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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO. 225 <br />220 HIGH STREET NI:: <br /> SALEM, OREGON 97301 <br /> <br /> PHONE: 588-5147 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 588~7904 <br /> <br /> DATE: 09/29/92 TIME: <br />............................. }¥Ax' ~OT: .......... ! ~AYEGonY~ <br /> i 56401000 RESIDENTIAL <br />KLE~N, L~RRY <br /> <br /> ~UHCVILLE OR 97325 <br />BUI'gO~NG; ........................................ <br /> <br /> 9804 HILL CREEK RD SE ~ ........................................ <br /> ~UHSVZLLE, OR <br /> PHONE: 749-2405 i V~LUflTZON~ <br /> <br />TYPE: ON-SITE SEWAGE <br /> <br />PERMIT OR APPLICATION <br /> <br />CONTRACTOR, MO. <br />KLEIN, LARRY <br />9804 HILL CREEK RD SE <br />AUMSVILLE, OR <br />PHONE: 749-'2405 <br /> <br />42507 <br /> <br /> WATER SUPPLY: PW <br /> TEST HOLES READY; <br />SITE EVALUATION NUMBER: <br />EXISTING TANK SIZE: <br />EXISTING ORAIN FIELD LINES: <br />SEPTIC TANK PUNPED~ 9-16-92 <br />PREVIOUS NO. BEDROOMS: <br /> <br /> ITEM QUANTITY AMOUNT <br /> AUTHORIZATION NOTICE - FLQ. VISIT I $1~0~00 <br /> <br /> TOTAL ASSESSED FEES $130.00 <br /> PRE~IOUS: RECEIPTS:, $130.00 <br /> : . THIS RECEIPT: :. $0.00 <br /> <br /> BALANCE DUE $0.00 <br /> <br /> PAYEE: RECEIPT NO: <br /> RECEIVED BY: PB .......... .. .... ~___~ ..... ~--LL--~ TYPE: CHECK ;~: 0 <br /> <br /> SEE ATTA~HEO OOCUHENT SYSTEH. <br /> <br /> * ~HIS IS A VALID PEEHII * FROM ITS I~SUE DATE. iF <br />CONSTRUCTION FAILG TO MEET AE~::REQUIREMEN~S OF;~T~E::LA~ANO HARION COUNTY 8UILOING AND <br />ZONING ORDINANCES, THIS PE:RHIT <br /> <br /> REMARKS: AUTH TO HOOK TO EXISTING SYSTEM <br /> OONALO E. WOOOLEY, MARION COUNCY BUILDING OFFICIAL / BY <br /> <br />/ <br /> <br />OFI;ICE COPY <br /> <br /> <br />