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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO. 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97;301 <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 /> OA'I'E: 04/09/92 TIME: 12:39:15 <br /> <br />OWNER: WILLAMETTE NATIONAL FORES'F <br /> <br /> MP <br /> DETBOi T <br /> <br />0S~d¢ B0i'LblNG: <br /> <br />i MAILING ADDRESS: <br /> <br /> CONSTRUCTION TYP~ <br /> <br />FOREST SERVICE RE Nb_ <br />~ ~ ?' ~l~,~ CONTRACT CITY UGB: <br /> MARION COUNTY <br /> <br />DE')'~iI' RANGER DIS'T+ <br />HO ?'3 tBOX 320 MiLL CITY ,9'1360 <br />PHONE: 465-694? <br /> <br /> NO <br /> <br />SUBDIVISION <br /> <br /> SITE NUMBER: 92-01434 <br /> VALUA'FiONt <br /> <br />LOT: BLOCK' SECTION TOWNSHIP: RANGE. <br />WIDTH; DEPTH: AREA ~. 8 JNITS; AC IRREG, LOT: <br /> <br /> ZONE: <br />5E <br /> <br />NO: ¢ORNSRNO <br /> <br />CATEGORY; COMMERCIAL, <br />OCCUPANCY: <br /> <br />O~U PANT gOAD: <br /> 180 <br /> <br />MAP: <br /> <br />TYPE: ON-~II'E ~P..~AGE <br /> <br />PERMIT OR APPLiCATiON NO$ 3515'7 <br /> <br />CONTRACTOR, NO. <br />WlLLAME'f"f'E NA'I'iONAL FOREST <br />DE'f'ROI'~' RANGER DIS'T. <br />RC 72 BOX 320 MILL CiTY 9?260 <br />PHONE: 485-6947 <br /> <br />WATER ~UPPLY: CN <br />'rEST HOLE~ READY~ <br />SiTE EVALUATION NUMBER: <br />~)<IS'FZNG 'rANK <br />EX[SI'iN~ DRAIN F[ELD LINES= <br />SEP'F~C 'rANK PUMPED: <br />PREVIOUS NO. <br /> <br /> ITEM <br />SITE EVAL. - FI~I' 1000 GAL F.,.~F' <br /> <br />PAYEE: <br /> <br />r~AN'F l TY AMOUNT <br /> 1 $180.00 <br /> <br />TOTAL AEA~ESSBB FEES <br />PREVIOUS RECEIPTS <br />THIS RECE[P'r <br /> <br />$180_00 <br />$180.00 <br /> $o.oo <br /> <br />BALANCE DUE $0. O0 <br /> <br /> RECEIP'F NO: <br />RECEIVED BY: o"J TYPE: CHECK ~: 0 <br />SEE ATTACHED DOCUMENT FOR REQU[RENENTS OF 0N-8[TE SEWAGE ~YSTEM. <br /> <br />NOTE: THis DOEI5 NOT GRANT OR iMPLY PER~IlSSION TO, BUILD ON THIS PARCEL. PLANNING AND <br />OONSTRUCTiON PERMITS MUST 8E OBTAINED BEFORE BUILDING OR SEPTIC iNSTALLATION BEGINS. <br /> <br /> THIS IS NOT A PERMIT <br /> REMARKS: SE R~2853/ S'T'D SYSTEM IQ INSTALL A SEPiI$ SYSTEM. ~ <br /> F.)ONAL[) E. NOODLEY, MARioN COUNTY BUiLDiNG OFFICIAL / BY ............................................ :....~ <br /> <br /> OFFICE COPY <br />FORM # MC 15-58 REV, 4/9o <br /> <br /> <br />