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MARION COUNTY BUILDING INSPECTION <br />S, ENATO.,R BLDG. NO. 22S <br />220 H'IGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br />PHONE: 588-8147 8:00 <br /> <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br /> Other <br /> I have read and agree to the terms stated on the reverse side of <br /> this document. <br /> <br /> DATE: 11/02/92 TIME: 16:35:12 <br />OWNSR~ <br /> KRAFT, JOYCE ..... <br /> ADDRESS: <br /> <br />...... fax L~'d ! CA'rEGow¢: <br /> RESIDENTIAL <br /> <br /> CONSTRUCTION TYPE: OdOUCANCY: <br /> <br />:OOOUPANT LOAD: <br /> <br />USE OF BUtLOiN~: <br />MAILING ADDRESS: SUE;DIVISION; <br /> <br /> SiTE HUMBER: 92-03860 <br /> PHONE: 981-0934 VALUATION: <br /> <br />:gO~r ~'~LGdE: : ~OTi~i ............ '~i~i ~ ~Ai ....... ,'~'~: : MA~: <br /> 36 6S 2W EFU 9 <br /> W~DTH; ,DEPTH~ ARNA; :UNtT: , IRRE~:'~Ti ~6~; <br /> ; 10. ~C NO ~ NO <br /> <br />TYPE: ON-SITE SEWAGE <br /> <br />PERHIT OR APPLICATIOH NO: <br /> <br />CONTRACTOR, NO. <br />KRAFT, JOYCE & FERRY <br /> <br />PHONE: 981~0934 <br /> <br />9043592 <br /> <br />WATER SUPPLY: PW <br />TEST HOLES READY: <br />SITE EVALUATION NUMBER: <br />EXeS'TING TANK SIZE: <br />EXISTING DRAIN FIELO LINES: <br />SEPTIC TANK PUMPED: 8/18/90 <br />PREVIOUS NO, BEDROOMS: <br /> <br /> ITEM <br />AUTHORIZATION NOTICE - PLO. VISIT <br /> <br />TOTAL ASSESSED FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />QUANTITY AMOUNT <br /> I $150.00 <br /> <br />$1~0.00 <br /> $0.00 <br />$150.00 <br /> <br />BALANCE OUE $0.00 <br /> <br />PAYEE: KRAFT, JOYCE & TERRY <br />RECEIVED BY: DH2 ................................... <br /> <br />RECEIPT NO: 45680 <br />TYPE: CK CHECK ~: 855 <br /> <br /> SEE ATTACHED DOCUMENT FOR REQUIREMENTS OF ON-SITE SEWAGE SYSTEM. <br /> <br />* THIS IS NOT A PERMIT. THIS APPLICATION MUST GO THROUGH A REVIEW PROCESS WHERE THE <br />FOLLOWING MUST BE COMPLETED. IT IS THE RESPONSIBILITY OF THE APPLICANT TO ASSURE THAT <br />ALL NECESSARY INFORMATION HAS BEEN PROVIDED. <br /> <br /> PLAN REVIEW: <br /> <br /> REMARKS: AUTH - FIELD VISIT <br /> <br />CITY JURISDICTION: BY .............. DATE <br /> <br />OFFICE COPY <br /> <br /> <br />