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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 />The work will be performed by a registered buildor. <br />Other. <br /> <br /> DATE; 07/23/92 TIHE: 15:49:50 <br />OWNER~ ZACMER, GALE <br /> <br />SITUS AbORESS~ <br /> <br /> ;L~?..].700MALO RO NE <br /> ~URORA OR 97009 <br /> <br />OAT~,¢ v. <br /> <br />OCCUPANO¥ <br /> <br />OCCUPAN'f LOAB <br /> <br />SUBDIVISION: <br /> <br />PHONE: <br /> <br />SITE NUN~ER: 92-027i7 <br />VALUA'IION: <br /> <br />,LOT; 'BLOCS: SECTION TOWNSHIP; <br />WIDTH: DEPTH; AREA 20~ · UNIT~ G <br /> <br />mANGE ZONE <br />~.}¢ EFU <br />,~. ~o~ <br /> <br />MAP <br /> <br />TYPE: ON-SITE SEWAGE <br /> <br />PERMIT OR APPLICATION NO: ~041467 <br /> <br />CONTRACTOR NO. <br />Z*C~ER, GALE <br />SAME <br /> <br />RNONE: 678~4.56 <br /> <br />WATER SUPPLY: PW <br />TEST FtOLES READY: <br />SITE EVALUATION NUMBER: <br />EXISTING TANK SIZE: 1000 <br />EXISTING DRAIN FIELD LINES: <br />SEPTIC TANK PUMPED~ 7/2~/92 <br />PREVIOUS NO. BEDROOMS: 3 <br /> <br /> ITEM QUANTITY AMOUNT <br /> AUTHORIZATION NOTICE - FLD. VISIT 1 <br /> <br /> TOTAL ASSESSED FEES ft;ZSO.O0 <br /> PREVIOUS RECEIPTS $iSO_00 <br /> TMIS R~CFIPT $0.00 <br /> <br /> BALANCE DUE $0.00 <br /> <br /> PAYEE: ~ RECEIPT NO:~3 <br /> RECEIVED BY: CR .. .~m~_~ TYPE: CHECK ,:: <br /> <br /> SEE ~I'T~CHED DOCUHENT FOR REQUIREHENTS OF ON-SITE SE~GE SYSTEH. <br /> <br />* THIS [S NOT ~ PERHIT. THIS APPLiCaTION HUST GO THROUGH ~ REVIE~ PROCESS ~HERE THE <br />FOLI_OMING ~UST BE COHPLETED. ~T IS THE RESPONSIBILITY OF TME APPLICANT TO ASSURE 'fB~f <br />ALL NECESSARY INFORHATION NAS BEEN PROVIDED. <br /> <br />REMARKS: AU[NORIZATiON FIELD VISI'/ <br /> <br />CITV JURISDICTION: BY_ ................ DATE .................... <br /> <br />OFFICE COPY <br /> <br /> <br />