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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG NO 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE 588-5147 <br /> CODE-A-PHONE4::30 RM - 8::00 AM <br /> <br />I ~m performing work on a property I own or occupy ~~~ <br />I am a registered bulldor OR (the authorized rep eso~ ave SIGNATUR~ OF APPL~C <br />of a registered builder <br />Tbo work will be performed by ~ reglstorod builder <br />Other <br /> <br />DATE; 09/08/89 TIME: 11:48=24a <br /> NOLTERS, BILL 5850"/-000 RESIDENTIAL <br /> <br /> 11972 STEINKAMP RD SE CONTRACTOITY UGB OCCU~N]LOA~ <br />AUMS¥ILLE OR 9?325 <br /> MARION COUNTY NO <br /> <br />11852 STEINKANp RD ,SE <br />PHONE.. <br /> <br /> 281 <br /> <br /> SITE NUMBER: 5692 <br /> VALUAT I Of 4: <br /> <br /> 33 8S 1N AR 48 <br />298 77778.0 SF NO NO <br /> <br />TYPE: ON-SITE SEWAGE <br /> <br />PERMIT OR APPLICATION NO: <br /> <br />CONTRACTOR, NO. <br />WOLTERS, BILL <br />11852 STEINKAMP RD SE <br /> <br />PHONE: <br /> <br />9014384~ <br /> <br /> ITEM <br />SITE EVAtJJATION, EA. ADDL. LOT <br /> <br />NATER SUPPLY: PiN <br />TEST HOLES READY: YES <br />SITE EVALUATION NUMBER: <br />EXISTING TANK SIZE: <br />EXISTING DRAIN FIELD LINES: <br />SEPTIC TANK PUNPED: <br />PREVIOUs NO. BEDROO~4S: <br /> <br />TOTAL ASSESSED FEES <br />PREVIOUS RECE~ PTS <br />THIS RECEIPT <br /> <br />QUANTITY ANOUNT <br /> I $145.00 <br /> <br />$145.00 <br /> $O.00 <br />$~45.00 <br /> <br />BALANCE DUE $0.00 <br /> <br />PAYEE: t'¢OLTERS, 8ILL RECEIPT NO: 15256 <br />RECEIVED BY; CL TYPE: OK CHECK ~t 10140 <br /> <br />SEE ATTACHED DOCUMENT FOR REQUIREMENTS OF ON-SITE SEN.AGE SYSTEM+ <br /> <br />NOTE: THIS 0OES NOT GRANT OR IMPLY PE~I-~qION TO BUILD ON THIS PARCEL. PLANNING AND <br />CONSTRUCTION PEENI~I~J. ST BE OBTAINED BEFORE BU~LDINe OR `SEPTIC [NSTALLAT[ON BEGINS. <br /> <br /> BY__,~LL.Jr,~ DATE_'_~:~_'_~__ CZTY JURISDICTION: 8Y ......... DATE .......... <br />PLAN <br /> REVIEW: <br /> <br />REMARKS: SE R~5996 <br /> <br />OFFICE COPY <br /> <br /> <br />