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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG NO 225 <br />22'0 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE 588-5147 <br />CODE-A-PHONE 430 PM - 8 00 A M <br /> <br />ov~TE: 01/03/89 TINE; <br /> POREMAN, THERESA <br />SITUS ADDRFSS <br /> <br />10:10;17a <br /> <br />RESIOENTI~L <br /> <br /> 562 11TH ST <br />AUMSV I LLE <br /> <br />OR <br /> <br />97325 <br /> <br />N <br /> <br />~ARION COUNTY NO <br /> <br /> SANE <br /> <br /> PHC~qE <br /> <br />LOT <br /> <br />749-1503 <br /> <br /> 25 <br /> <br />271 380 10'2980. <br /> <br />SITE NUMBER: 8289 <br />VALUATION: <br /> <br /> 2N AR <br /> NO NO <br /> <br />MAP <br /> <br />TYPE: ON-SITE SEWAGE <br /> <br />¢ERMi'[ OR APPLICATION NO: <br /> <br />CONTRACTOR, NO <br />FOREMAN, THERESA <br /> <br />PHONE: 749-1503 <br /> <br />9013282 <br /> <br />WATER SUPPLY: PN <br />TEST HOLES READY: <br />SITE EVALUATION NUMBER: <br />EXISTING TANK SIZE: <br />EXISTING DRAIN FIELD LINES; <br />SEPTIC TANK PUMPED: 12-26-86 <br />PREVIOUS NO. 8E0~DCxvL~: <br /> <br /> t TEN QUANT i TY Af4OUNT <br />ANNUAL EVAL, - TEMP OR HOSHP MM i $60.00 <br /> <br />TOTAL A~SESSED FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />$60.00 <br /> $0.00 <br /> <br />BALANCE DUE $0.00 <br /> <br />PAYEE= FOREMAN, THERESA ,~---~- RECEIPT NO= 14080 <br /> <br />SEE ATTACHED DOCUMENT FOR REQUIREMENTS OF ON-SITE SEWAGE SYSTEM. <br /> <br />* THIS IS NOT A PERMIT. THIS A~PLIOATION ~ST ~ ~ A R~I~ P~ ~ERE ~E <br />FOLL~ING ~ST BE ~PL~ED. ZT IS ~E R~S~BILZ~ OF ~E APPLIC~T TO ~RE ~AT <br />ALL NEC~RY INFO~ATI~ H~ BE~ P~VIDED. <br /> <br />RE~ARKS; ANNUAL HARDSHIP SEPTIC <br /> <br />OFFICE COPY <br /> <br /> <br />