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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO. 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br />DATE: 11/03/89 TIME: ~ :30:28p <br /> <br /> TURNER, LORRAINE <br /> <br /> PHONE 588-5147 <br />CODE-A-PHONE 4:30 P.M. - 8:00 A.M. <br /> <br /> SIGNAYURE OF APPL[CAN'~: <br /> <br />RESIDENTIAL <br /> <br /> 20936 HUBBARD CUT OFF RD NE <br />AURORA OR 97002 <br /> <br />USE OF 8tJI[,$1NG: <br /> <br />CONTRACT CITY. JOB OCCUPANT LOAD: <br />r, tAR I ON COUNTY NO <br /> NO 0F RI'0R00M!~ <br /> 3 <br /> <br />MAIL]NO ADDRESS: <br /> <br /> SANE <br /> LINDA 8~I 882-2914 REALTOR <br /> <br />WIOTH; SEPTH; AREA: 1 . 33000 ' <br /> <br />SUBDLVISION: <br /> <br /> SITE NUMBER: 8?65 <br /> VALUATION; <br /> RA~E: ZONE; MAp: <br /> <br />4S lW EFU 3 <br /> <br />AC IRREG. LOT: NO CORN~=o <br /> <br />ON-SITE SENAGE <br /> <br />PERMIT OR APPLICATION NO= 9020041 <br /> <br />CONTRACTOR, NO. <br />TURNER, LORRAINE <br />SANE <br />LINDA BASSANI 682-2914 REALTOR <br />Pt..tON E: <br /> <br />NATER SUPPLY: FiN <br />TBST HOLES READY= <br />SITE EVALUATION NUMBER: <br />EXISTING TANK SIZE: <br />EXISTING DRAIN FIELD LINESz <br />SEPTIC TANK PUMPED: NILL BRING IN <br />PREVIOUS NO. BEDROOMS: <br /> <br /> ITEM <br />EXISTING SYSTEN EVAL. RPT. <br /> <br /> QUANTITY AMOUNT <br /> 1 $100.00 <br /> <br />TOTAL~ESSED FEES $100.00 <br />PREVIOUS RECEIPTS $0.00 <br />THIS RECEIPT $100.00 <br /> <br />PAYEE: Dt~RK NIKLA.S <br /> <br />BALANCE DUE $0-00 <br /> <br />RECEIPT NO: 21275 <br /> <br />RECEIVED BY: F9 ~~ TYPE; CK CHE,'OK ~: 1292 <br />SEE ATTACHED DOCUMENT FOR REQUIREMENTS OF <br /> <br />$ ~IS IS NOT A PE~IT. ~IS APPLI~TI~ ~ST ~ ~ A R~I~ P~ ~ERE ~E <br />FOLDING ~ST BE ~P~ED. IT IS ~E R~SIBILI~OF ~E APPLI~T TO ~RE ~AT <br />ALL NEC~RY INFO~TI~ H~ BE~ P~VIDED. <br /> <br /> REf~,RKS: LOAN R~6233 <br /> <br />FOnM ~ MC i~ ,%r, RFV ./.¢ OFFICE COPY <br /> <br />CITY JURISDICTION: BY DATE <br /> <br /> <br />