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MARION COUNTY <br /> BUIL~'31NG INSPECTION <br />Serlamr Building ,. 220 High Street NE ,...%cond Floor · Salem. Oregon 97301-36711 <br /> <br /> Office Hours; 8:00 -4:~'0 Phone: 588-5147 C{xlc-A-Phone: 4:30 p.m.- 8:00 am. <br /> <br />08/10/88 <br /> <br />;._.A I S, TOM <br /> <br />TINE: 3:37:44p <br /> <br /> 14955 4TH S7 NE <br />&L;XORA OR 97002 <br /> <br />AURORA iq(-] <br /> <br />PO SOX 427 <br />AURORA 97002 <br />PMONE: 6?8-$??9 <br /> <br />165 <br /> <br />YES NO <br /> <br />,PE: ON,.-SI%E SEWAGE <br /> <br />?ERNIIT OR APPLICA'FION NO: <br /> <br />CONTFL&CTOR, NO- <br />L_AIS, TOM <br />/>O BOX 42'7 <br />AURORA 97802 <br />~HCNS: 5'79-~5'779 <br /> <br />NATSF~ %UPPLYt C~4 <br />]"E'ST HOLES ~A21Y: <br />SI7~ EVALUATION NUN~BEik; <br />EX!S'~ZNG TANK SIZE: <br />EXi:ST !NG 0RA!N <br /> <br />~RSV IOUS NO, <br /> <br /> iTE~J OUANT ! TY ANIOUN T <br />STANDARD ON-SIT'E ~YS?Ei~ ~ ' $155.00 <br /> TOTAL ~ESSED FE~S $165.00 <br /> PREVIOUS RSCEi PTS $0.08 <br /> <br />~'*.&~EE.: LAIS TOM INVOICE NO~ 11048 <br />F<EGfIVE0 BY: O~ .................................... 'TYPE: ~N CHECK ~: O <br /> <br />SEE ATTACHED DOCU~IENT FO~ RE~LIIREMENTS OF ON-Si-FE SENAGE <br /> <br />* ~iS IS NOT A PE~IT. THIO APPLICATI~ NUST ~ THR~GH A R~IEN <br />FOLL~ING ~ST BB ~PL~BD. IT IS THE R~SiBILITY OF THE APPLIC~T TO <br />ALL NEC~RY INPO~TI~ H~ BE~ P~VIDED. <br /> <br />PL.AN REVIEW. BY DAT~ .... i~ JURiSDICTiON: <br />RENAR~S: STANBARD SYSTE~ <br /> <br /> <br />