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MARION COUNTY BUILDJNG INSPECTION <br />SENATOR BLDG NO, 225 <br />220 HiGH STREET NE <br /> SALEM~ OREGON 97301 <br /> <br /> PHONE 588-5147 <br />CODE-A-PHONE 4::30 PM - 8 00 AM <br /> <br />DATE: 03/14/89 TIME: 12:21:47p <br /> <br />OWNER GARCIA, ARf4ONE~O <br /> <br />TAX LOT <br /> <br />RESIDENTIAL <br /> <br /> ~AW SQUARE RD <br />AUtVEjWI LLE OR <br /> <br />9003 SHAW SQUARE RD <br />AUMSViLLE, OR 9?325 <br />PHONE: 749-1011 <br /> <br />LOT BLOCK <br /> <br />97325 <br /> <br />24 <br /> <br />3.00000 <br /> <br />SUBDIVISION <br /> <br /> SITE NUMBER; <br /> VALUATION: <br /> <br />8S 2N <br /> <br /> 6612 <br /> <br />ZONE <br /> AR3 <br /> <br />TY~E: ON-SZTE SE~GE <br /> <br />PERMIT OR APPLICATION NO: <br /> <br />CONTRACTOR, NO, <br />GARCJA, ARNONDO <br />9003 SHAW SOUARE RD <br />AUMSVtLLE, OR 9?325 <br />PHONE: 749-1011 <br /> <br />9014526 <br /> <br />TEST HOLES READY: YES <br />SITE EVALUATION NUMBER: <br />EX[STING TANK SIZE: <br />EXISTING DRAIN FIELD LINES: <br />SEPTIC TANK PUMPED: <br /> <br /> ITF~ QUANTITY AMOUNT <br />SE < 6 MONTHS OLD 1 $110,00 <br /> <br />TOTAL ASSESSED F~ES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />$1't0,00 <br /> $0_00 <br />$110_00 <br /> <br />BALANCE BUR $0.00 <br /> <br />PAYEE: GARCIA, AFClP~.P¢ RECEIPT NO: 15396 <br />RECEIVED BY: PR _=~f("'"~_~=:_z.-~ TYPE: CK CHECK ~: 3581 <br /> <br />SEE ATTA~ED ~UHEN7 FOR REQUZREM~T$ OF ON-SITE SENSE S%TEH. <br />* ~IS IS NOT A PE~IT. ~IS APPLI~TI~ ~ST ~ ~ A R~IB P~ ~ERE ~E <br />FOL~I~ ~ST BE ~PL~EO. IT IS ~E R~IBIL[~ OF ~E APPL[~T TO ~RE ~AT <br />ALL NEC~ INFO~TI~ H~ 8E~ P~VIDEB. <br /> <br />CITY JURISDICTION: BY DATE <br /> <br />~ORM # MC- iR.58 ~4EV ~18¢ OFFICE COPY <br /> <br /> <br />