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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG NO 225 <br />220 HIGH STREET NE <br /> SALEM OREGON 9~301 <br /> <br /> PHONE 588-5147 <br />CODE-A-PHONE 4;30 PM - 800 A M <br /> <br />I am performing w~rk on a property I o~n or occupy <br />I am a registered builder OR / ) the authorized representative <br />ol a reg,stered builder <br /> <br />SIGNATURE OF APPLICANT <br /> <br /> DATE <br /> <br />Ow~BATE= 10/02/89 TIME: 3:36=03p <br /> <br /> SO.PACIFIC RR (MEEKER fERTILIZER) <br /> <br />TAX LOT <br /> <br />CONSTRUCTION TYRE <br /> <br />CATEGORY <br /> <br />OO~IMERC IAL <br /> <br /> 11598 MCCLELLAN RD <br />AUiv~VILLE <br /> <br />OR 97325 <br /> <br />SE <br /> <br />CONTRACT CITY UGS <br />MARION COUNTY NO <br /> <br />OCCUPANT LOAD <br /> <br /> NO OF BEDFIO~MS <br /> <br /> CONTACT: ART GROSE <br /> 1795 - 16TH ST SE <br /> PHONE: ?69-2930 <br /> <br />LOT BLOCK <br /> <br />SALEM 97302 <br /> <br /> AREA '] ~ UNITS <br /> 1. O00O0 <br /> <br />SITE NUMBER: 8499 <br />~ANG,~/ALUATION: ;'oNs <br /> <br />9S IRREG LOT 2W CORNE~ AR <br />AC YES NO <br /> <br />MAP <br /> <br /> 62 <br /> <br />TYPE: ON-SITE SEWAGE <br /> <br />PEF¢4IT OR APPLICATION <br /> <br />SO.PACIFIC RR (MEEKER <br />CONTACT: ART GRO8E <br />1795 - 16TH ST SE SALEM <br />PHONE: 769-2330 <br /> <br />WATER SUPPLY: <br />TEST HOLES READY: NO <br />SITE EVALUATION NUMBER: <br />EXISTING TANK SIZE: <br />EXISTING DRAIN FIELD LINES~ <br />SEPTIC TANK PUMPED: <br />PREVIOUS NO. BEDRC]OMS= <br /> <br /> ITE~ <br />SITE EVAL. - FIRST 1000 GAL DSF <br /> <br />PAYEE: MEEKER fERTILIZER) <br />RECEIVED BY: DM <br /> <br />TOTAL ASS~ED FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />BALANCE EYJE <br /> <br />OUANTI]~Y AMOUNT <br /> 1 $175.00 <br /> <br />$175,00 <br /> $o.oo <br />$175.00 <br /> <br />$0.00 <br /> <br />RECEIPT NO: 20480 <br />TYPE: CK CHECK ~: 16085 <br /> <br />SEE ATTACHED DOCUMENT FOR REQUIREMENTS OF ON-SITE SEWAGE SYSTEM. <br /> <br />NOTE: THIS DOES NOT ~RN4T OR IMPLY PERMISSION TO BUILD ON THIS PARCEL. PLANNING AND <br />CONSTRUCTION PERMIT~)D~JST BE O~TAINED BEFORE BUILDING OR SEPTIC INSTALLATION BEGINS. <br /> <br />PLAN REVIEW: BY .... I//,~"'~__ DATE.j~-~____ CITY JURISDICTION: BY ........ DATE <br />REMARKS: SITE EVAL P~7156 <br /> <br />COPY <br /> <br /> <br />