCUMENT FOR REQUIREMENTS OF ON-SITE SEWAGE SYSTEM, <br /> <br />* THiS IS NOT A PERMIT. THIS APPLICATION MUST GO THROUGH A REVIEW PROCESS WHERE THE <br />FOLLOWING MUST BE COMPLETED. IT tS THE RESPONSIBILITY OF THE APPLICANT TO ASSURE THAT <br />ALL NECESSARY INFORMATION HAS SEEN PROVIDED. <br /> <br />FORM # MC 15.5~ R~V 4/gO OFFICE COPY <br /> <br /> <br />