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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' 8:00 - 4130 <br />24 HOUR CODE-A-PHONE:: 588-7904 <br /> <br />I havo r(~ad and agree to the terms stated on the reverse side of <br /> <br />DATE: 05/31/90 rIME: 13;20:39 <br /> LYONS, HARt)LB RE'biDENI iAL <br /> <br /> 74?8 E~EP, FtAN RD <br />AUr4~VJ LLE OR 97325 <br /> <br />SAME <br /> <br />PHONE: 749-1047 <br /> <br />fqARI ON COUNTY NO <br /> <br /> SiTE NUtflBER= 10303 <br /> VALUA'r ! ON: <br /> <br />85 1W 48 <br />AC NO NO <br /> <br />1YPE: Of 4-SIle, SEWAGE <br /> <br />PER~VIIT OR APPLICAIION NO: 9024476 <br /> <br />\ CONI~TOR, NO. 349161,,x-2 <br /> ,S'rAY'tON MiLL ClfY 5[LVE,R'FON <br /> 41155 S[AY'¥'0N ~CIO DRIVE, <br /> SlAY'tON, OREGON 97383 <br /> PHONE: 709-2302 <br /> <br />~I'ER ~UPPLY: F~ <br />F~T HOLES READY: <br />SITE E,¥ALUATiON NU~4BER: <br /> <br />~ISTiNG D~iN ~IELD LINE~: <br />SEPTIC r~K ~MPED: <br />PREVi~S NO. BED~: <br /> <br /> I~EIZ <br />AL'TERAI'ioN <br /> <br />TOTAL ASSESSED FEES <br />PREVIOUS RECEIPTS <br />YHIS RECEIPT <br /> <br />BALANCE, BUr,- <br /> <br />PAYEE: SrAYf'ON MILL CIfY SiLVER"tON SEPTIC <br />RECEIVED BY: CL <br /> <br /> (~J,~,NTiFY AIv~OUNF <br /> 1 $145.00 <br /> <br /> $145.00 <br /> $0+00 <br /> $~45.oo <br /> <br /> $o.0o <br /> <br />RECEiPt NO: 25926 <br /> <br /> IYPE: CK CHECK ~: 5062 <br /> ATTACHED O(:X$UMENI FOR REQX. J[REMENI$ OF ON-SIT£ SEWAGE SYSIEt4. <br /> <br /> THi~ 1~ NOT A P~IT. THI8 APPLi~TI~ ~ST ~ ~ A R~[~ P~ ~E THE <br />~L~I~ST BE ~PLET~. IT 1~ ~E R~IBiL/~ ~E APPLJ~T TO--RE THAT <br /> <br /> R~RKS: ALIE~II~- ~ISFING ~ NEI~O~ N~R <br /> <br /> OFFICE COPY <br />FORM # MC 15-56 REV ,4/90 <br /> <br /> <br />