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MARION COUNTY BUILDING INSPECTION <br />'~ENAT~R BLDG. NO 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE 588-5147 <br />C~DE-A-PHONE 4.30 PM. - 8::00 AM <br /> <br />o! a registered builder <br />Tho WOrK will be performed by a reg{$tered builder <br />Other <br /> <br />D&TE, 0 iI27IS9 TIME: 4: '~cJ :43m <br /> <br /> ,ii, <br />BIGNATURE OF APpUCANT <br /> <br /> SO ~ <br /> <br />CONSTRUCTION TYPE <br /> <br />qE$I DEN FIA~ <br /> <br /> 20252 CFIL-~ERT ST NE <br /> AURORA OR 97,~32 <br /> <br />USE OF BUILDING .. * <br /> <br /> CONTRACT CITY <br /> <br />A~RORA <br /> <br />MAILING ADDRESS <br /> <br />SUBDIVISION <br /> <br />PHONE: 65-7~5-2¥.9 (.~/~- "'~.-[ ~q <br /> <br /> 55 90 <br /> <br />TYPE: ON-SiTE SEWAGE <br /> <br />PEF~,ZT OR APPLICATTON NO: <br /> <br />CONTRACTOr:, NO. <br />SMITH, JCJqN F <br /> <br />PHONE: 65?-52'79 <br /> <br /> ~[TE '4.,f~ER: 6442 <br /> VALvAT i O~: <br />SECTION TOWNSHIP RANGE ZONE <br /> 13 4,.S <br /> 4950.00 SF NO NO <br /> <br /> ~ATER SUPPLY: Cw <br /> TE?.T HOLES READY: <br />9019740 SITE EVALUATICt'~ NUf"~ER: <br /> I EXISTING T~NK S~ZE: ~50 <br /> ~ * :.~,~: ~ISTING D~N FIE~D ~I ~S: <br /> ~ ~ SEPTIC T~K ~HPE0:1-"9-89 <br /> <br /> ; TEM <br />4UTHORIZAT~ON NOTICE - FLD. VISIT <br /> <br />MAP <br /> <br /> @ <br /> <br />m&YEE: Slvi~T'r-i, ,cOl'tN F <br />RECEIVED BY: ¢1 <br /> <br />TOTAJJ~ A.S.SE.S.SEO FEES- <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />CiJ ANT I Ty A{V{OI~ NT <br /> I $105.0,9 <br /> <br />$105.00 <br /> $0.0¢ <br />$ ;05_06 <br /> <br />DUE $0. JC <br /> <br />· TH'rS TS NOT A PEt;Y4IT. THIS A~PLIOA~'0N-FiJBT GO THREXJ~{ A REVlEc¢ PROCESS >~ERE TH= <br />FOLLOWING t4LJST B~ COMPLETED. IT IS THE RESPONSIBILITY OF THE APPLICANT TO A~C.,~E THAT <br />A~L NECE%SARY IN~O~'~,IATI,SN HAS SEEN P~:~)VIOED. <br /> <br /> <br />