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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG NO, 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97801 <br /> <br /> PHONE 588-5147 <br />CODE-A-PHONE 430 PM - 8 00 AM <br /> <br /> Other <br /> <br /> DA]E; 02/0]/8S TIME: <br /> <br />Owner AL, FORD C.A. <br /> <br />TAX LOT <br /> <br />~E~I DEN1-[ I,~ <br /> <br /> 20912 NE FILBERT <br />AURORA <br /> <br />SAME <br /> <br />PHONE; 538-,~348 <br /> <br />OR 538-4346 <br /> <br /> CONT¢~ ACT CITY UGB <br />AURORA NO <br /> <br />SUBDIVISION <br /> <br />NEW COLONY <br /> <br />SiTE NUMBER: 846? <br />VALUATION: <br /> <br />I OT 8LOCK SECTION <br />4 4 <br /> <br /> 13 4S 1W R-2 <br />4950.00 UNITS SF IRREG LOT NO CORNERNO <br /> <br />TYPE~ ON-SITE SEWAGE <br /> <br />PER~IT OR APPLICATION NO: <br /> <br />CONIAACTOR. NO_ 33966 <br />~08'S BACKHOE SERVICE <br />17004 AR~OR GROVE RD NE <br />NOODBLIRN. OREGON 9?0'7 <br />PHON g: <br /> <br />901380~- <br /> <br />TEST HOLES READY: <br />SITE EVALUATION NU~ER; <br />EXISTING TANK SIZE: <br />EXISTING DRAIN FIELD <br />SEPTIC TANK Pt,JMPED: BOERS BACKHOE <br />PREVIOUS NO_ BEDROO~S~ <br /> <br />;TEM QUANTITY &MOUNT <br />REPAIR - MINOR 1 $55.00 <br /> <br /> TOTAL ASSESSED FEES $55,00 <br /> PREVIOUs RECEIPTS $55.00 <br /> THIS RECEIPT <br /> <br /> BALANCE DUE <br /> <br />PAYEE: 808'S SAOKHOE SERVICE INVOICE NO; <br />RECEIVED BY: c~ TYPE: IN CHE_.K ~: 0 <br /> <br />SEE ATTACHED DOCUMENT FOR REQUIREMENTS OF ON-SITE SEWAGE SYCTEM. <br /> <br />* THIS IS NOT A PERNIT+ THIS APPLICATION t4UST GO THROHGH A REVIE~ PROCESS INHERE THE <br />FOLLONING MUST BE COMPLETED. IT IS THE RESPONSIBILITY OF THE APPLICANT TO ASSURE THAT <br />ALL NECESSARY INFORICATION HAS BEEN PROVIDED. <br /> <br />PLAN *EVIE , OI= RISO,OTION: ............. <br />REMARKS: MINOR,COULD BE MAJOR REP~ZR <br /> <br />FORM~ M(::1~.51~ nEV 11,.8 OFFICE COPY <br /> <br /> <br />