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MARION COUNTY <br /> BUILDING INSPECTION <br />Senator Buildirlg * 227~,High Street NE * Second Floor · Salem, Oregon 97301-3670 <br />Office Hours: 8:00 -4:30 Phone: 588-5147 Code-A-Pliolle: 4:30 p.m.- 8;00 a.m, <br /> <br />DATE~ 08/09/88 TIME: 10.'05.'08~ <br /> ~OLTER, 8tLL <br /> <br />56503-000 <br /> <br />RESIDENTIAL <br /> <br /> 11852 STEINKAMP ROAD SE <br />AUNSVIL, LE OR 97325 <br /> <br />MARION COUNTY <br /> <br />NO <br /> <br />15995 SaW PEAVINE RD <br />MCMINVILLE, OREGON 97128 <br />PHONE; ?89-?744 <br /> <br />SITE NUMBER: <br /> VALUATION: <br /> <br />4898 <br /> <br />243 962 <br /> <br />9S lid AR <br />SF YES. NO <br /> <br />48 <br /> <br />TYPE: ON-SITE SEWAGE <br /> <br />PERMIT OR APPLICATION NOr 9010299 <br /> <br />CONTRACTOR, NO. J.ADAMS <br />SANTIAM VALLEY HOMES <br />11373 MILLCREEK RD SE <br />AUMSVZLLE OR 9?325 <br />~ONE: <br /> <br />WATER SUPPLY: PM <br />TEST HOLES READY: <br />SITE EVALUATION NUMBER: 9899 <br />EXISTING TANK SIZE: <br />EXISTING BRAIN FIELD LINES: <br />SEPTIC TANK PUMPED: <br />PREVIOUS NO+ BEDR0~NS: <br /> <br /> QUANTITY <br />SE < 8 MONTHS OLD 1 <br /> <br />PAYEE: MOLTER, BILL <br />RECEIVE[;) BY= CL <br /> <br />TOTAL ASSESSED FEES <br />PRg~/IOUS RECEIPTS <br />THIS RECEIPT <br /> <br />BALANCE DUE <br /> <br /> AMOUNT <br /> $110.00 <br /> <br /> $1t0.00 <br /> $0.9o <br /> $110.00 <br /> <br /> $o.oo <br /> <br />10979 <br />5055 <br /> <br /> RECEIPT NO: <br /> TYPE: CK CHECK <br /> <br />SEE ATTACHED DOCUMENT FOR REQUIREMENTS OF ON-SITE SEWAGE SYSTEM. <br /> <br />* THIS IS NOT A PERMIT. THIS APPLICATION MUST GO THROJ(~ A RE3/IEW PROOE:~S I~-IERE THE <br />FOLLONING I'¢JST BE COMPLETED. IT IS THE RESPONSIBILITY OF THE APPLICANT TO ~RE THAT <br />ALL NECESSARY INFORtcLATION HAS BEEN PROVIDED. <br /> <br />REMARKS: STD SYSTEM <br /> <br />CITY JURISDICTION: BY ...... DATE <br /> <br /> <br />