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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 /> I am a registered builder OR ( ) the authorized representative SIGNATURE OF APPLICANT: <br /> of a registered builder. <br /> The work will be performed by a registered builder, <br /> Other <br /> <br /> OATE: 11/25/92 TIME: 15:05:12 <br />OWN~ R: TA× LOT'. <br /> ! CATEGORYz <br /> OAVIDSON~ JOHN 591000 ' RESIOENT~L <br /> <br /> AURORA OR 97002 ~ <br /> <br />USE OF BUILDING: <br /> <br />MAILING ADDRSSS; <br /> <br />; SUBDIVISION: <br /> <br />BUYER: OUFFY 80YLES ~ : <br />547 SE 74TH PORTLAND, OR%~ ~ SITE NUNSER: 92-04068 <br />PHONE: 25~;-2847 VALUATION: <br /> ! SLOCK: <br /> <br />~80 :DEPTH'. <br /> <br />TYPE: ON-SITE SEWAGE <br /> <br />PERNIT OR APPLICATION NO: <br /> <br />CONTRACTOR, NO. <br />DAVIDSON, JOHN <br />BUYER: DUFFY 80YLES <br />547 SE 74TH PORTLAND, OR <br />PHONE: 25~-2847 <br /> <br />44009 <br /> <br />WATER SUPPLY: PW <br />TEST HOLES READY: <br />SITE EVALUATION NUMBER: <br />EXISTING TANK SIZE: <br />EXISTING DRAIN FIELD LINES: <br />SEPTIC TANK PUMPED: <br />PREVIOUS NO. BEDROOHS: <br /> <br /> ITEM QUANTITY AMOUNT <br />SITE EVALUATION, EA. ADDL. LOT 1 $185.00 <br /> TOTAL ASSESSED FEES $185.00 <br /> PREVIOUS RECEIPTS $185.00 <br /> THIS RECEIPT $0,00 <br /> BALANCE DUE $0.00 <br />PAYEE; RECEIPT NO; <br />RECEIVED BY: PB TYPE: CNECK ~: 0 <br />SEE ATTACHED DOCUHENT FOR RE~UIRE~ <br /> <br />NOTE: THIS DOES NOT GRANT OR IHPLY PERMISSION TO BUILD ON THIS PARCEL. PLANNING AND <br />ONSTRUCTION PERMITS MUST BE OBTAINED BEFORE 8UILOING OR SEPTIC INSTALLATION BEGINS. <br /> <br />REMARKS: SITE EVAL <br />DONALD E. WOODLEY, <br /> <br />FORM # MO 15-56 REV. 4/90 <br /> <br /> STD SYB <br /> <br />MARION COUNTY BUILDING OFFICIAL / BY <br /> <br />OFFICECOPY <br /> <br /> <br />