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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG, NO, 225 <br />220 HIGH STF~EET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE: 588-5147 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />of a registered builder, <br /> <br />' OWNER: <br /> DARE., 08/89/90 'f' [ME: <br /> <br /> SITUS^DDR~$~I, NDAL, D,F- & <br /> <br />8:58:55 <br /> <br /> ?757 ~"tEP. JVLN~ RD <br />u~C,~Cc,~b~ OR-.~7325 <br /> <br />MA~LING ADDRESS: <br /> <br />510 ~ ?TH <br />,'~JBLiNi'I'Y OR <br />PHONE: 769~5969 <br /> <br />0ATEGORY: <br /> <br />i' ~ONSTRUCTION TYP~; OCCUPANCY; RE,~i DEN I' IAL <br />;' ~)Nf~ACT C~TY: b~e: OCOUPANT LOAD: <br /> <br />~E <br /> <br /> Iv!ARtON COIJNTY NO <br /> ! SOBDiWS~ON: <br /> 3 <br /> <br /> CAIVlELL~A HEIGHTS NO.3 <br /> <br /> · SJ'f'BNUlV~ER; 10906 <br />s~cTIoN: 'ToW~MIF: ~A~LUA,i, iDN: <br /> <br />MAP: <br /> <br />: A~EAz : (JNITS; <br /> 29 8S <br /> <br /> '~. 3;37 AC <br /> <br />IRREG· LOT: CO~NER: <br /> lW AR 48 <br /> <br />TYPE: ON-S['I'~ ~EWAGE <br /> <br />PERMIT OR APPLICATION NO: 9026290 <br /> <br />CON'rRACTOR, NO. ~N,?k~) <br />ANDAL~ D,F'. & B.J, -- <br />510 ~ 7'fH /¢.~.~ <br />SUBL~NI'FY OR 9'1385 ~, <br />PHONE: 769-5989 <br /> <br /> 1'1'E~ <br />STANDARD ON-SirE SYS'J'EJvl <br /> <br />PAYEEt ANDAL, O.F. & <br /> <br />WATER SUPPLY: P~ <br />TEST HOLES READY: <br />~ITE EYALUA'FION NURSER: C~ELLIA HEIGHT <br />EX~STING TANK SIZE: <br />EXISTING BRAIN E[~LO LINES: <br />SEPTIC TANK PU~PEO: <br />PRE¥IOUS NO. BEDROOt4S: <br /> <br />QUANTITY AblOUNT <br /> 1 $165,00 <br /> <br />l'O'i'AL:.A,2%~ED FEES <br />PREViO(JSREcE~PTS <br />I'HISRECEiPT <br />BALAN¢~ ~E <br /> <br />$165.00 <br /> $0.0o <br />$155.00 <br /> <br />$0,00 <br /> <br />RECEiP'r ND: 27845 <br /> <br />RECE~.VED BY: P[~ TYPE: CK CHECK ~: 2356 <br />SEE AT'rACld,b.;O DOCIJNEN'~' FOR RE~rzR~'rs OF ~-S~'rE SEWAGE SYS'r~. <br />* fHI~ is NOT A PE~IT. THIS APPLI~T[~ ~ST ~ TH~ A R~i~ P~ ~ERE THE <br /> <br />REMARKS: NEW SEPTIC fk~2356 <br /> <br />CITY JuRISOIC'rION= BY ............................ DATE ............................ <br /> <br />OFFICE COPY <br /> <br /> <br />