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MARION COUNTY BUILDING INSPECTION <br /> SENATOR BLDG. NO. 225 <br /> 220 t-JIGH STREET MI-- <br /> ',, SALEM, OREGON 97301 / <br /> <br /> The work will be performed by a registered builder. <br /> Other <br /> ~ have read and agree to the terms stated on the reverse side of DATE: <br /> <br /> DATE: 10/16/92 TIME: 12:56:10 <br />i OWNER: <br /> TAX LOT; , ~ATEGO~Y; <br /> MORRISON, RONALD 56113000 RESIDENTIAL <br /> <br /> 9844 KEENE LN SE <br /> AUMSVILLE OR <br /> <br /> SAME <br /> SiTE NUMBER: 92-05697 <br /> PHONE." 749-1018 VALUATION: <br /> <br />LOT: ~ BLOCK: <br /> ; SECTION: TOWNSHIP[ , RANGE: ZONE: ~ MAP'. <br /> 19 8S 1W AR5 46R <br />,W~6i',: 580 197980. : SF ' NO i NO <br /> <br />TYPE: ON-BITE SEWAGE <br /> <br />PERMIT OR APPLICATION NO: <br /> <br />CONTRACTOR, NO. <br />MORRISON, RONALD <br />SAME <br /> <br />PHONE: 749-1018 <br /> <br />9045267 <br /> <br />WATER SUPPLY: PW <br />TEST HOLES READY: <br />SITE EVALUATION NUMBER: <br />EXISTING TANK SIZE: <br />EXISTING ORAIN FIELO LINES: <br />SEPTIC TANK PUMPED: <br />PREVIOUS NO. BEDROOMS: 2 <br /> <br /> ITEM QUANTITY AMOUNT <br /> AUTHORIZATION NOTICE - FLD. VISIT 1 $130.00 <br /> TOTAL ASSESSED FEES $150.00 <br /> PREVIOUS RECEIPTS $0-00 <br /> THIS RECEIPT $130.00 <br /> <br /> BALANCE DUE $0.00 <br /> PAYEE: MORRISON, RONALD RECEIPT NO: 45548 <br /> RECEIVED BY: CL TYPE: CA CHECK ~: 0 <br /> SEE ATTACHED DOCUMENT FOR REQUIREMENTS OF ON-SITE SEWAGE SYSTEM. <br /> <br />* THIB 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 />REMARKS: AUTH <br /> <br />OFFICE COPY <br /> <br /> <br />