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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO. 225 <br />2¢'0 HIGH STREET NE <br /> SALEM, OREGON 97'301 <br /> <br /> PHONE 588-$147 <br />CODE-A-PRONE 4:30 RM. - 8:00 A.M, <br /> <br />DATE; 02/22/90 TIME: 15:03;14 <br /> D T H HOMES <br /> <br /> 14684 KABEL COURT <br />AURORA <br /> <br />OR 97002 <br /> <br />NE <br /> <br />USE OF BUILDING: <br /> <br />24755 SW 55TH <br />TUALATIN OR 97062 <br />PHONE; 638-8291 <br /> <br /> 12 4S <br />38000011 uNn's: AC <br /> <br /> 20448-000 RESIDENTIAL .... <br />CONSYRUC~]0N T'I'P~i OO0UPANOY~ <br /> <br /> CONTRACT C~¥; UGB; .... 00~PAN¥ LJ2~O; <br />AURORA NO <br /> NO. OF BEDROOMS: <br /> <br /> KASEL CO JRT <br /> <br /> SITE NUMBER: 5~89 <br /> VALUAT [~: <br /> <br /> ~A¢: <br /> 1W R-1 3 <br /> I~n~G, LOT'. CbRN~ <br /> NO <br /> <br />TYPE: ON-SITE SEWAGE <br /> <br />PEF~I[T OR APPLICATION NO: 9022090 <br /> <br />CONTRACTOR, NO. <br />D T H HONE~ <br />24'755 SN 85TH <br />TUALATIN OR 9?062 <br />PHONE: 638-8291 <br /> <br />HATER,SUPPLY: Old <br />TEST HOLES READY: <br />SITE EVALUATION NUMBER: 11134 <br />EXISTING TANK SIZE: <br />EXISTING DRAIN FIELD LINE~: <br />SEPTIC TANK PU~PED: <br />PREVIOJS NO. BEDRODF~ <br /> <br /> ITEM <br />STANDARD ON-SITE SYSTB'4 <br /> <br />QkJANTITY <br /> 1 <br /> <br />TOTAL ASSESSED FEES <br />PREVIOOS RECEIPTS <br />THI~ RECEIPT <br /> <br />8ALANC~ DUE <br /> <br />PAYEE: D T H HONES <br /> <br /> INVOICE NO: <br />TYPE~ <br /> <br /> AJ~NT <br /> $165.00 <br /> <br /> $165.00 <br /> $o.oo <br /> $165.00 <br /> <br /> $0.00 <br />23424 <br /> <br /> RECEIVED BY: cl ..................................................................................... tN 6~EOK ~: 0 <br /> <br /> ~EE ATTACHED DOCUMENT FOR REQUt[REI~4ENTS OF ON-SITE SEHAGE SYSTED1. ................ <br />~ THIS IS NOT A PER,lIT_ 'THIS APPLICATION ~ GO THROUGH A RE'F,/'rlD4 PROCESS 1~4ERE THE <br />FOLLONING ll~.lST BE COMPLETED+ IT IS THE RESPONSIBILITY' OF.THE .APPLIC_,/t~T TO ~,~.~GUI~E THAT <br />ALL NECEGE, ARY INPOFi~,IATION HAG EIEEN PROVIDED+ <br /> <br />PLAN REVIEW: BY ................................ DATE ................................ <br />REMARKS; PEP¢4I T <br /> <br />CITY JURISDICTION:"BY ........................ DATE ...... <br /> <br />OFFICE COPY <br /> <br /> <br />