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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO. 225 <br />220 HIGH STREET NE <br /> SALEM, QREGON 97301 <br /> <br /> PHONE: 588-5147 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br /> I am performing work on sproperty I own or occupy, <br /> I am a registered builder OR ) the authorized representative <br /> of a registered builder, <br /> The work will be performed by a registered builder, <br /> Othe¢ <br /> I have read and agree to the terms stated on the reverse side of <br /> this document, <br /> <br />DATE: 06/17/92 TIME+' 18.-92:19 <br /> <br /> HANKiNS , Rrj~ERT J JR. <br /> <br /> AD~ViLLE OR 97325 <br /> WARION C~JNTY NO ~ <br /> <br /> ~E: 371-0483 '~ SiTE NU~ERt 92-02014 <br /> ; VA~AT ~ ~ <br /> <br />i 29 88 ~ AR <br /> <br />!WIO?H; DEPTH; ' X~A' 1 ~4 ~UN TS' I RRE~ LOT y~CORN~RNO <br />; : .' AC ~ <br /> <br />'i'YP£: ON-SITE SE.~AGE <br /> <br />'40247 <br /> <br />PERffllI' OR APPLICAI'IONNO=' <br /> <br />CONTRACTOR, NO ..... <br />HA1HKIN~. , .ROeERT J JR. <br />800 EON ViE{,,~K~,N'I' OR <br />PORTLAND, OR 97225 <br />PHONE: ~71-048~ <br /> <br />HATER ,SUPPLY: PIN <br />'F6ST HOL~ READY: <br />SiTE EYALUATION NUMBER: 28246 <br />~Is'riN6 'r~K SZZE: <br />~ISTiN6 D~tN F~/LD. LINES: <br />SEPTIC T~K ~PED= <br />PREWi~8 NO. BED~: <br /> <br /> iTEM <br />STANDARD C~N~-~II'E SY~TE]Vl <br /> <br />TO'FAb .A,S~EF:~ED EEE~ <br />PREVI(~JS RECEIPTS <br /> RECEIPT <br /> <br />qUAN'riTY A~-DUNT <br /> z $210.00 <br /> <br />¢210.00 <br />210.00 <br /> $0.00 <br /> <br />BALANCE DUE $o.oo <br /> <br />PAYEE: RE"CEIPT NO: <br />RECEZVED BY: PfC TYPE; C~ECK ~: 3 <br /> <br /> SEE ATTACHED [X)CUMENI' FOR RE(~JiREt~IEN.TS OF ~ll'E .S~E ~T~+ <br /> <br />~ THI~' [~ A,VAL/D, ~IT: ~, ~i~ ~IT ~IR~, 360 ~"~ IT5 I~E ~TE+ i~ <br />~T~TI~ ,~ TO ~ ~ R~L~T~ ~ ~TATE ~ ~D ~RIB ~TY BUILDI~ ~D <br />~I~ ~I~, THI~ ~IT ~ALL B~ ~L ~D.~ID. <br /> <br />RSVlARKS: SEPI'iC. USE EXTRE]~IE CARE IN SITING SEPTIC I'ANK, DRAINFiELD LINES AND UPSLOPE <br /> CURTAIN DRAIN.. SEE REVISED PLOT PLAN DA'rED 8/18/92. <br />DONALD E. WOODLEY. F[ARiCI~ COUNTY BUILDING OFFICIAL / BY <br /> <br />FORM # MC 15-66 REV, 4/90 <br /> <br />OFFICECOPY <br /> <br /> <br />