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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO. 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE 588-5147 <br />CODE-A-PHONE 4:30 P.M, - 8:00 A,M. <br /> <br />0ATE: 07/14/88 TIME: <br /> <br />OWNER: <br /> <br />SITUS ADDRESS: <br /> <br /> 5157 DUMORE DR <br /> AU~SV;I LLE <br /> <br />USE OF BUILDING: <br /> <br />MA~L~NG ADDRESS: <br /> <br /> SAJ'4E <br /> <br /> PHONE: 362-7113 <br /> <br />GRAHAM, <br /> <br /> DONSTRUDTION TYPE: i OCGUPANCY; <br /> SE ! ........................................... ~ <br /> OR 97~25 ~ GONTRAOT CITY; ; UGB: iOGGUPANT LOAD <br /> M~RION COUNTY NO i <br /> 3 <br /> <br />DENT I AL <br /> <br /> SITE NUMBER: 4850 <br /> VALUATION: <br /> <br />12 8S i 2~ ! ARS 49 <br /> <br /> AC , ,R.E~..0~, YES <br /> <br />TYPE: ON-SITE SEWAGE <br />PERMIT OR APPLICATION NO: 9009573 <br /> <br />CONTRACTOR, NO. <br />SAMEGRAHAM' MARKL & L,NDA ~.,..]¢(~b~ <br />PHONE: 352-7113 $/ <br /> <br />~ATER SUPPLY: PN <br />TEST HOLES READY: <br />SITE EVALUATION NUMBER: <br />EXISTING TANK SIZE: 1000 <br />EXISTING DRAIN FIELD LINES: <br />SEPTIC TANK PUMPED: 5/13/87 <br />PREVIOUS NO. BEDROOMS; <br /> <br />45O <br /> <br /> ITEM QUANTITY ,AMOUNT <br />EXISTING SYSTFJV] EVAL. RPT. 1 $100_00 <br /> <br /> TOTAL ASSESSED FEES $100.00 <br /> P~EVIOUS RECEIPTS $0.00 <br /> THIS RECEIP% $100.0O <br /> <br /> BALANCE DUE $0.00 <br /> GRAHAM, MARKI & LINDA <br />PAYEE:RECEiVED ............ <br /> NO: <br /> ..................... CHECK ~: 1820 <br />SEE ATTACHED DOCUMENT FOR REQU~RE. MENT$ OFQN-$ITE:SENAGESYST~. <br /> <br /> THIS IS NOT A PERMIT+ THIS APPL~CATION MI, JST ~C, THROU(~IA REVIEN ~ROCESS !,~HERE THE <br />FOLLON[NG MUST BE COMPLETED. IT ~S THE RESI:'~N$IB[LITY OF:'rTHE:APPL[CANT TO ~RE THAT <br />ALL NEC~A'Y ~NFORNATION HAS BEEN PROVIDED. <br /> <br />PLAN REVIEW: BY ..... DATE_ ~ CITY 3UR~SDIC~ION: BY DATE <br /> <br />REMARKS: SEPTIC EVAL FOR LO~W R~4032 <br /> <br />:/l~ uc~5-5~ ~v<v~ OFFICE COPY <br /> <br /> <br />