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MARION COUNTY BUILDING INSPECTION <br />SENATO, R BLDG. NO, 225 <br />220 HIGH STREET NE <br /> SALPM, OREGON 97301 <br /> <br /> PHONE: 888-8147 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 88847904 <br /> <br />ORI'E: 11/04/92 TINE: 10:46:17 <br />GUSTAFSON, CARL 90250-525 RESIDENTIAL <br /> <br />DETROIT OR 97542 . <br /> <br /> PATTON J_ <br /> <br /> SITE NUMBER: 92-0~895 <br />PHONE: VALUATION: <br /> <br />LOT: <br /> <br /> 2 <br />WIDTH: <br /> <br /> BLOCK: 's~'dTiS~: TCWNSNIP: RANGE: ! ZONE: , MAP: <br /> <br /> 4 1 10 5E RS 105 <br /> T~ IRREG. LOT: I CORNER'. <br /> :DEPTH: AREA; UNI "F <br />90 100 9000. i NO NO <br /> <br />TYPE: ON-SITE SEWAGE <br /> <br />PERMIT OR APPLICATION NO: <br /> <br />CONTRACTOR, NO. <br />GUSTAFSON, CARL <br /> <br />PHONE: <br /> <br />904365~ <br /> <br />HATER SUPPLY: <br />TEST HOLES READY: <br />SITE EVALUATION NUMBER: <br />EXISTING TANK SIZE: <br />EXISTING DRAIN FIELD LINES: <br />SEPTIC TANK PUMPED: <br />PREVIOUS NO. BEDROOMS: <br /> <br /> ITEM <br />SITE EVALUATION, FIRST LOT <br /> <br />PAYEE: GUSTAFBON, CARL <br /> <br />TOTAL ASSESSED FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />QUANTITY AMOUN~ <br /> 1 $220.00 <br /> <br />$220.00 <br /> $0.00 <br />$220.00 <br /> <br />BALANCE OUR $0.00 <br /> <br />INVOICE NO: 45758 <br /> <br />RECEIVED BY: CL TYPE: IN CNECK fl~: 0 <br />SEE ATTACHED DOCUMENT FOR REQUIREMENTS OF ON-SITE SEWAGE SYSTEH. <br /> <br />NOTE: THIS OOES NOT GRANT OR IHPL,Y PERMISSION TO BUILD ON THIS PARCEL. PLANNING AN() <br />ONSTRUCTION PERMITS MUS/ BE OBTAINED BEFORE BUILDING OR SEPTIC INSTALLATION BEGINS. <br /> <br />PLAN REVIEN: B .......... DATE ........ CITY ~URISDZCTION: BY ............... OATE .................... <br /> <br /> OFFICE COPY <br />FORM ~ MC 15-58 REV, 4/90 <br /> <br /> <br />