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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 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />of a registered builder. <br /> <br />Other~ <br /> <br />SIGNATURE OF APPLICANT: <br /> <br />OWN~': ..... T~X t.b~: ~ATEGdRY <br /> DATE: 04/02/92 TIr, IE: 11:44:53 <br />~I~US ADDRESS: CONSTRUCTION TYPE: OCCUPANCY: <br /> FOOl'E, KEN 90221-240 <br /> <br /> CE~+~A~+ ~i+Y: ~B; [dCCUP~NT LOAD; <br /> 290 <br /> <br />RESIDENTIAL <br /> <br />DETROIT NO <br /> <br /> HAC~fON D ADDI I'ON <br />1922 BEAVER bP NN <br />3~.LEtfl OR 9?304 <br />~ONE~ 588'~0 SE~TION: , ~.E NU~ER~ ~8~01337 MAP,. <br /> : VA~A'r i ~: <br /> <br /> 2 0 9 2 10 5W <br /> <br />50 139 6950 . SF NO NO <br /> <br />TYPE: ON-SiTE SEWAGE <br /> <br />PEf',~II'f' OR APPLiCATiON NO: <br /> <br />coN'rP~o'roR, NO. 36421 <br />KEVIN' S BACKHOE <br />P O BOX 465 <br />DE'I'ROi 'I', 97342-0000 <br />PHONE: <br /> <br />9039122 <br /> <br />~A'rER SUPPLY.* CN <br />TBST HOLES READY: NO <br />SiTE EYALUA'FION NUMBER: <br />Eg<iSI'ING 'rANK SIZE: <br />aXIS'rING D~IN FIELD LINES: <br />SEPTIC 'I'~K PUMPED: <br />PRaVI~ NO. 8EO~: 1 <br /> <br /> iIEM QUANTITY A~4OUNI' <br /> REPAIR- f~4~J OR 1 $105.00 <br /> TOTAL ~ES,SED FEES $105.00 <br /> PRE¥iC~JS RECEI PT~ $0 + 00 <br /> THiS RECEIPT $105.00 <br /> BA~CE ~E $0.00 <br /> PAYEE: KEV IN ~S 8ROYCE iNVOICE NO = 41153 <br /> RECEIVED ~Y: CL TYPE: ~N C~ECK ~ 0 <br /> <br />* m~s ~s No~ A .~I~. mis ,~u~i~ ~ f~ ~ ~i~ ~-~F~ .... <br />BLL~IN6 ~ST 8E ~LETEO. if I8 fHa RE.SEnILITY OF THE APPLi~T TO aRE fHAf <br />ALL N~ INFO~TI~ H~ BE~ P~iOED. <br /> <br />DA'T E <br /> <br /> OFFICE COPY <br />FORM # MC 15.56 REV, 4/90 <br /> <br /> <br />