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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO. 225 <br />~ 220 HfGH 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 />DATE: 08Z~1/92 ~.IME: 10:05."32 <br /> ] fax Lb¥1 iOATEGORY; <br />MILLER, ~HOMAS & MARINA ~ ~ COMMERCIAL <br /> , <br /> <br /> ~30 BREITENBUSH -- ~UG8: ~OOOUPANT CHAD: <br /> OETROIT OR 97542 ~DETROIT ~ NO ; 54 <br /> <br />SITE NUMBER: <br />VALUATION: <br /> <br />PO ~OX 523 <br />DETROIT¢ OR 97342 <br />PHONE: 854-5421 <br /> <br />:TOWNSHIP; I RAN~; [zpN~i MAP'. <br /> <br />TYPE: OH-SITE SEWAGE <br /> <br />PERMIT OR APPLICATION NO: ~04~2~8 <br /> <br />MATER SUPPLY: CW <br />TEST HOLES READY: <br />SITE EVALUATION NUMBER: <br />EXISTING TANK SIZE: <br />EX];ST~NG DRAIN FIELD L.,INE¢_ <br />SEPTIC TANK PUMPED: <br />PREVIOUS NO.'BEDROOMS_ <br /> <br />CONTRACTOR., NO. <br />MILLER, THOMAS & MARINA <br />PO BOX 523 <br />OETROiT, OR 97542 <br />PHONE: 854-3421 <br /> <br /> QUANTITY AMOUNT <br /> i $200.00 <br /> <br />TOTAL ASSESSED FEES $2oo.oo <br />PREV]:OUS RECEIPTS $0,,00 <br />TFIIS RECEIPT $200.00 <br /> <br />8ALAMCE DUE SD.O0 <br /> <br /> INVOICE NO: 44298 <br /> TYPE: IN CHECK ~: 0 <br /> <br /> iTEM <br />STD ONSITE SYB < 1000 GAL. <br /> <br />PAYEE: MILLER, THOMAS & MARINA <br />RECEIVED BY: PW <br /> <br /> SEE ATTACMEQ DOCUMENT FOR REQUIREMENTS OF OMni:SITE SEWAGE SYBTEH. <br />* THIS IS NOT A PERMIT. THIS APPLICATION MUST GO THROUGH A REVIEW PROCESS WHERE THE <br />FOLLOWING MUST 8E COHPLETEO. IT IS THE RESPONBIBILITY OF THE APPLICANT TO ASSURE THAT <br />ALL NECESSARY INFORMATION HAS BEEN RROVIDEB, <br /> <br />REMARKS: CONL ORAINFIELO REPAIR <br /> <br />OFFICE COPY <br /> <br /> <br />