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,. MARION COUNTY <br /> B(~ILI)ING INSPECTION <br />Senator Building * 220 High Street NE · Second Floor · Salem, Oregon 97301-3670 <br /> <br /> OfFice 14ours: 8:00 - 4:3(I Phone: 588-5147 Code-A-Phone: 4:30 p.m. - 8:00 a.m. <br /> <br />DATE: 03/29/89 TIME: 11:02:45a <br /> <br /> ~ARTIN, KIM & DIANE <br /> <br />11808 l184~DUCK INN <br />GERVAIS OR 97026 <br /> <br />NE <br /> <br />~RION COUNTY <br /> <br />NO <br /> <br />RESIDENTIAL <br /> <br />11848 DUCK INN RD NE <br />GERVAIS, ORECq~N 97026 <br />PHONE: 792-4259 <br /> <br />SITE NUMBER: <br /> VALUATION: <br /> <br />4643 <br /> <br /> 35 5S 2W <br />28.0000 AC NO <br /> <br /> EFU <br /> <br />NO <br /> <br />18 <br /> <br />TYPE: ON-SITE SEWAGE <br /> <br />CERMIT OR APPLICATION NO: 9014681 <br /> <br />CONTRACTOR, NO. <br />NARTIN, KIM & DIANE <br />11848 DUCK INN RD NE <br />GERVAIS, OREGON 97026 <br />PHONE: ?92-4259 <br /> <br />WATER SUPPLY: PN <br />TEST HOLES READY: <br />SITE EVALUATION NUMBER: <br />EXISTING TANK SIZE: <br />EXISTING DRAIN FIELD LINES: <br />SEPTIC TANK I>UMPED~ <br />PREVIOUS NO. 8EDREX)MS; <br /> <br /> ITFTM <br />ALTERATION <br /> <br /> QUANT I TY A,M(~ N T <br /> .Xoo ,Sg,, 1 ,145.oo <br /> TOTAL ASS~ED FEES $145.00 <br /> ~ PREVIOUS RECEIPTS $0.00 <br /> THIS RECEIPT <br />  BALANCE DUE $0.00 <br />PAYEE: ~RT~N, KIN& DI~E RECEIPT NO: 15741 <br />RECEIVED BY: DN ~PE; OK ~EOK ~: 1895 <br />SEE ATTA~EB B~NENT FOR RE~IREN~TS OF ~-SZTE SE~GE SYSTEN. <br /> <br />~ ~IS IS NOT A ~E~IT. ~IS A~LI~TI~ ~ST ~ ~ <br />FOL~IN6 ~ST BE ~PL~ED. IT ~8 ~E R~SIBILI~ OF ~E AP~LIO~T TO ~RE ~AT <br />ALL NEO~ INFO~TI~ H~ BE~ <br /> <br />REMARKS: ALTERATION NEW SEPTIC SYSTEM R~7341 <br /> <br />CITY JURISDICTION: BY DATE <br /> <br /> <br />