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MARION COUNTY BUILDING INSPECTION <br />SENA:f~R BLDG NO 225 <br />~-220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE 588-~147 <br /> CODE-A-PHONE 4::30 RM - 8::00 <br /> <br />~m perfofm*n9 wo(k o,/a propert¥ I Own or ooc up~ <br /> <br />ow~TE: 07/2~/B9 TIME: <br /> HOLTERS, BILL <br /> <br />58507~000 <br /> <br />RESIDBNTrAL <br /> <br /> 11962 STEINKAMP RD <br />AUMSVILLE <br /> <br />OR 97325 <br /> <br />SE <br /> <br /> OONTRACT CITY UGB <br />MARION COUNTY NO <br /> <br />11852 STEINKAMP RD SE <br />PHONE: <br /> <br />SECTION <br /> <br />TOWNSHIP <br /> <br /> PARCEL 2 <br /> <br />SITE NUf4BER; <br />nANG~4LUATION: ZONE <br /> <br />MAP <br /> <br />299 <br /> <br /> 33 UNITS 8S I~neG mT 1%4 0OI-~NEH AR 49 <br />78039 .O SF NO NO <br /> <br />TYPE: ON-SITE SEWAGE <br /> <br />PERNIT OR APPLICATION NO: <br /> <br />CONTRACTOR, NO. <br />MOLTERS, BILL <br />11852 STEINKAMP RD SE <br /> <br />PHONE: <br /> <br />9017806 <br /> <br />WATER SUPPLY: PW <br />TEST HOLES READY; <br />SITE EVALUATION NUMBER: <br />EXISTING TANK SIZE: <br />EXISTING DRAIN FIELD LINES: <br />SEPTIC TANK PUMPED: <br />PREVIOLJS NO. BEDROOIvlS: <br /> <br />SE '.. 6 MONTHS OLD <br /> <br />QUANT I TY AMOUNT <br /> 1 <br /> <br />TOTAL ASSESSED FEES $110,00 <br />PREVIOUS RECEIPTS $0.00 <br />THIS RECEICT $110_00 <br /> <br />8ALANC~ DUE $0,00 <br /> <br />PAYEE: HOLTERS. BI~ RECEIPT NO: 18711 <br />RECEIVED BY: PR~¢ .......... TYPE: CK CHECK ~: 10891 <br /> <br />SEE ATTACHED DOCUMENT FOR REQUIREMENTS DP ON-~IT~ SEWAGE SYSTE~. <br /> <br />* /NIB IS NOT A PEI%~4IT. T~IS APPLICATION f4dST ~ ~ A R~I~ P~ ~ERE ~E <br />FOLL~IN6 ~ST BE ~PL~ED, IT IS ~E ~SI8ILI~ OF ~ A~LIC~T TO ~RE ~AT <br />ALL NEC~ INFO~TI~ H~ B~ P~IDED+ <br /> <br />REMARKS: NEW SYSTEM <br /> <br />CITY JURISDICTION: BY ......... DATE .......... <br /> <br /> <br />